As an ER doctor, I’ve worked with plenty of recruiters.

Emails, phone calls, LinkedIn messages and *cringe* texts, offering me “exciting opportunities” and “a chance for work-life balance”.

I empathize with recruiters because there’s a significant overlap between our jobs: We both have to call people we’re not well acquainted with and try to get them to work more. 

You’re trying to get people to pick up a few more shifts (or switch jobs completely). I’m trying to get an internist to admit a patient for social reasons at 3:00 a.m.

These are equally challenging spots to be in!

Spots that could learn a lot from each other. It’s time to get over the antagonistic relationship a lot of doctors have with recruiters and get to a point where we can help each other.

Ultimately, it can only benefit us both to have higher quality interactions.

Honesty

It’s not an “exciting opportunity”, “a great career change” or a “chance for work-life balance.”

It’s work.

And there’s nothing wrong with work. Emergency physicians are a group that like to work hard; we picked a physically, emotionally, and intellectually demanding specialty. Job opportunities aren’t a foreign notion that needs to be eased into.

By the time we’re being recruited, we have insight that the grass isn’t greener on the other side, even if it’s presented that way. The real question is: What work are you offering and how much would I want to be paid to do it? 

I’m going to determine if the work can be balanced with my life and whether this is a great opportunity. What I need to know are the details to help me figure those questions out.

Call it what it is and lets move forward.

Direct, clear speech

Emergency physicians spend years of training learning how to gather and present immediately useful and relevant information. Information that’s actionable.

We’re looking for the meat.

So when you’re cold-calling an emergency physician, it makes sense to speak that language. The content of your language may be about a job but the gold is in the way it’s delivered. Focus on the meat, speak directly and say what you mean.

Also, it isn’t advisable to make your initial contact by text. It can be seen as too informal. If an unknown number pops up and says “Hi, This is Chris from Doctor’s Recruiters, are you interested in a few more shifts?” one thing is for sure: Doctor’s Recruiters doesn’t understand its audience and I probably won’t like working with them.

Texting is convenient for some things—so if we talk and I’m interested in moving forward with a job, ask what my preferred method of communication is. Like anyone else, you prefer some methods of communication for certain things because it lets you triage when you’ll respond.

Same thing here, just ask first.

Specifics about the hospital and its community

What is the actual name of the hospital?

It’s always suspicious when I hear about the great stuff happening in the same region as a hospital but no one will tell the name of the facility. It would be better to say “General Hospital, 20 miles south of Omaha” than “A community hospital near the bustling Omaha nightlife!”

It makes it sound like you’re hiding something.

We work in a range of facilities by the time we’re done with medical school and residency. The chances are that we have experience in a facility like the one you’re representing. When a recruiter describes a hospital, the first thing I’m thinking is “Oh, this place is like Hospital X. I liked it there/didn’t like it there. I could see myself working there again/never in a million years.”

If you work in enough ED’s, you realize that they just have different proportions of the same patients. Geriatrics, trauma, pediatrics, drug seekers.

They also have different proportions of the same problems. This one has a cath lab, that one doesn’t. This one has great culture with a few malignant people, that one has tons of malignant people and a few great ones.

Same problems, different proportions.

When I talk to a recruiter, I’m trying to figure out what proportion of patients and problems I’m going to be dealing with. It’s the ability to picture myself working in a facility that informs my initial yes/no decision when being presented with a job opportunity.

This is supported by understanding the community it serves and solidified with information discovered when researching the actual facility.

Specifics about how well the hospital functions

The ED is the canary in the coal mine.

When the hospital fails, it backs up into the ED. I want insight into how much time I will spend managing hospital issues versus being an ER doctor.

Throughput metrics help tell this story. What is the Left Without Being Seen (LWBS) rate? What is the door to provider time? What is the average length of stay in the ED? How much boarding is there?

There is a wealth of information about these metrics online, but the idea is the same; they’re vital signs for the hospital. If you tell me that an ED has 30K visits/year but an 8% LWBS rate and a 6 hour length of stay in the ED, there’s a major problem.

What you’ve communicated to me is that the ED is congested, I’m going to be boarding a ton of people, will probably wind up seeing people in the hallways or in odd physician roles. Even though these issues aren’t inherently ED issues, they frequently become ours to solve.

Many ED’s have these problems, it’s part of working in an ED. But knowing these numbers gives me a sense of how burdened I will be and helps paint a picture of what my days would be like.

Also, a recruiter knowing this communicates that they understand the industry.

Specifics about the ED and job itself

The basic vital signs of the ED are what you typically see in the ads. Patient volumes, shift lengths and times, APP coverage, admit rates, and what services are available are expected information.

When I hear this information, I’m doing calculations to get a sense of what my day would look like. For example, a recruiter tells me that there are 30K visits/year, 24 hours of doctor coverage in two twelve hour shifts, 12 hours of APP coverage and a 15% admit rate.

There’s no cath lab, no GI services.

I take this information and break it down to see what my day will look like.

30K/365 days per year = 82 patients per day.

82 patients per day divided by 24 hours of doctor and 12 hours of APP coverage (each APP hour is about 0.5–0.8 of a doctor’s hour), means I’ll be seeing about 2.5 patients/hr or about 30 total in a shift. I’ll admit 4 to 5 of them.

You’ve also told me that I will be likely transferring out heart attacks and GI bleeding, these are probably not represented in the admission rate.

That’s how I look at this information, it gives me a very clear sense of what my days would be like. I take these calculations, put them in the context of the locale described and think: OK, what would I have to be paid to work there? 

This question is never answered satisfactorily with the phrase “Competitive pay.”

If it were awesome pay, it would be your opening line, right? You wouldn’t hide $500/hr!

So say it up front, it pays $X/hr with an RVU bonus, therefore averaging $Y to $Z/hr. Eventually, we’re going to gain this information either way, so be clear and direct with it.

The dollar amount doesn’t take the deal off the table. I may be fine with lower pay because I want a slower ED than the one I’m in or I simply want a change. This information only answers the question of what it would be worth to put myself in that situation.

Specifics about the staffing

This also paints a picture, these are my future colleagues, people whom I have to assume care from and work with.

Questions I’m going to have about the staffing will be:

Why are there holes in the schedule? Is the ED expanding, or can they not keep providers? Did someone retire or quit? What’s turnover like there?

When are the holes in the schedule? Nights? Weekends? Holidays? How can I be assured that I won’t get a disproportionate amount of undesirable shifts?

Who makes the schedule?

Who makes up the staff? Are there lots of locums? Are there many physicians who aren’t boarded in emergency medicine?

What’s the administrative structure like? Tell me about the medical directors. Can I meet them or set up a time to talk with them?

Overall, you’re painting a picture—the better you can make it, the more likely I am to see myself working in it.

As a final point, physicians can be challenging to work with. Getting a phone call from a recruiter is a sign of job security. In our economy, anyone who has strangers throwing work at them should be grateful, not irritated!