Bernie Sanders is "middle of the road"

To anyone familiar with Germany and it's politics, Bernie Sanders is a middle of the road politician, not radical at all. Pretty much everything he advocates and fights for is already reality in Germany - with good results and citizens are happy and striving with it.

1. Campaign financing: The federal government in Germany allots funds for campaigns, each party receives a percentage of the available funds equal to votes recieved in the last election. A party that won 40% of the vote, receives 40 % of the funds.

This did make it impossible to buy votes, as the "Citizen's United" rule does. I recommend reading "Dark Money" by Jane Meyer about the history of the Koch family, their rise due to the large profits of petroluem refining and their political leanings and support for libertarian ideas and politics. Only then can you begin to understand how some politicians such as Ted Cruz ("Crusted") is able to state that "regulation cost money" and that he wants to abolish or at least limit the EPA 9plus a number of other outrageous and ridiculous ideas - he is much more dangerous than Trump, because he is calculated and sneaky)

Federal allotment of funds - problem solved

2. Progressive taxes: already a reality in Germany, nobody is suffering, no entrepreneurship is thwarted etc etc. The maximum tax is around 65%. 

Think about it, when you earn 10 million a year, you still get ot keep 3.5 million. You are not poor, you can live happily. And that is what counts. I believe that charity should not be left to individuals, because then it becomes random, spotty, unpredictable, insted of wise and just, as in the case of government directed charity.

Progressive taxes mean that if you earn a lot you should pay more precentage wise, because your survival and your luxury of living increases only marginally after you arrive at the top of the food chain. and with progressive taxes, many more of your fellow humans get to benefit.

This speaks to a fundamental issue: Do you really feel alone, an independent individual or do you feel as a part of a community, as part of a group where your benefit and luck might contribute to the benefit of all? I beleive that this is a fundamental difference in the philosophies underlying the republican and democratic parties.

3. Free colleges and universities: Standard in Germany as well as in most industrialized countries and especially in Europe. The more people learn and study, the better off the country - you knew that, didnt you? Yes, this is paid by taxes, but the higher taxes are worth it.

4. Healthcare for all. Instituted by law in 1884 in Germany, has worked beautifully sicne then. Yes, Germany has problems with being short on funds to be healthcare, just the same as the US. That is because the root cause of the unstoppable rise of cost of healthcare is NOT the system by which healthcare is provided, it is the rise science and technology, ever newer, better and more complicated and more expensive diagnostic and therapeutic procedures and developed and introduced. It is also due to the lack of emphasis on prevention, the lack of emphasis of a healthy diet (big agrobusiness fights vigorously against healthy food) and an increasingly sedentary lifestyle, also thanks to advancing science and technology. Medicare for all is definitely not my favorite ( sicne I am a physician it will make things more complicated, dramatically jack up regulations and lower income, discouraging hard work), but in the end it might be an advantage for everybody.

And, the main point of Sanders campaign: income inequality! Yes, he is correct, and this needs to be said as looudly as possible. The billionaires have rigged the economy against the remaining 99% and it is about time we changed that. That is the true source for the pervasive disappointment, disillusionment and anger that both Trump and Sanders benefit from.

That has to change - and the best way is what Sanders proposes: Progressive taxes and fees on Wall street trading.

Yet, a word of wisdom - Germany, with all this in place, is still not paradise. The world will not turn into the best of all possible worlds, there will always be some degree of corruption and a good amount of discontent, but it will be a friendlier, more benign world, a nicer world, a world you will like and will like to live in, a world that is not as scary, that does not hreaten you with bankruptcy or homelessness at every turn. a world worth voting for.

Open to Cuba! Remember Germany and the collapse of the iron curtain

What the German experience could mean for the American-Cuban relationship

President Reagan's public appeal ito Gorbatsov while at the wall in Berlin to "tear down that wall" - probably has not done much. What truly changed the mood in East Germany was the increasing knowledge about everyday life in Western Europe. Easterners became aware of the higher standard of living, they realized that pretty much everybody in Western Germany had a car that looked nice and ran fast (unlike the East German Trabbi), a video recorder (a hot item back then) and a few more staples of life that were highly desired in the East, yet not available for purchase - not even for Western cash.
Easterners simply wanted some basic freedoms, such as the freedom to travel, to visit relatives in the West, and just to even visit the West to see what it looked like.
So knowledge about life in the non-communistic West with its material benefits and freedoms got through to the Easterners, spread created unrest. It led the the simple question: we do we not live as well and why do we not haver the same freedoms? And this questions created unrest ultimately leading to public protests for opening the walland having freedom to travel. And after a while, the military and police commanders in Berlin simply did not dare anymore to violently disperse the protesters - and the political leaders had to open the wall. And just like that it was over for the East.

How does this transfer to the Cuba situation? That the best things for the people of Cuba, for freedom and democracy will be a million American tourists simply visiting Cuba. Every single one will carry a smartphone, an iPad or some similar device. On that device they will have hundreds of photos and the Cubans will discover that the "Capitalist Imperialism" does not enslave people, that people in the US are not suppressed, suffering, miserable or on the other hand ill meaning, communist haters, but simply - very simply - human beings. Human beings with the same desires, wishes dreams and daily troubles as the Cubans. And it will dawn on them that the difference is just the political and economical system. And then they will want to change it.

So, the best path to freedom in Cuba is simply to open relationships and to travel to Cuba, to visit, to talk, to enjoy life there, eat out, hang out on the beach and on the Havana promenade. Human nature will do the rest.
No political changes needed. No big treaties, no negotiations, no this or that.....The worst thing for the people in Cuba would be to keep up the insulation. Insulation protects the present government. It does not hurt the members of the government, the communist elite is always privileged, they have always had what they needed and wanted. The common people feel it the most.

So, enjoy the opening, travel to Cuba and talk to Cubans.

The German history supports it.

Trump speech in Chicago cancelled

Yes, Trump stimulated rough behavior during his speeches, and yes, protests are fine.

But calling for boycott of a candidate's rally and publicly calling for a boycott and encouraging thousands of people to disrupt a candidates event is wrong. It is not demoractic, it is influence by mob - pretty much what these organizations supposedly are oh so opposed to. Politics by mob is plain and simply wrong, no matter how much you dislike the message of a candidate.

What would those protesters say if Trump or Cruz or Rubio supports showed up at Bernie Sanders rallies chanting and screaming and calling him a communist and whatever else you may come up with?

And, Bernie Sanders should at least tell his supporters to stop mobbing events of other candidates, and I am saying this because quite a few protesters cheered "feel the bern". That is wrong, very simply wrong. You do not try to muzzle another candidate by mobbing. Bernie correctly pointed out that Trump is in part responsible for the violent disruption, but I am really msising his clear call to his followers to stop this nonsense. Protest all you want, but peacefully and outside.

the presidential race

One of the most important issues for me: national debt.
Presently around 18 trillion, yes 18 million Dollars times a million!
It has increased dramatically under republican president GW Bush and dramatically under present democratic president Obama.
Why? I suspect that politicians get elected and stay in power if they promise and give things to people. Nobody gets elected for telling voters to be more frugal, spend less, save more and pay more taxes.
Elected officials seem addicted to spending more money than they have, more money than the government takes in. It should be standard not to spend more than what they have and also to pay back what the federal government owes. Because you have to pay interest, and for the US that has risen to hudnreds of billions of dollars every year - yes, more money you can imagine, just for interest. Paying large amounts of interest means having less money to do what you want. Simple. Would you personally like to be settled with credit card debt that is 4-5 times your annual budget? How would you feel? Would you just keep borrowing with the attitude "well, we'll live it up today and my children can put up with what I cannot handle?" Is that responsible? Is that good economical behavior? Is that ethical?
And why does not a single candidate address this issue seriously? Have you seen clear promises for balanced budgets and plan for debt repayment?

In my personal opinion the best place to start to save would be the military. Over 1 trillion dollars a year. Is that truly all necessary? Do we need it to defend our shores? Is Isis about to send their Navy over? Hardly. I am no expert, but I am sure the military could do with less bang and more diplomacy. Starting with letting the wealthy gulf states handle their own mess, instead of relying on us - while charging us for the gas to do it. And we do not need to be the policeman for the whole world, especially not if the outcomes are usually not that great - the typical scenario being: The US moves in, a drawn out battle with some success follows, and consequently country destabilizes and things get a lot worse - so the US has to stay longer, see more Americans die, spend more money, in the range of billions every month - only to ultimately be blamed and hated even more by the locals. Really? Do we deserve that?

Do we truly need the most powerful military in the world? With a budget larger than then next 10 nations? Follow the money - who benefits? The military complex, exclusively. Everybody else loses.

But our national debt is so enormous that even if we dismanteled the military completely, it would take us over 10 years to pay back our debt. Hard to imagine, but true.

Why I don't trust Hillary

I appreciate independent and now democratic candidate Bernie Sanders for telling the truth - the truth about how the economy, our economical and financial system is rigged against the lower and middle class. Most of us have the experience that our economical situation is not getting better over time, but worse - or that it stagnates. My income certainly has not improved over the last 10 years, and in the meantime housing costs have gone up 20-40%, healthcare costs about the same, food has gone up etc. Sanders describes on his website how massive the wealth transfer from the middle class to the upper 1% has been over the last few decades. It is shocking.
And why do we not drive electrial cars already, why is solar energy not common place, why do we engage in wars, while being silent or inactive on climate change - when it is about as certain as it can be that climate change is the most dramatic challenge to our way of life.
Why do we still engage in wars far away from the American mainland - at billions every year? Why is everything we buy now "made in China" and not in the US anymore? and on and on.
Because ........all this benefits the few billionaires at the top of the food chain. Because the Walton family makes much more money if they manufacture in China, that's why - just one example.
And more and more people are feeling the pain, the economical pain. And economy is the most important factor. With a great economy we can forgive a few other things, but we definitely want a great economy.
...and now to the point: Hillary has received about $ 700,000 for three talks to Wall Street companies. But of course, this is not going to influence Hillary, right? Oh no, she says, Obama has received a lot of donations from Wall Street firms, and then enacted some of the strongest restrictions...Really? How come the size of the 4 or 5 largest banks has gone up, their income has gone up? Business has not changed...
Isn't it funny, that physicians are not supposed to accept anything, anything at all, from pharmaceutical representatives! Nothing, nothing...because, studies have shown, that despite physician claims to the contrary - gifts from the pharmaceutical companies DOES influence!
SHould we not treat politicians just the same? Should lobbyists not finally be banned from Congress?
And, back to Hillary - obviously we all would love to find out what Hillary told the Wall Street managers in those talks - it would be very enlightening to find out what kind of information is worth 200K for 2-3 hours....Bernie had a very good comment: "at 200,000 a talk these talks must have been so great, so good - why do you not share them with the American people?
Yes, why not, Hillary?
She has been asked repeatedly by Bernie Sanders to make the content of these talks public - to no avail. Recently, during a townhall meeting, she was asked by the moderator if she would publish the content of those talks.
And here is her fascinating answer: "Well, if everybody else makes their talks at Wall Street public, then I will do it too, but I do not see why a different standard should apply to me"
This is rhethorical jiu-jitsu! Nobody has been trying to set a standard, nobody has asked everybody else to make their talks public, maybe similar to their tax returns. The clever and sneaky introduction of "standard" is the trick here.
This question is only and EXCLUSIVELY directed at Hillary, and maybe at Sanders, who of course does not give talks on Wall Street (well, except maybe with a bullhorn down on the street in front of some financial headquarter building, and he is certainly not getting paid for that...).
The question is directed at Hillary alone and the true question is: What relationship do you REALLY have to Wall Street, what do you tell them behind closed doors, and why do they pay you so much for it? It is not about standards, but about the credibility of a presidential candidate who proclaims toughness, but most likely will turn out to be in the pocket of Wall Street just like every other politician.
Ever wonder why nothing changes?
So, next time you see  Hillary and get a chance to ask her a question, ask her to release the content of those talks - and no excuses please
Hillary is the establishment candidate, Hillary will make sure business as usual continues, and with that corruption as usual continues. The rich will continue to get richer and everybody else with continue to get poorer.
Yet, Bernie Sanders might not have succeeded this time, but another Bernie will in 4 years, or of not, then in 8 years!

My daughter is 16, what car should I get her?

Here are my recommendations for your daughter:

if you want her to be invisible - Toyota Corolla

if she has Asian looks or a lot of Asian friends - 3 series BMW, only 3 series BMW, only and

exclusively BMW 3 series

if she hangs out with the hispanic crowd - Honda Civic

if she has come out as a lesbian and vacations in Provincetown, MA - Subaru Outback

if she is scared of driving, will likely never drive faster than 25 mph and her serum testosterone is below detectable levels - Honda CRV

if you live on the periphery of town and she helps out around the house - Ford F150

if you want her to look sophisticated and sportive - Audi A4

if you want her to look as bland and boring as possible - Toyota Camry

if she hangs out with those stuck-up, spoiled kids from the leafy suburb - Lexus IS 250

if she is an aspiring supermodel - Mini Cooper

if she plans to go to design school - VW Beetle with flower on dashboard

if she is crunchy, concerned about the environment, wears Birkenstocks - Prius

if you truly love her, want her to be safe, and also want her to have great driving experience - Mercedes C class

Japanese honor?

Remember those old movies about the Japanese? Honor..... one of their highest values, an essential, basic, profound value. Without honor, they seemed to be unable to go on, without honor, they apparently could not live anymore. Honor lost, meant life lost, sometimes literally. Ahhh, the movies. How sweet..... and how wrong.
Modern day Japanese honor is different. Copying, interpreting, plagiarism - which to me is incredibly close to stealing - is compatible with honor. Reminds me of the honor of the mafiosi. Honor is strictly limited to whatever benefits the family, when it comes to others, to anybody outside the family blackmailing, killing and pretty much everything else is just fine.

Copying, interpreting (or however you want to call it) is OK in Japan, it is now an art form....plagiarism of car designs is good, plagiarism of brand image is good, imitating car types is fine....Every Lexus rolling on our streets is proof that all this is part of the new Japanese honor. A Lexus has to look like a Mercedes or BMW in dim light, or it is not a Lexus....The pick up truck, an original American concept, never needed nor seen in Japan before, now proudly a Japanese product, oh, the Tundra. When are we finally going to see an ad where the Tundra sits on the copier and out comes the copy, the F150?
Strangely enough, other car companies survive and thrive without plagiarism. Ford never steals designs, their cars may not look particularly well (except for pickup trucks and SUVs), but at least their designs are original. They can walk proud. That one Ford 500, later renamed into Taurus, that looked like slightly enlarged VW Passat, yes, we can forgive that and call it a "hommage" to the now classic Passat. Audi never copies, Audi IS COPIED. Audi has emerged in the last decade as one of the most innovative car companies when it comes to design, starting with the TT. The front of many cars, even American cars, owe their design to Audi. And Audi now sets the standard in light design. Volkswagen does not copy, VW made design history with the Passat. Chevy deos not copy, Chrysler does not copy, Subaru, Infiniti, Mazda do not copy (Yes, they are Japanese, I know), BMW does not copy, BMW blazes the way in design.
Turns out that Germany is quite the design power in automobiles. We used to think that Germans were just great engineers, but no, they are great designers as well. Leading the world, actually.

On the other side, Honda copied the 3 series BMW when they created their successful Accord many years ago. When BMW came out with the X6 -what a coincidence - Honda came out with the Crosstour. Acura routinely copied Audi until recently, Nissan's successful Altima and Maxima are based on the design of the VW Passat.

But Lexus, Lexus is in a whole different category. Lexus "copied" automobile design, "brand feeling" and automobile technology purposely, it was a basic, founding principle of the company. They went far beyond what anybody else thought moral.

I recently traveled to Rome, Italy and Freiburg, Germany. Hardly a Lexus on those roads there. I might have seen a single Lexus in the metropolis of Rome, but every politician and wealthy person and powerful appearing Italian had either a) a black Mercedes or b) a black Audi or c) a black Maserati Quattroporte. Those where the cars parked in front of government buildings and the cars that pushed their way through rushhour traffic with Polic escorts. Italians are the foremost experts in taste and beauty. They are very well aware of quality, and they know to distinguish between true class and beauty and imitations. So, no Lexus on their roads...
Germans on the other hand, grew up with the original, with the perfection that Lexus publicly claims to be pusrsuing, with.... Mercedes. And they reject copies and imitations.

When I asked a Japanese aquaintance about the morale behind Lexus and their shameless imitation of Mercedes he said with a smirk "Imitation is the highest form of flattery"
Oh, God. I hope someone "flatters" Toyota and Lexus one day and gives them a dose of teir own medicine. So far, they have nothing much worth copying....

Every Lexus on the road is a symbol of lack of honor, of lack of the ability and decision to build your own car, of going your own path. Every Lexus on the road is a symbol of shameless imitation and of the attempt to hook onto the excellent reputation built by Mercedes over decades of research, engineering and racing expience. As a parasitic design, Lexus lives off the feeling and memories you get when you see a mesterfully built car, a Mercedes-Benz. Lexus tries to steal those feelings, by looking as close as possible to a Mercedes. It tries to steal those feelings and to attach them to their own cars. Not quite honorable.

When is Lexus going to grow up? Other companies al over the world are quite able to manufacture their own cars in their own right and be proud of it. Not just BMW, not only Audi, yes, also Cadillac. Cadillac is a prime example. Cadillacs have very distinctive lines, a clear design that says "I am a Cadillac and I am proud of it". Cadillac does not advertise that it "pursues Medcedes", Cadillac simply announces in their ads that they are a thrilling, powerful and elegant car.

Why is Lexus so terrified to stand on it's own feet? Is the company not aware that it loses all respect by being the copy-cat company, by being the parasites on Mercedes' back, the "moochers"?
Yes, Lexus may have to get rid of that calcified stubborn top management that clings to the notion that only Mercedes and BMW are great cars. The upper management of Lexus is so conservative in their attempt to mimick Mercedes and BMW that they did not copy the Audi lights - the row of small circular lights in the main front headlights. No, they had to wait until Merecedes adopted them too - and "Bang", suddenly Lexus had them too, the lines of little circular bulbs in their headlights. Now even their lights at night are hard to distinguish from a Mercedes.
Guys, stop already. Hire a few original designers, and yes, there are plenty of them around, and go for it. Create your own look. Italians are particular good at design, Californians are good, hey, great designers are everywhere. Although I suspect it is really the upper management at Lexus that has to change before this happens.
Stop being the moochers! Nobody has respect for copiers and imitators. As long as Lexus keep imitating, imitating, persuing, persuing, running after Mercedes, as long as Lexus does that, the company is an embarrassment for it's country. Stand by yourself, grow up! Everybody else does it...

Fascinating

I always find it fascinating when a patient tells me that she took acidophilus bacteria by mouth....to improve her vaginal flora.
Hmmmm....
I remember learning way back then in medical school that the stomach is a pretty hostile environment, that it is about a hundred times more acidic than Coca Cola and if you left a tooth overnight in Coca Cola it would completely dissolve and disappear. I learned that that stomach acid kills pretty much all bacteria except for tuberculosis bacteria and, I learned this a few years later, H. Pylori. And that this was one of the main barriers for the body to prevent bacteria from coming into the body.
So, those acidophilus apparently just pass the stomach acid unharmed. Not only that, they make it all the way though the bowel and then - miraculously - into the vagina! Ok, that is possible, E. Coli does it all the time. But still...
And why not insert the precious acidophilus directly into the vagina? Does the acidophilus get better after receiving a once-over in the bowel? Does it need to "christened" or "matured" or "pre-digested" or maybe "activated" by stomach acid?
Mysterious indeed, very mysterious!

Reminds me of the latest Geico ad:  Road runner stops by, zooms off again, Wiley coyote gets ready to eat our gecko, but gets buried by safe. Gecko shaking head: "Meep-meep??? What a strange place!"
I love that ad!

Physician - How to find your dream job

A reader of this blog wrote:
"I recently graduated from residency and relocated to the Dallas/Fort Worth area and have been utilizing nothing but job search engines and recruiters without any successful job matches....everything you've said hits home--its scary."

It was scary for me when I started looking after residency. I had graduated from a residency at a Harvard teaching hospital and thought it would be a snap to get a position in Boston itself.
No such luck! Nobody was rolling out the red carpet, nobody at all. Without knowing what I know now I took a position 40 miles from Boston.

I learned quite a bit from these experiences.

1. Ask your residency program director and your chairman for help. Talk to them, tell them what you are looking for, don't be afraid, don't be embarrassed. Ask all your attendings for help. Activate the network they have. Ask your relatives, family, neighbors, friends. Talk, ask.... you never know who comes up with a good lead.

2. Listen to their feedback. I wanted to do gyn only and one attending told me "you have to deliver babies, at least at first". How true, as I know now. This way you get in at a hospital/practice/group etc you like. Then you can work on reducing your OB or quitting OB. Also, once you are in a location you like, it is much easier to get into the loop and hear about good new job openings - because now you have access to the "Hidden Job Market".

Remember, the hidden job market encompasses all the jobs that are never advertised, because they are so attractive that word of mouth spreads about those jobs and they fill almost by themselves.

HIDDEN JOB MARKET- GOOD

Recruiters never ever get even close to the hidden job market and they will acknowledge its existence only under duress, since it is not part of their world. All the "great opportunities nationwide", all the "thousands of job openings" did NOT pass the hidden market test. They were not that desirable, they had to advertised, and even worse, much worse, advertisements were not enough, they needed to go through a recruiter. A recruiter is an instrument of last resort for employers, expensive, involved, but sometimes necessary.

RECRUITER JOB MARKET - BAD

3. Do not start your job search by contacting recruiters, do not answer their calls, as seductive as it might sound - "oh, I am sure they will have a job" - Sure they do, but it is a "left-over-job". Starting your job search by contacting a recruiter is the equivalent of shooting yourself in the foot! Stay away from recruiter websites!
Screen the online jobs engines such as NTNJobs and HealtheCareers, especially the ones that advertise jobs with mention of location and income range. That should be a minimum requirement to send a reply.
Everybody seems to just loooove the pathetic expression "competitive salary" - meaningless filler sentence. Oh, really? Competitive? Competing with what? Minimum wage? Average wage? What? And how did the "competition" turn out, did you salary lose or win? More often than not, they lost....

4. Search though my blog. I have given very valuable tips (and vented) for a few years now and you will find most of the headaches of physician job search AND their solution in here

5. Mass mailing! Send your cover letter and CV to hundreds of physicians in the area you would like to practice. The absolute best way to find a job you like in exactly the area you want. I have described the technique in this blog in the past and you can also find it on WIKI HOW "How to find a physician job". You can do it yourself, quite easily, and feel the satisfaction that you - all by yourself - found your dream job!

6. Contact me by email. I'll help you with advice and ore tips

What was that kid thinking?

Recently I was surprised to see an 18 year old guy, baseball cap sideways on his head, driving a...yes, a.....Silver Camry!
Man, if you want to be cool, and I guess you want to, what other reasons would you have to turn your cap sideways.....if you want to be cool, get the hell out of that car! What are you doing sporting a sideways turned cap in the most vanilla car on the road?

The best way to become completely invisible is to...drive a silver Camry! Or even better, an older model dark blue Camry. Nobody will notice that you drove by, nobody will remember you, ever.
The Men in Black are thinking of switching their cars.....

A classic recruiter attitude towards criticism

In 2007 I posted "Avoid physician recruiters", a blog post where I summarized my bad experiences with recruiters.

Now, 5 years later, someone came across that blog post and sent in the following comment. I am posting it here, because it is a great example of how recruiters think. And it is worth going into the flaws of that attitude:

"Anonymous" comments are in " "- and my comments follow without quotation marks....


Anonymous wrote:

"Your points are only valid dealing with recruiters who are very unprofessional and have no idea what they are doing."

Which makes up the vast majority of the about 150 or so recruiters I have personally dealt with. It is quite a convenient way of escaping criticism to simply say - the others are bad, but this does not apply to me, I am one of the good ones! A variant of this is "of course there are bad apples among the recruiters, as in any other field", usually followed by "but not too many".....
Very strangely, those "good recruiters" only seemed to surface after I posted my bad experiences. Before posting my complaints, the good recruiters were remarkably absent. You know, had I found the job I wanted without all the misleading ads and all that BS that got me so upset, I actually would have been happy and I would have never posted any bad experiences on my blog. Doesn't that make sense? Where were all the "good recruiters" when I was trying to find a job?

"If done correctly we recruiters find jobs that are off the radar - nobody else has these jobs."

ROFL!
This is hilarious!
Recruiters finding jobs that are off the radar....It is hard to believe that recruiters have so little inside in the job finding process that they actually dare to say this. Dear Anonymous, I challenge you to tell me HOW you find jobs that are "off the radar". I would be most interested in your definition of "off the radar" and in your way of finding them.

And here is the executive summary about job finding - for my physician colleagues:

1. The best jobs are passed on among people who know each other personally or have a close working relationship to each other. I hear from a friend over a beer at night that at a hospital nearby, closer to town and near the water a colleague is relocating to another state. Next day I call the chairman and get the job. Another way this may work is that the chairman announces a future vacancy and calls around or announces the position to the graduating residents and / or fellows. The really good jobs are actively pursued by physicians and passed on by word of mouth.
Think Harvard system jobs, close to downtown jobs, jobs in generally very desirable areas.

2. The OK jobs are not snapped up immediately by active physicians that monitor certain hospitals or employers, but require either a longer time in "spreading the word" or even ads in throw away magazines such as "OBGmanagement" or similar. For the employer, this is still an inexpensive option, these ads cost thousand to a few thousand and are usually effective in reaching enough candidates to fill the position. These jobs often are located at the edge or beyond the suburbs of larger cities or have some other drawback, such as lower pay, higher call etc. Recruiters that monitor the throwaway journals find them and often try to present their candidates to these employers. Obvioulsy these jobs are anything but "off the radar".

3. Hard to sell jobs. The community hospital in Desert Gulch, despite being in several "Top Hundred" hospital lists (aren't they all....) consistently has difficulties luring young physicians into their remote location. They are the classic client for recruiters. I have multiple posts on my blog that poke fun at the euphemisms that recruiters routinely use to fudge over undesirable locations, oh the ways they try.....family oriented, easy access to, plenty of outdoor recreation, affordable real estate, low crime rate and many more...
Maybe these are the job that "Anonymous" refers to. Yes, these jobs are most certainly "off the radar" for most physicians...and yes, they always are offered through recruiters.

The Munford law applies: The more desirable a job is, the less likely it will be presented by a recruiter. And of course, the inverse is true as well. The less desirable a job is, the more likely it will be presented by a recruiter!

And, yet again, for the n-th time, my definition of what physician recruiters do:
"Physician recruiters specialize in selling the undesirable, left-over jobs that are too hard to fill for the employers - to unsuspecting physicians"



But, back to the comments of "Anonymous"
"We suggest NOT posting any CV online in order to avoid unwanted harrassment and the perception of desperation."

Huh? Who suggests posting CVs online? Most certainly not me. Try to find that recommendation in my blog. Maybe Anonymos did not read much of my blog?

"I only involve myself as much as my candidate wants me to involve myself."

That I do understand, more than that would be pushy and would not get you anywhere....duh.

"My wife is a physician and so are all my friends at Harvard."

Ahaaa! Anonymous has credentials! Many "friends at Harvard". Good going! From now on, we should believe and trust this Anonymous, right? He has friends in high places!
Did I mention that I trained at a Harvard hospital myself? As a physician...?

"I NEVER suggest only using me.. I always help them to apply to groups that won't use recruiters and explain how to get their CV to the decision maker."

Oh, one of the few recruiters that I unfortunately never met. No recruiter has ever offered me such a great deal. No recruiter ever introduced me to groups that do not work with recruiters. Again - all these statements about helping physicians in unconventional ways only surfaced AFTER I started blogging about it. Strange, very strange indeed....

"You really should not make suggestions about ALL recruiters as if they are the same. I feel bad for you because your experience with recruiting is obviously not favorable."

We commented on that before...

"Most likely you are not a physician because if you were you would be entirely too busy, as most GOOD physicians are, to do your own busy work to find great opportunities."

Well, well, well....after preparing the field by slipping in the "all my friends at Harvard", here comes the kill shot - I am most likely NOT a physician!
That caught me by surprise, because last time I checked, and that was yesterday, my MD ID was still in my wallett, my board certification was uptodate, my graduation certificate from a Harvard hospital was still on the office wall...and, ah, what is the title of this blog? Care to notice? It reads "A Physician on...."
But, Anonymous backs it up, he has a very good reason for suspecting that I am not an MD! Wait, wait, wait, he is not done....
Anonymous thinks that "GOOD physicians" (sic!) are "entirely too busy" "to do their own busy work to find great opportunities" (notice the busy..busy in the same sentence?)
Huhaaaaa!
Now the cat is out of the bag - I am not a GOOD physician! Damn, that 5 star rating on the web must be an error...And the fact that I have not been sued must be an error as well...
Nice try though...

A basic truth in lfe is that efficient and successful individuals actually do have a lot of time. The inefficient ones don't. Another issue is where you place your priorities, and finding the right place to work was certainly a high priority for me.
What else might "GOOD physicians" not have time for? I can only guess...
But I will certainly remind our president that "GOOD lawyers" should not have time to get involved in politics! There you go!
I love this argument, this link between being GOOD and not having time for a lot of things....

This particular comment was my main reason for posting this. It is a classic recruiter myth that you just need a recruiter to find a job, yes, you need it, because you are such a busy physician. Recruiters hand physicians this compliment and at the same time very smartly push themselves on you. Compliments always, always work, no matter how untrue they are (scientifically proven BTW). Everybody loves compliments. This is actually a very clever marketing and sales trick. Who would not fall for the hidden compliment in that comment "You - as a good physician - are sooo busy" and say "yes" to it. And once the physician started agreeing with the recruiter, once the physicin started saying "yes", it is a much smaller step for the physician to say "yes" again to the recruiter's next statement, which invariably will involve "you need a recruiter". Basic and very effective sales technique. Has been used by used-car-salesmen for decades! Read more about sales techniques in "Influence: The Psychology of Persuasion" by Robert Cialdini. Of course, no GOOD physician would have time to read such a book.

"Hence the three... now four comments."

At this point Anonymous feels he is finishing me off by stating "nobody reads your blog anyway".
Who cares? Those who read it benefit from it - if they are physicians - or get a rare opportunity to explore the dark side of their business practices - if they are recruiters.

My point is: Dear collegue, your job search is by far too important to involve a recruiter!

Hilarious TV ad shows that Lexus is growing up

Have you noticed a recent ad on TV where a Lexus SUV is sitting on a huge copier? It is being copied and out at the bottom come 3 other brand SUVs, among them a Mercedes.
This is absolutely hilarious! Lexus is the company that introduced replica cars to the world, that elevated the concept of shameless imitation to a new art!
In the 70s groups of Japanese traveled the world, and particularly visited Germany, back then as well as today home to the best cars, most advanced technology, outstanding craftsmanship and original innovations. The visitors were known for their broad smile, extreme politeness and constantly clicking cameras. Soon the purpose of all these photos became clear. A company called Lexus started shipping "luxus" cars that almost looked like an original Mercedes, especially in dim light.
According to unconfirmed rumors, several Lexus designers and whole design teams were fired on the spot when it became clear that you could easily distinguish their designs from a Mercedes. Another joke was that it takes ten people to design a new Lexus - one designer and nine copyright lawyers. The designer would start with the large photo of a Mercedes and modifiy the image ever so slightly while the lawyers were debating heatedly if the changes were enough to fend off copyright suits. We all have seen the results. How many Lexus models looked like last year's Mercedes? By far too many - or was it all of them?
Then, something unheard of happened in the upper management of Lexus - a dramatic, sudden shift in design! Unbelievable, a dramatic break with their tradition of copying Mercedes! About 4 years ago, they decided to drastically revamp their design guidelines! And so it is...now they are "interpreting".....BMW.
And whereever Lexus designers strayed from direct copying they seemed to adhere to the principle of "noncommittal undecisive blandness". Other cars have style and are recognizable by design elements - Cadillac is a great example. Agressive styling, modeled after a pyramid, representing sportiveness, grip to the road and strength. You know a Cadillac when you see one. The same goes for Audi and BMW.
Lexus has no such characteristic styling elements that run through their whole line of cars. No styling elements are recognizable as "pure Lexus". This is not surprising at all, considering their history of "interpretive" designs and their history of avoiding anything edgy, innovative and unusual with a paranoia-like obsession. When a design team is forced to very closely copy for over a decade they most definitely are unable to develop their own visual language.
So, what does it mean that Lexus now tries to pull the wool over people's eyes by pretending that they have innovative designs? And even better, that they would like us to believe that they are in fact the original? What a daring thought! What chuzpah!
Are we going to see more ads like this? Maybe Toyota invented the pickup truck? Are we going to be treated to an ad where the Toyota pickup truck - what was it's name again? - stands on the copier and out comes....the Ford F150? Hey, Al Gore invented the internet! Lexus might as well have invented the SUV and the pick up truck...
People with enough money to buy whatever they want and whatever is best drive - Mercedes. Which head of state, minister, billionaire or multimillionaire has ever been seen driving a Lexus? We are still searching for them. Mercedes on the other hand....There is one in every ultrasuccessful human's garage.
Lexus in Germany? Rare - people know how to compare and they are able to distinguish an original from an interpretation...
Lexus in the US was always the "value option", the choice for all those that wanted to look like they were driving a Mercedes, but that did not want to spend the money to get the real thing. Very much like wearing a replica Rolex watch...
Another, more gentle interpretation comes to us if we compare the growth and development of a car company to the growth of a human being. According to this viewpoint Lexus has now reached young adulthood and behaves like my son, who claims to be independent and completely different from me and has forgotten where he got most of his genes and his education from - his parents. And I leave him be. I simply like his confidence and know that he sooner or later he will realize where he came from.
So will Lexus. After all...one slogans remains true: "Lexus - the relentless pursuit of Mercedes!"

The "Munford Law Of Physician Job Search"

The more attractive a position is, the less likely it will be presented to you by a physician recruiter.
The more drawbacks a position has, the more likely it will be presented to you by a recruiter.

Looking for a physician job? Run if you hear these trigger words

Dear fellow physicians: If you are searching for a job, you are aware of the importance and power of words. Words can be powerful or devastating, the choice of words is often very revealing.
During your job search you may encounter certain words and expressions that should raise a flag and should trigger an immediate termination of a conversation about a position. These trigger words should also make you move on if you read them in a magazine or online ad.
What words are we talking about?

When you hear these words - run!

1. "opportunity", used to label positions or physician jobs. Typically used by salespeople that are neither potential employers nor colleagues. If you hear or read "opportunity" you are dealing with a middleman, and by nature of their training (if any) and experience they have not "walked in your shoes", they are not your colleagues, they do not feel for you. And this is an "opportunity" for THEM - an "opportunity" to make money off of - you. Physician recruiters are only hired when a job is hard to fill. The more drawbacks a job has, the more likely a salesperson will be needed to fill it! Have you ever seen recruiters advertising "Office in San Francisco/LA/Manhattan/Boston with harbor view and above average pay"? Why not? Those jobs are gone even before anybody ever places any ad in a magazine...Have you seen salespeople recruit for Harvard faculty position? When you hear "opportunity", a salesperson had to be hired at significant cost to sell you a left-over job! You know that recruiters receive 30,000 plus for a signed job contract. That is the "opportunity". Remember, employers have positions, salespeople hawk "opportunities". If you hear that word - Run!

2. "easy access to..." common sales euphemism that is slipped in to cover up a remote, unattractive location - usually 1-3 hours from where you want to be. An undesirable location is a common reason to have to hire help. Salespeople fudge over the fact that a location is unattractive by using vague, and positive sounding terms such as "easy access". This trigger word is usually accompanied by colorful description of supposedly available "culture" and "communities bursting with activity". Visiting just a few of these "easy access" communities will clarify the term and allow you to understand that "easy access" is a variation of "fly-over country". And remember, it is not the recruiter's fault that he or she has to sell this job, because those are the only jobs they get!

3. "low crime rate, affordable housing" "plenty of outdoor (sic!) recreational activities" are equally euphemisms for remote, unexciting locations. Ever heard of "affordable housing" on the shore in San Diego, Miami or Boston? I prefer to be in a more expensive housing area, and usually those areas just happen to come with low crime rates. In areas advertised by salespeople, sadly, the crime rate is usually low because there is nothing left to steal. And when everybody knows everybody else, the crime rate is naturally low...
Another often used term that should stop you in your tracks is "family oriented community". In those communities family is really the sole and exclusive focus of activity, since there is...really, really nothing else to do. You have 5 stores, 4 restaurants including all diners, 3 movie theaters and 2 hours of car travel along the 1 road that leads out of town to the city where you originally wanted to work. Should the ad mention "hunting and fishing", then the moose population is generally larger than the human population.

4. "This area is oversaturated" or "There are no jobs in this area". Immediately end contact to any person that utters these words! Seriously. "Oversaturated" means "nobody is willing to fork over $ 30,000 to have a job filled". A classic sign of an attractive area, where jobs are not advertised, but handed over without magazine ads, online ads and especially without involvement of recruiters. The more attractive a job is, the less likely it will come through a recruiter - the first law of job search. Of course there are jobs in those areas - actually there are a ton of people working in Boston, New York, Washington, San Francisco etc. And they change jobs as often as anywhere else!
You can easily find a position in any "oversaturated" - meaning attractive area by direct mail. You write your cover letter, CV, mailmerge the addresses of all physicians in your target area with the cover letter. For every 100 letters you send out you will receive 2 interested answers. Contact information of physcicians is readily available at infoUSA.com and similar websites that sell physician contact info. You can download the excel or CSV list within seconds after paying with your credit card.

THAT is the real way to find a job! Or you can click over to "The Doctor Job.com" and have them do all that for you - for a fee of course. Might be worth it.
And do not forget to check the website of practicematch.com, where you will find job ads by actual employers - real people that are willing to employ you and that post their actual correct and complete address and telephone number as well as an email address!

The end of the physician recruiter era

The internet will soon make third party physician recruiters obsolete - and we are getting very close to that time.

Imagine internet services that have access to ALL email addresses of physicians in the US together with fairly complete contact information, data on education and professional experience as well as a few basics of personal preferences. Imagine the marketing possibilities.

At that point you can market any position as well as any job seeker in a most inexpensive way to any chosen target population. It will all come down to writing a good description of the job or a good presentation of the candidate. Then you can send this to any target group you wish, large or small - let's say, all physicians in one specialty in one state, all physicians that prefer to work in rural areas, all the ones that like warm climate or all who prefer cold climate or let's say skiing, that prefer to live on the water etc. You could market appealing to entertainment and hobby opportunities, to desired income etc.
And it all will cost close to nothing, and can be done from any keyboard.

We are almost there. The companies are still divided into those that look at job search from the perspective of the employer (the vast majority) and those that look at it from the perspective of the job seeker. On the employer side "Practicematch.com" fulfills all above criteria and on the side of the job seeker "TheDoctorJob.com" is the clear winner and outstanding business and service.
Both services do exactly the same thing, one services the employers, the other one the job seekers. The service they provide is the same. Could they unite or merge? Could each one do the job of the other one as well?

There are new and useful ancillary services as well. A new service called "Physician's Agency" is able to analyze any location for a reasonable fee for any physician looking to relocate and is able to help with salary and contract negotiations.

The basic need for employers is to get the description of a position in front of candidates
The basic need for job seekers is to get their cover letter and CV in front of employers.
All this can easily be done through the net. No need for any middleman. It is solely a matter of information, access to information. And that access is spreading like a wildfire, every day and every night.

We have come a long, long way way and we are almost there.
Easy, hassle free, straighforward job and candidate search without much manipulation and misleading and money making monkey business are within reach.
We are very close. And the days of the fast talking overpromising pull-the-wool-over-your-eyes telephone salesman (aka recruiter) are coming to an end. Another benefit of the internet.

Physician Recruiters - be afraid, be very afraid!

After a few years of focussing on other issues I recently came back to my previous hobby , the issues of physician job search. And.....how the world has changed! Practicematch.com cought my attention. It has evolved from a seemingly small recruitment and data company to a very smart enterprise that basically provides absolutely everything in the field of job search an employer could wish for! If hospitals and employers only realized what Practiematch can do, third party recruiters / commission based recruiters would be out of a job! Seriously.
Practicematch collects data on physicians, on all physicians. And, clever as they are, they "catch them when they are young". They start collecting info about residents and actually interview (!!) them over the phone, either in planned, targeted fashion or should the resident contact them. They collect email adresses - very smart, very smart - email marketing is dirt cheap...And they collect preferences of the residents and physicians -where do you want to practice, what kind of practice do you prefer, what do you want to do, are you married, what does your wife do? Excellent details to know when it comes to recruiting...
Then they follow physicians along their way and keep collecting data.
Where they get their data from is not revealed exactly, understandably - AMA? USPS confirmation?
But they claim to have excellent, tested, confirmed addresses, telephone numbers and email addresses on most physicians in the US.

Just imagine what you can do with this information!
You can target physician groups by email, literally for free! using the stored preferences you can target your marketing even better! Wonderful...
All this specifically to serve hospitals and other employers. Practicematch looks at the world throught the lens of the employer. Not bad, but not complete.
Not to forget the physician, they offer a fabulous job board as well - jobs are actually advertised here with exact location and include the precise contact information of the actual employer! Great!
No vague wishi-washi of "this opportunity is located in a wonderful family oriented community with easy access to blabla city" - which later turns out to be a backwood or backwater village and they "easy access" turns out to be an excruciating three hour drive to the next acceptable metropolis...this is the typical recuiter opportunity description....
None of this at Practicematch.com. Practicematch delivers real positions, with photos, precise location and contact info. Bravo!
That is what physicians are looking for!
Now, if you could just include the salary range. Please break that stupid taboo of "oy, you never talk about money". I never understood why employers seem deadly afraid of even mentioning a salary. No, dear employer, you do NOT lose negotiating power by being the one "who quotes a number first". Not true, nonsense. You simply allow the physician to walk into an interview with more certainty, with the reassurance that the position pays what he expects and is willing to work for.
I still remember how I had to withold my anger when I heard an unacceptable low salary offer - AFTER I had traveled a whole day, and gone through the whole interview and seen the whole practice and and and....I could have strangled the guy! The nerve!
Please, Practicematch, do something about that. Openness about money is a good thing - trust me!
And please, ban that stupid "competitive salary". Are your clients paying YOU "competitive fees"? And the salary is "competitive" with what? Oh, sure, competitive with MGMA guidelines - you got to be kidding - absolutely no resident knows what exactly the MGMA guidelines say, so why refer to them? "Competitive"? How "competitive"? Competitive without a chance of winning? Competing to lose? What is it now?
If you thought only 3 seconds about this phrase you would discover that "competitive salary" contains no information at all. You might as well leave it out. Please ban it from any and all adverstisements!

So, having all contact info for all US physicians allows Practicematch to target pretty much as many or as few physicians as they need or want to.
Practicematch actually has absolutely everything an employer could dream of having! Contact Practicematch - recruitment done! Can't do better than that....Who needs recruiters?
Again - who needs recruiters in view of what Practicematch can do?
N-O-B-0-D-Y
Think about it, take a few minutes, let it sink it.
Third party recruiters are obsolete. Period.
Employers just have to figure it out.
And Practicematch works with in-house recruiters / the in-house recruiter network....and the hospitals are taking over more and more of medicine, so they reach of Practicematch is easily growing bigger and bigger.
Be afraid, third party recruiters, be very afraid.
The sign is on the wall, look at the bottom of the Practicematch.com website - I looked and laughed!
Here is what it says:
"Third party recruiters are prohibited from using this website"
WOW! Confident and strong. They clearly can do without the dollars of third party recruiters...
Good for you Practicematch.com!
I welcome the publication of more honest, clear, precise, straightforward information about job offers!

Kiyosaki - bad, Tim Ferris - good. The 4-Hour Workweek

Self-help books, recently relabeled into the more euphemistic "self-development" category have been a secret vice of mine for quite a while. One book that stood out as particularly disappointing was Kiyosaki's "Rich Dad, Poor Dad". The basic concepts can be summarized on a single page. And yes, we know that it is better to have your money work for your instead of working for your money - gosh, who would have thought so? I just wish I already did have the money to do this. I can't wait to have my money work fr me instead of working for my money! My few thousand dollars of savings just do not seem to cut it when it comes to working for me! Well, I should invest? Sure, and then? Get $2,59 in return every month? You got to be kidding! And it was curious to have "asset" redefined as something that makes you money and "liability" as something that drains your account. And the "cash-flow quadrant" is certainly worth considering. This book actually seems to help you AFTER you made your money and then it is obsolete anyway.
But when you are done reading the book, boy, do you feeel confident that yes, you can be rich too. But then the trouble starts, you wake up and ask - how do I do it? Kiyosaki offers outstanding advice - after looking through the whole book looking for answers, I found the solution. I seems that our wise author finds it vital to form "your team" - consisting of a realtor, an attorney and a finacial advisor. Great! But...wait a minute, what I tell those poeple about what they are supposed to do? And "forming a team" is going to make me rich? Based on what the lawyer is cahrging me by the hour, the result will be quite the opposite.....
I probed further into the riches of Kiyosaki's adice, and finally, after a lot of leafing and leafing, I dug up a single sentence, truly one single sentence - no kidding - in the middle of another Kiyosaki book, here it comes, watch this, are you ready? "Turn your ideas into companies" - done, end of advice, finito, that's it, end of story, end of advice! And then he immediately proceeds to waffles on with the 5th, 6th and 7th repetition of the cash flow quadrant or another similar hot "economics 101 for 6 year olds" topic. Kiyosaki does not write "how to become rich". He simply writes motivational "feel-good" leaflets. Detailed advice that helps you in real life? Anything of practical use? None, zero, nada....
Yet, Kiyosaki mentiones an annoying amount of times how much he learned listenting to "Rich Dad" discuss business with his son during dinner - but, somehow he never gets around to sharing any of those pearls with us, the interested readers. What did he do with all that knowledge, with the accumulated wisdom of rich dad? Where is he hiding it? Why is Kiyosaki afraid of sharing it? Instead of sharing it, he repeats his basic concepts ad nauseam until you fall asleep or throw his books away or start writing bad reviews and bad blog posts about him. And here I am.
I did not fully realize just how pathetic Kiyosaki was until I read something that actually delivers the goods - the book by Tim Ferris titled "The 4-Hour Workweek".
Now here is a gem - fully packed with practical, usable information, and almost no fluff. Chock full of innovative ideas on how to come up with ideas, test ideas, create a product, how to test it, how to market it and how to outsource the whole manufacturing and advertising and administration and go traveling around the world with the money you make. Tremendous insights on how to work more efficiently and how to actually LIVE. An incredible amount of inspiration and information packed into one single book.
Ferris does not hold back, he does not ration his information nor his advice, because in the back of his mind, he is already planning to publish a whole series of similar books and does not want to share eveything at once - none of that. He freely tells you what he knows. Importantly - he mentions other books and people he learned from and gives you his sources. This is good, since you can read his sources and understand them better, learn more. I believe this to be the sign of a good author. You could almost call him charitable. He truly shares, he does not seem to sell. It is not one of those thin books with slightly larger print and wide margins that beats a single thought to death. He really lays it all out. Great! Great! Great!
Kiyosaki, you are a ...(can't print this here)!
If you, dear reader actually had the patience of finishing a Kiyosaki book, now is the time to throw it out, donate it to a Pre-Kindergarden program or give it to someone you don't like (great waste of her time).
Then read the real deal: The Four Hour Work Week. This is one of the few books with the potential to be life changing. Tim Ferris delivers what others only promise.

Boy, you have the industry pegged!

This is a comment on one of my past posts. It is so clear that it does not require any additions. Hear the opinion about physician recruiters from someone who has done it, who worked as a phyisian recruiter...! Emphasis added by me.

Start quote:
Boy, you have the industry pegged! It is funny, I have been a "Physician Recruiter" for over 15 years and started to work for myself at home because I hated the way the industry was run. I have given physicians the name and contact information to positions that do not pay me a fee (worked for free) because it was in their best interest. I was tired of working for people who played games with Physician's lives for the sake of the almighty dollar.

Now, I may not be rich doing business this way. I "loose" a placement or a fee by handing over information but I can look at myself in the mirror everyday and I also know, if they took a job that I could not get a fee for, then that was ok because it only means they would not have been happy if they accepted a job from one of the hospitals which would pay me a fee. I am happy to say, once I started "giving" jobs away, I could still pay my bills and I received more referrals from physicians I had helped and I stopped calling myself a "recruiter" and became a "Physician Career Consultant".
End quote

Post jobs and find jobs for FREE on Sermo - a 60,000 and growing online physician community

I love Sermo, for many, many reasons. The community is physicians-only, it is free, you may even earn a bit of money by giving your opinion and it is a great community. Responses are many, diverse, friendly, supportive, interesting, funny. Sermo has a great humor section. What started in 2006 with just a few people is now a vibrant 60,000 physician community and continues to grow by about 1000 a month.

Here is one more reason to love Sermo: Recently they have started a job board - FOR FREE. And it will stay free. So, this is my new favorite in the physician job market. Please take look at Sermo.com, and if you are a physician, register for free and and look around. Go to the posts in your specialty, go to the "general interest section" and go to the job board.

The Founder and CEO introduced the job board with the below quoted post in Sermo. And, not to my surprise, I found that my opinions on the physician job market and in particular on physician recruiters are widely shared by my fellow physicians!

Quote start:

From the Founder: Return to Professional Courtesy - SermoJobs

Being the son of a physician I remember very vividly the role of professional courtesy. While I was always blessed with access to incredible physicians, dentists, and orthodontists, I can recall several occasions where professional courtesy became a topic of great discussion between my parents. To my father, and ultimately myself, it represented something much more meaningful; the willingness and desire of physicians to help one another in any way that they could.

Almost a year ago, when Sermo started to consider the features, services, and products that our community would find valuable, a Jobs Board quickly became a topic of great discussion. It has always been clear that a large physician community could benefit from a very powerful "network effect" if all physicians could use the medium for their collective interest. Then members of this community repeatedly posted jobs and contacted me about their strong interest in a jobs board. Then our Chief Medical Officer started talking about this in terms of a return to professional courtesy and it hit me. This community wants to cut out the third parties. Physicians want to connect to one another, network, discuss, and ideally resurrect the professional courtesy that was once so central to our profession. Sermo could do that As we researched the concept of a jobs board, the community was very consistent in the feedback:

• Demand for physicians is soaring, especially of late. The necessity to resort to recruiters is becoming all the more common.

• Physicians are frustrated by the intrinsic conflicts of interest that third parties (recruiters, head hunters, etc.) bring to the recruiting process.

• With so many financial pressures on physicians, the 10-33% of starting salary paid out to recruiters is increasingly unbearable.

• There is no single resource where physicians can present and discuss employment opportunities to and with one another.

Sermo Jobs is a free resource to all active physician members of the community and will not be accessible to any for-profit third parties. I can, however, foresee a model where physician employers such as hospitals, IPAs, and institutions could eventually participate, perhaps in a way similar to our client postings.

Job postings will benefit from the same community moderation and discussion that have made Sermo so successful. Should the author choose to engage in commentary around their posted job, they will not be identified as the author but their real Sermo user name will appear. This system allows the individual physician to independently choose if they would like to reveal their Sermo user name.

Sermo encourages the philosophy of physician professional courtesy and shared benefit between the job poster and applicant. It is our hope that when a candidate accepts a job position the two parties will share any financial resource that would have been spent as a recruiting fee thus keeping more money in the pockets of hard working physicians.

Daniel Palestrant, MD
Founder & CEO
Sermo, Inc

Quote End.

Thank you, Dr. Palestrant and thank you Sermo Team, for this great opportunity to pass on jobs directly from physician to physician. This is exactly what I wished for and predicted in the age of the Internet. No middlemen, no third parties that distract more than they help. Direct contact from physician / employer to physician.

Professional courtesy. Now we are talking!

Another grrrreat recruiter email! Have fun

Hello Dr.

We have many new and Great opportunities available in ALL STATES which include, $alary increase, sign on bonus, relocation packages. Locums and Perm National Positions Available!!! Open ended Assignments!!! Great rates $$$ All expenses are covered including lodging, mileage, and malpractice for Locums. VERY FLEXIBLE HOURS!!! GREAT FOR THE FAMILY!!! Must have a State license for Locums and Client will wait for Perm. Recent grads are welcomed. Excellent support staff and coverage. Possibility to covert to a permanent position. Low Stress Environment!!! All Submissions are strictly confidential.

Thank You,

Besides the very personal approach so familiar from too many recruiter emails "Dear Dr.", this recruiter apparently had help from his children armed with their new crayons! And I love the specific details! Are all his jobs so great? I guess so...I suspect he put all the superlatives from many many ads in a blender and out came....
It was very, very hard to resist calling him!
What else can you say if you receive such a customized personal message? You truly believe that he is "going to customize a search for you".