questions to asks yourself when offered a job (job searching)

[foot meister]

Ok so I've read quite a few threads on tips and tricks on how to find a job and these threads touch on this subject (little nuggets) but I wanted specifically to know what questions I should ask myself when presented with a Podiatry job offer. Specifically on what business practices I should avoid, and what I should accept. I know a lot is a personal preference thing but I'm a checklist kind of person and so this could guide me to making a good future decision. (if anyone knows any really good threads that are more specific [not general] to this subject let me know).
P.s this is not about how to find a job but rather how to analyze a job offer.
p.s.s with benefits: what benefits seems great but aren't and what ones are underrated.

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[ExperiencedDPM]

Ok so I've read quite a few threads on tips and tricks on how to find a job and these threads touch on this subject (little nuggets) but I wanted specifically to know what questions I should ask myself when presented with a Podiatry job offer. Specifically on what business practices I should avoid, and what I should accept. I know a lot is a personal preference thing but I'm a checklist kind of person and so this could guide me to making a good future decision. (if anyone knows any really good threads that are more specific [not general] to this subject let me know).
P.s this is not about how to find a job but rather how to analyze a job offer.
p.s.s with benefits: what benefits seems great but aren't and what ones are underrated.

Wow. I could write a monograph on this question

1) is the practice truly busy enough to afford your salary

2) if your salary is percentage based, will you be busy enough to earn a living

3) if you have ANY reservations or concerns regarding the ethics of the practice, follow your gut feelings.

4) if the doctor's wife or relative is the practice manager, run, don't walk in the other direction

5) if your salary is production based, ask what happens when you see any capitated patients or when you see the boss's post op patients for free

6) ask if the patients are divided fairly or if the new associates c
traditionally get all the lower paying insurance patients

7) ask how many associates have preceded you and ask for names AND call these docs

8) check the state board website to see if the doctor has ever been sanctioned

9) if the doctor brags about his car, boat, home or how much he makes....bolt out the door

10) find out if there is hospital, holiday and weekend call and who covers that schedule

11) ask the time that is expected for you to start the partner process and if it's mandatory.

12) ask if the partner process requires a buy in or is based on sweat equity or if payment can be deducted from your salary or in lieu of a salary increase

13) ask if there are nursing homes or house calls

14) ask to shadow for a week so you truly get to see a fair sampling and cross section of patients

15) make sure any restrictive covenant is fair and reasonable. If the practice has 8 offices only ageee to sign a restrictive covenant for the offices you actually work ( and yes, these agreements are often enforceable) though not legal in Calif.

16) find out if the practice deducts the cost of CAM walkers, orthoses, etc, before you get your portion if paid on production and ASK to see those actual costs.

17) make sure the practice lets you do your own billing or at least review your billing. You can be personally and financially responsible for fraudulent billing if the practice uses your NPI and not theirs. I've seen docs bill something and somewhere along the line it gets changed without the doc's knowledge. It's sleazy buy it happens.

18) ask if the practice has been audited and for what reason or codes

That's a starter list, I've got a lot more!

 

[dr.phoot]

@ExperiencedDPM : doc, why should you avoid a practice where a fam member is manager / handling some administrative aspect?

 

[ExperiencedDPM]

@ExperiencedDPM : doc, why should you avoid a practice where a fam member is manager / handling some administrative aspect?

There is a conflict of interest and often two sets of standards. It's a no win situation for the employee.

 

[NatCh]

4) if the doctor's wife or relative is the practice manager, run, don't walk in the other direction

Excellent list.

#4 above made me literally laugh out loud. Right out of residency I was part of a group in which the founder's (very young) second wife would blow through the office about once a week and cause total chaos. She'd start barking orders at everyone for no apparent reason other than to push the staff around. It totally wrecked the flow of everything. She referred to the founder as "The Big Cheese" and the rest of us docs as "Little Cheeses."




I need a drink.

 

[JewOnThis]

Great list.

 

[foot meister]

This is fantastic! Exactly what I was looking for! And if you would like to add more... be my guest. All of this is extremely applicable in the field, and I'm sure this will help a lot of people.

 

[bunNfxr]

1. Quotas for Surgery, Orthotics, foot creams, laser treatments or Toenail products--Are you comfortable and how comfortable are you pushing these to keep your job/ pay?
2. Travel between offices--How much do you want to do this? some rural practices can be 100 miles apart sometimes your commutes are close but you are in a different place every day of the week. decide what you want?
3. Ask yourself How long you want to spend buying in and are you actually better off when you own 1/2 the responsibility for the practice?
4. Do you want to take over the practice style of the person hiring you? Some DPMs see 60-80 patients a day--Do you want this? Can you do this? Can you do this in light of the new MACRA/ MU/ PQRS documentation requirements?
5. If the practice owner fell ill, would you be able to cover the overhead with your own production?
6. Surgery cases- does the practice have what you want? Is there room/amenable referral sources to expand and utilize your training?
7. How many 11730 codes are being billed without administering anesthesia (This is something you may not know until you are working there, but should affect your future plans as this is the most common indictment against podiatry).
8. How effective is the billing staff or contractor? All your claims should be paid but they won't be if you are seeing <95%of your claims getting paid , then the practice is not tenacious enough. It cost them money to go after small amounts, but, it costs YOU money if they don't.
9. Ability to pursue a residency directorship and serve on hospital committees?
10 How much does the practice rely on non-core medical care and how much do want to deal with that. (Namely: Diabetic shoes are less and less relied upon for income, but some practices still push shoes heavily. If that goes away, how much income is left?)

Good luck

 

[ExperiencedDPM]

A few more questions:

1). As per a prior post, is the practice busy enough to hire you.

2). Will you have a relatively busy schedule from day one, or do they expect YOU to build the practice. (I am not a believer that an associate with no shares in the practice should have to build the practice. If a practice isn't busy enough you shouldn't be hired. This is especially true if working a percentage or incentive).

3). Will you be expected to give free lectures at meetings or facilities to build the practice? When you're doing that you aren't earning any money.

4). Will you be the one who has to stand like a buffoon at a health fair? Once again earning no money and having to answer stupid questions for free for people looking for free advice.

5) does the practice have any "not busy" offices they want YOU to build or satellite offices that aren't busy? If YOU are the one sent to those offices, how are you supposed to make money?

6). How do they sterilize their instruments? If all the instruments are "cold sterilized" in a solution tray......run out of the office. In today's times if a practice isn't sterilizing instruments in autoclave and put in sterile packs, it's barbaric, irresponsible and malpractice.

 

[heybrother]

Good luck

I would be interested in hearing more of your thoughts. Welcome to the forum.

 

[dr.phoot]

I would be interested in hearing more of your thoughts. Welcome to the forum.

I agree! I've exchanged several PMs with him. I like his views

 

[dtrack22]

A few more questions:

1). As per a prior post, is the practice busy enough to hire you.

2). Will you have a relatively busy schedule from day one, or do they expect YOU to build the practice. (I am not a believer that an associate with no shares in the practice should have to build the practice. If a practice isn't busy enough you shouldn't be hired. This is especially true if working a percentage or incentive).

3). Will you be expected to give free lectures at meetings or facilities to build the practice? When you're doing that you aren't earning any money.

4). Will you be the one who has to stand like a buffoon at a health fair? Once again earning no money and having to answer stupid questions for free for people looking for free advice.

5) does the practice have any "not busy" offices they want YOU to build or satellite offices that aren't busy? If YOU are the one sent to those offices, how are you supposed to make money?

6). How do they sterilize their instruments? If all the instruments are "cold sterilized" in a solution tray......run out of the office. In today's times if a practice isn't sterilizing instruments in autoclave and put in sterile packs, it's barbaric, irresponsible and malpractice.

Similar to what's been said which is in depth and fantastic advice...maybe getting more specific:

1) how many new patient referrals/apt requests does the practice get per day?
-They need to be around 10 per doc per day to be able to kick you a reasonable amount from day one.

2) What is the non-compete and does it apply to offices that you don't cover regularly?
-I would recommend trying to get non-competes outright waived (at least down to 1 mile) from offices that don't count for 20% of your production

3) What is the practice worth? Was the valuation made up by the owner(s) or did they have a professional firm that does valuations for a living asses the practice?
-it should never be some % of gross collections. There is a job posted on the acfas job board right now where the valuation is 80% of gross collections. That is insane. If the owner(s) made up the number, do not agree to it unless it is just some portion of assets. If it was done by an accounting firm that does valuations for a living, you will get a fair deal because medical practices aren't worth as much as they used to be

4) Do DME and/or ancillary revenue streams count towards your production as an associate?

5) As an associate are you free to pursue outside (medical related) investment opportunities? Or is anything and everything you do property of the practice/corporation?