Nephrology Candidate Interview Strategies Presented by DaVita SOURCE

Interviewing for a job you hope to turn into a career while you’re also trying to balance your fellowship studies can be intimidating. The DaVita SOURCE team is here to provide guidance and advice that makes this big step more manageable.

Blog Post: Your Guide to a Successful Phone Interview
Blog Post: Navigating the On-Site Interview

Having made up your mind on what your requirements are prior to even thinking about setting up an interview can help to focus your search. Be sure you have viewed our blog post The most successful interviews happen when you are prepared. At this point in the job search process you have have some clarity on where you want to live, the type of structure you want to practice in, and where your long-term financial goals are. When making a decision about your future, it often comes down to those three things. Knowing your priorities can help you focus on the right jobs. If you have not thought much about this yet, check out our blog post on the Needs vs Wants Checklist.

The telephone interview is meant to be exploratory, allowing both parties to provide some high-level details about each other and the opportunity. This interaction assists both parties in determining whether an in-person interview is the right next step. It is okay to decline an in-person interview if you do not think the opportunity is right for you. Your time, as well as the practices, is very valuable. Invest in opportunities you could really see yourself being part of.

The interviewer will generally coordinate a time to call you via email or text. Be sure to allow at least one hour for the call. Make sure you are able to be in a location with adequate phone service. As you likely know, the hospital can have terrible reception. Have your CV available to reference and your calendar for the coming month so you can look at viable dates for an in-person interview if needed. However, be prepared for the interviewer to contact you without scheduling a call. It is acceptable to ask to reschedule if you are not prepared or not in a position to take the call.

The in-person interview is an opportunity for both parties to highlight their attributes and assess long-term goals and fit. This is the appropriate time to dive deeper into the details of the practice and share why you are the best physician for the position.
In most interviews, the practice will cover important information, such as:

  • Patient volume
  • Demonstration of need – why they are hiring
  • Call Schedule
  • Relationships with hospitals and referring physicians
  • Compensation/benefits
  • Partnership
    • How long it takes to be a partner
    • What is expected of you to become a partner
    • How will you benefit from being a partner
    • Do you have to buy-in
  • General financial information

Let’s drill down a little more on why the above information is important. Patient volume will give you a general idea on how busy the practice is, if there are enough business to support a new physician and the overall scope of practice covered. Understanding why they are hiring is important. If it is to replace a retiring physician that is good. This means people are staying with the group long-term. If it is because someone is leaving for other reasons you will want to know why. It could be a red flag, but not always. People move for family, spouse jobs, etc. The other reason practices hire is that the growth of patient needs exceeds what the current physicians can handle. Call schedule is obvious but we will share more details later in this article on what to ask and why.

Perception of a practice/physician in the community in terms of reputation as individuals and patient care is often demonstrated by the relationships with hospitals and referring physicians. This is what keeps them busy. Hang your hat on a group with a good reputation. A bad one will automatically attach itself to you.

Financials are always a touchy subject. We will talk more in-depth about that later. It is important to understand how you are paid, how much you are paid and what benefits you have. It is equally important to know the financial health of the practice you join. You will be assuming their debt and/or assets when you become a partner.

Saving the best for last, partnership. It is like a marriage so you want to make sure you are committing to the right people and clearly understand the path to get there and the benefit in doing so.

Compensation is a touchy subject. The truth is no one wants to talk about it but everyone wants and needs to know compensation information.

During your interview, the interviewer should bring up the subject of money. If you are working with DaVita SOURCE, we may already know the starting salary and have a good idea what the market rate is in the area. Below are some additional tips about how to handle the compensation conversation:

  • If asked your salary expectation and you are not familiar with the starting salary, here is a sample response: “My focus has been on the long-term potential and I do not have a specific number in mind. However, I do expect a fair salary that is competitive with the market. Can you provide more detail on your group’s compensation and benefit structure?”
  • Avoid trying to negotiate a salary until you have an offer on the table and are able to assess the entire compensation and benefits package. Negotiating without an offer could lead to no offer at all. Additionally, you could be arguing away other benefits that you are not aware of in lieu of a higher salary.
  • Look at the long-term as well as the short-term income potential. First year guarantees are impressive, but what really matters is what you can expect to earn in five years and beyond – both financially and otherwise (i.e. partnership, etc.)
  • The best way to measure the value of an offer is net benefit. Simply put, net benefit is the economic benefit you receive, factoring in all sources of income, the value of benefits paid for by the practice, and the cost of living in the are. Remember to include state and local taxes in the analysis as some states do not have personal income taxes. An income of $160,000 goes a lot further in Des Moines, Iowa than in San Diego, California.

The financial health of the practice is important if you are intending to make a long-term commitment to a private practice. How so? There are many financial aspects of a practice that matter to your bottom line as a partner.

Overhead Expenses – what does it cost to run the practice? A few examples:

  • Office monthly rent
  • Utilities
  • Staff salaries and benefits
  • EMR monthly lease
  • Answering service
  • Cellular phone charges
  • Internet

Billing and collections – technically this is part of overhead expense but we are breaking it out because there are so many things to consider, here are a few to think about:

  • Does your billing company charge a flat rate or a percentage of collected revenue?
  • What is their collection rate? Why does this matter?
    • If they only collect 80% of revenue billed then you are only earning 80 cents on every dollar earned. Not a big deal if your revenue billed is a dollar but what if its $500k and you are leaving $100k on the table?
    • How do they handle denied claims?
      • Are they reworked?
      • What percentage are not handled and collected on? The national average is 5.1%1.

Debt and assets matter too. When you become a partner, you may assume debt the practice has already agreed to such as a new EMR system, additional staffing, investments or the buy-out clause for senior partners. However, there is often assets you can benefit from, such as medical directorship opportunities and revenue, investments or a patient revenue stream not factored into your earnings until you became partner.

1 The Physician Billing Process, Navigating Potholes on the Road to Getting Paid – 3rd Edition, Deborah Walker Keegan, PhD, FACMPE, Elizabeth W. Woodcock, MBA, FACMPE, CPC

The definition of being a partner in a practice can vary. In most cases, it means you share ownership in the entity or the practice, the name and goodwill it represents, as well as your equal share of the lobby and office furniture. You also own the debt, the decision-making and the administrative burdens. Additionally, you may benefit from other items such as, medical directorship opportunities and revenue, the opportunity to invest in real estate or dialysis centers and the revenue from an existing patient base.

Understanding the potential impact to you personally, professionally and financially in being a partner and the path to achieve it are very important.

Every interview is different and every employer wants to know different things. Below is a list of questions that are commonly asked in either the phone interview, on site interview, or both. Giving some thought to how you will answer those questions will give you confidence and poise under fire.

  • Tell me about yourself.
  • Why are you looking for a new job?
  • Why are you considering this practice?
  • Where do you see yourself in five years?
  • Why should we hire you?
  • Why do you want to work with us?
  • Why would you want to live here?
  • Why did you choose to go into medicine?
  • Why did you choose your medical school?

If the interviewer does not ask the right questions to bring out your interest and expertise, be sure to tell them. Do not complete the interview without letting them know who you are and why you want the job.

During your interview, remember that this is not intended to be a one-way conversation. A good way to express your interest in the opportunity and learn everything you need to know is to prepare a few good questions in advance.

You should carefully frame your questions to elicit the information you want to know when considering if the job is right for you. Write them down and to take them with you on the interview so you don’t forget them. Make sure that your questions are specific to the practice so they can see you have done your research ahead of time. Having questions prepared will help ease stress during the interview and will impress your interviewer. Below are a few suggestions that may help you when creating your list of questions for the interview, organized by topic:

  • History
    • Tell me about the history of the practice
    • How many people have left the group? Why?
    • Has anyone not made partner? Why?
  • Why are they hiring and what are are they looking for?
    • How did this opportunity with your practice become available?
    • What are your expectations for the new physician?
  • Practice volume – how will you know they have enough business to hire you or that you can build a practice from?
    • What is average inpatient census at the hospital?
    • How big is your CKD patient pool?
    • How many ESRD patients do you have?
    • How many new office consults do you get each week?
    • What is your non-urgent patient wait times to see someone in the office?
    • How many hospitals, LTAC’s and dialysis centers do you cover?
  • Practice structure
    •  Can you give me an example of your typical day? Are the other physicians set up the same?
    • Does each physician create their own schedule or do you have weekly rotations? i.e. one person/one week in the hospital only, one person outpatient only….etc.
    • What does the call look like?
    • How does your group make decisions about the business?
    • Do you have satellite offices? If so, how is the scheduling for that decided?
  • How will they support your success?
    • If I was to join, how will the new office consults be handled?
    • What support would you provide me to ensure my success in the group? (Marketing, referral introductions, new consults, patients from a retiring physician)
  • Compensation/Partnership
    • Can you provide me with an overview of the compensation package and benefits?
    • What can I expect to make as a partner after a few years?
    • What are the benefits to being a partner?
    • Is there a buy-in? If so, how was that value determined?
    • How are medical directorships handled?
    • Are there opportunities for investments in real estate or dialysis centers?
    • How do I become a partner?
    • What are the requirements to become a partner?
  • Business – a practice is a business and you will need to know the health of the group. Not all practices will share this information. You can assess their openness during the interview and determine which questions might be most appropriate.
    • Who manages the billing and collections?
      • Will I be able to monitor my productivity through reports from them?
      • Do they handle denied claims for each physician? Not managing this properly means you may not be compensated for some of your work.
    • Do you mind sharing with me what percentage of income goes to overhead expenses?
  • Other
    • Why did you join this practice?
    • What do you think the strengths are of the group?
    • Where do you see the practice in 5 years?
      • How do you plan to achieve these goals?

The answers to these questions are valuable to you when making a decision about your future practice. If you have been working with DaVita SOURCE we should have the answers for you with regard to a specific practice prior to scheduling an interview. If you are navigating your job search independent of us then you may consider these questions when you head out to your interview.

  • Be yourself – The interviewer’s goal of the interview is to determine if you are a good fit for the role and the practice. Compatibility can only be determined if you are true to yourself.
  • Be open – You need to get to know one another, so share your thoughts with the interviewer.
  • Tell them what you can do for them – Nothing turns an interviewer off faster than a “what’s in it for me” attitude.
  • Provide feedback – They need to know how you feel as well as how you think.
  • Do not be afraid to express your concerns.
  • Tell them what you like about the practice, location, and people. It takes a lot of work to arrange a good interview, so do not be shy about showing appreciation
  • If you want the job, say so! Given two equally qualified candidates, an interviewer will make an offer to the one who shows enthusiasm for the position and a willingness to make a decision. End your conversations by saying something like, “Thank you for taking the time to meet with me. This is the type of practice I’m interested in..”
  • Be prepared to make a timely decision – Just as you want to know as quickly as possible if you are going to receive an offer, the interviewer also needs to know where you stand. It is best to respond to an offer from a practice within 7-10 days.
  • Be sure to send an email or personal thank you note to all of your interviewers.
  • ASK FOR THE JOB IF YOU WANT IT. We cannot stress this enough. If you want the position, close your interview by sharing your interest and enthusiasm.
  • If you are working with DaVita SOURCE, call your consultant as soon as possible. It will only take a few minutes and it is extremely important for us to know your reactions and confirm that the interview went well. This will allow us to follow up on your behalf and enhance your attractiveness to the practice. The practice will usually contact us to inquire about your feedback.