- March 27, 2017
- ByHeather Chappell
Are you an anesthesia resident seeking your first practice opportunity as a board-certified anesthesiologist, or an experienced anesthesiologist looking to make a change? As the world of medicine grows increasingly complex, it is important to find an anesthesiologist job that is the right fit for you.
In order to help you to assess your options, we have compiled a list of common questions to ask during the anesthesiologist hiring process. Prior to your interview, research the opportunity, practice, or hospital online. Gather information regarding the job and the facility, and make a list of remaining questions to ask your recruiter, medical director, or a clinician already practicing within the group.
1. Will I be practicing as an employee (W-2) or independent contractor (1099)?
Practicing as an independent contractor offers distinct advantages for anesthesiologists in terms of flexibility, retirement planning and tax savings. With increased control over earnings, physicians practicing as independent contractors can choose only the benefits they want and need. They are also able to purchase these benefits with pre-tax dollars. Learn more about the benefits of independent contractor status here.
2. How many surgical cases are performed each year, and what is the case mix?
Some practices expect anesthesiologists to perform a wide variety of cases, while others focus on only a certain type. Ensure you are comfortable with, and enjoy, the types of cases you will be handling within this practice. Several types to consider include:
- Chronic pain management
- Obstetric (OB Anesthesia)
- Critical care medicine
- Outpatient surgery
- Regional anesthesia
- Acute pain management
Find out more about our current opportunities and case types for each practice here.
3. Are there opportunities to advance into a clinical leadership role (if desired)?
If there are opportunities for career advancement, does the practice offer any leadership development programs or training? At ApolloMD, we take pride in equipping our outstanding physicians for success as medical directors. We also understand that a great clinical leader possesses more than excellent skills in the clinical arena. Through our Leadership Academy, we provide physicians with the operational and leadership skills needed to successfully manage a practice.
In addition, all ApolloMD clinical leaders are invited to attend the ApolloMD Leadership Conference – an annual two-day event held in Atlanta, Ga. This event brings medical directors and lead APCs from all practices across the country to discuss strategies around managing and leading in the ever changing healthcare environments.
This two-day conference consists of a keynote workshop, various speakers on a variety of topics, specialty- specific breakout sessions, meet and greet networking dinner, as well as an awards ceremony to recognize those who have gone above and beyond leading their teams throughout the year.
4. Does the practice offer opportunities to become an owner?
Whether practicing in a local, democratic group or a national, multispecialty practice, many physicians desire the financial and practice benefits of becoming an owner. Find out whether the practice offers any ownership opportunities, and if so, what is required for eligibility.
At ApolloMD, we are proud to offer the ApolloMD Partners, Inc. ownership program. With no ambiguity regarding eligibility, the program is exceedingly popular among our physicians, advanced practice clinicians and employees. In addition to the financial benefits, we have found our physicians enjoy practicing alongside other dedicated partners.
Although we are a large, multispecialty practice with more than 2,500 clinicians, the ownership option allows our team to stay connected with their partners across the country.
5. How many anesthesiologists and anesthetists practice within the group?
Researching the dynamics of the workplace for which you are interviewing is useful and important. Some anesthesia practices utilize physician-only models while others promote the use of anesthetists. Ask how many anesthesiologists and anesthetists are on the team currently, or if the practice is growing, how many roles are expected to fill the team.
This may also help you to understand how the practice functions and better determine duties and responsibilities of each role. It could be helpful to look at groups with diverse models in their usage of anesthesiologist and anesthetists to allow a wide span of variety based on your preferences.
6. What is the call schedule? Does the schedule allow for a day off post-call?
Work-life balance and flexible scheduling is important in any position you pursue. In comparison to other specialties, anesthesia clinicians typically work longer shifts and take longer call periods. For this reason, it is helpful to ask what the expected scheduling model is.
Groups which promote a healthy work-life balance will likely have implemented multiple schedule options which allow for a mixture of short shift, long shift, call shift and day-off post-call scheduling models. Some facilities have a designated “call room” available for physicians taking long call shifts. These can be used for resting and rejuvenating for the remainder of the shift.
7. Will I be medically directing or medically supervising CRNAs or AAs? If so, what is the MDA: Anesthetist ratio?
Understanding the distinctions between medically directing and medically supervising anesthetists and the compliance levels required by Centers for Medicare and Medicaid Services (CMS) for each designation is critical.
Medically Directed Practices: Occurs when an anesthesiologist is involved with up to four simultaneous anesthesia procedures with a qualified clinician (anesthetist). For each anesthesia procedure, the anesthesiologist must complete the required services themselves.
Medical Supervised Practices: Occurs when an anesthesiologist is involved with over five simultaneous anesthesia procedures. Supervision can also occur when the required services under medical direction are not executed by an anesthesiologist.
Your level of comfortability and interest in medically directing or supervising CRNAs and/or AAs is important to determine if a practice is the right fit for you. If you are CRNA or AA, understand your level of desired autonomy within a practice.
Learn more about medical direction vs. medical supervision from the American Society of Anesthesiologists.
8. Are the anesthesiologists and anesthetists supported by anesthesia techs?
Anesthesiologist technician or technologist support the anesthesia physicians, CRNAs, AAs and practice by performing a wide variety of tasks before, during and after surgery, dependent on the individual’s credentials. Anesthesia technologists work directly with the anesthesiologists or CRNA to monitor or operate equipment for intravenous (IV) or gas anesthesia. Anesthesia technicians, and in some cases technologists, help prepare, gather, and clean the equipment and all other supplies needed to administer anesthesia to patients prior to surgery and after surgery. Anesthesia techs may also be responsible for managing inventory and ordering supplies.
If a practice you’re interviewing with doesn’t have an anesthesia technologist or technician, ask how this will impact your role, responsibilities, and daily schedule.
Learn more about the anesthesia tech role and responsibilities here.
9. Does the group provide malpractice insurance for this anesthesiologist job opportunity? If so, what are the coverage limits?
There are two different types of liability policies on the market today – occurrence and claims made. It is important to know which policy is offered, what it means and what limitations are present. The difference between the two types can best be described by giving an example.
The occurrence policy provides protection through the insurance company that insured you at the time of the incident and must defend you and pay any judgment against you, up to the amount of coverage you purchased, even though the policy may no longer be in effect.
A claims-made policy requires you not only have a policy in effect when the incident or accident occurs, but also later when you are sued for the accident or incident. If you are not insured with the insurance company when the suit is actually brought against you, you will not have any protection from the policy. As long as you continue to renew your claims-made policy with the same company, it is obligated to defend you for claims arising from incidents that have taken place while you have been insured with the company.
When you cancel or non-renew a claims-made policy, you must buy tail coverage, which provides coverage for the tail of claims made against you later for things you did while you were insured with the company. Tail coverage is referred to as Extended Coverage, Extended Reporting Period or Extended Reporting Endorsement.
Learn more about the differences between claims-made and occurrence policies here. If you are uncertain about any of the information provided by the organization you are interviewing with, ask to speak with the malpractice team or coverage provider.
10. How is vacation coverage handled?
Each practice varies in how they manage vacation time. Some positions utilize models which have built in time off throughout the year while others will offer you a set number of weeks pending on your status and how frequently you work. It is also important to note 1099 positions have different policies and obligations in providing vacation time versus W2 employees. This question will go hand-in-hand with questions about scheduling flexibility and expectations.
11. Do you utilize non-compete clauses?
Non-competes are important to look into as they can hinder your ability to earn additional income from groups outside of the one you are presently with or prevent you from working at the present location if the facility decides to switch groups. If you are interviewing with a group which has non-compete clauses within their agreements, you may want to ask for more details about the parameters of the non-compete clause.
Some non-competes can also restrict you from working at a neighboring hospital or any hospital outside of their group for a certain amount of time. If you are looking to explore additional opportunities or committed to a certain location/facility, you will definitely want to know the ins and outs of the clause and any limitations it may have.
12. What is the compensation structure? Do you offer an incentive for efficiency and/or quality?
Understanding the group’s compensation structure will help set one practice apart from the others pending your expectations. This could vary across the board as some groups pay per hour, shift, or month salary. This is usually determined by the type of employment model used by the organization (1099 or W2). Independent contractor (or 1099) models usually promote hourly or shift pay while W2 models promote a monthly salary.
On top of your monthly earnings some practices will offer incentives for productivity/quality. These metrics usually are based on your team’s collective efforts and encourage the group to work cohesively together. They are usually outlined in the contract and/or offer letter for review.
Before You Accept
Before moving forward with accepting an anesthesiologist job offer, ask to see a sample contract. Read through to be sure you are aware of all the clauses, conditions and obligations under the contract. The best practices utilize physician-friendly contracts that are short and easy to understand rather than bombarding physicians with lengthy documents that aim to confuse.