For many freshly minted physicians entering the job market, private practice jobs provide the ideal balance between autonomy as a physician and support from colleagues and a healthcare “system” that’s not as large as a hospital. There are many advantages to a job in private practice, whether that be a group of a few physicians that serves a local community or a practice that’s part of a larger conglomerate serving a larger geographic area. Here we will focus on some important questions to keep in mind when prepping for an interview. Coming prepared with thoughtful questions is a way to show potential employers that you’re really interested. The answers to these questions can also be very telling regarding the culture or day-to-day life within that practice.
How long have the physicians currently in the practice been there?
It is helpful to know whether there is high turnover at a practice. This could be indicative of many things, including senior leadership that is difficult to work with, issues with culture or working environment, or opportunities for professional growth. It’s important also to note if a practice consists mainly of long-termers who have had a hand in shaping what the practice is today; these physicians likely hold much of the decision-making power within the group, so you want to make sure your goals and values align with theirs. It is helpful to ask directly about turnover, and what a particular practice’s motivations are behind hiring a new physician in the case that it is not simply to fill a vacancy left by someone who moved on or retired.
What elements of the job are defined by seniority?
Similarly, to the power dynamics mentioned above, the structure of power within a practice likely will model that which exists throughout medicine- the older and more experienced you are, the less “scut” work you will likely do and the more administrative responsibilities you will have. As a junior physician in a group, will you be assigned disproportionately more call or weekend shifts compared to your colleagues? What non-clinical responsibilities will you assume as a new member within a practice? Knowing these details upfront is key and will also provide a window into the attitudes about hierarchy within a group.
Is there a backup system for call in the event of someone having an emergency?
Unless you are in one of the very lucky specialties that does not take weekends or nights call, you will likely have to enter a rotation for call within your group. The ways that practices break this up within a calendar year can vary vastly. While the logistics of call are typically made obvious when jobs are advertised, it’s also useful to know what systems are in place (if any) for physicians assigned to call that they cannot take, for example in an unexpected circumstance. This will no-doubt happen to you at some point and knowing you won’t be left out in the cold to sort out a solution yourself shows that a practice prioritizes supporting its physicians.
Do office staff typically eat lunch together?
For some, this element is not important. However, if you value culture and having a sense of community within your workplace, its important to know whether everyone hides in their office to eat lunch, or if there is a sense of conviviality among colleagues. Knowing how and if people socialize during their down time at work is a good way to find that out.
What is an example of a systems problem that was escalated to leadership, and how was it addressed?
Physicians who are able to see the “big picture” and solve problems/come up with solutions on a systems level are very valuable. It is worthwhile finding out how a given group identifies systems issues (if they do at all!). This could include issues with technology or the EMR, sorting out insurance issues and prior authorizations for patients, billing, and even supply chain issues for stocking exam rooms and procedural rooms in an office. These issues directly impact the flow and quality of everyday life and work for physicians, so it is essential to determine how smoothly these types of issues are solved in a potential workplace.
What is the relationship like between front desk/administrative staff and the MDs?
Is there a culture of respectful communication and value placed on throughput of patients during clinical office hours? How do people speak to one another during the day? Are all members of the healthcare team treated with respect and are their voices heard?
Do the MDs within the practice have generally similar attitudes with regards to evidence-based practices?
One surprise you do not want to encounter when starting a new job is trying to make a certain management plan for your patient and being told that is not “how we do things here.” If you value total autonomy in clinical decision-making, or if you are strongly adhered to evidence-based guidelines for practice, you must determine if your practice aligns with those attitudes. This is truly one of the most crucial elements in finding a workplace where your colleagues are like-minded, and you can feel comfortable if one of your patients ends up in their care.
What efforts are made to monitor and maintain patient quality and safety?
If safety and quality are important to you, you should absolutely ask about how a practice examines its own behavior and patient outcomes. It is helpful to ask for concrete examples of how safety issues were identified, what was addressed, and how outcomes were tracked to ensure that said issue was truly resolved.
These are just a few examples of the less “traditional” but equally vital questions you should be thinking of when preparing to interview with a private practice. They are a way of both coming off as prepared and interested, standing out as a candidate, and gaining insight into the cultures and attitudes within a group. Good luck!
