Issue 510

Subscribers: 21,846

Jan 24, 2023

Practice Perfect 846
Some Thoughts on the Job Search
(Or Why You Should Create a Portfolio)

  Jarrod Shapiro, DPM, FACFAS, FACPM, FFPM, RCPS Glasg

PRACTICE PERFECT   January 24, 2023

If you’re a podiatric resident graduating this year, then this one is for you! As I’m writing this, it’s the latter end of January, and this is the time the search can get intense. As someone who’s been in practice for almost two decades, I’ve seen a number of doctors come and go from several different positions. To try to help those who haven’t yet found a position, here are some mediations on the job search.

First, if you haven’t found a job yet, you should be starting to feel the pressure. If you haven’t begun looking for a job, what are waiting for? Between finding a reasonable employer, contracts, negotiations, and relocating, the process can take a lot of time. Also, despite the large need for podiatrists due to the aging population, many cities are saturated, and you might find yourself competing against several applications. You should expect that some of the highest paying jobs with large organizations will have a good number of applicants.

Second, when looking for a job, location is important, but it is not the primary indicator of a satisfying position. Consider instead the quality of the job itself and your potential for satisfaction as the number one factor and location second. I know this sounds like I’m asking you to move away from your family or a region of the country where you’ve wanted to live. Think about it this way: you’re going to spend all of your professional career and much of your weekly time at work. If you’re unhappy with the job, how important is it if you can go snowboarding on the weekends?

Next, realize that no matter what program you’re training at, how much experience you have, or how many surgical cases you’ve done, this will not translate into everyone knocking down your door to hire you. Every entity looking to hire a new podiatrist will have their own needs, and instead of thinking they will change their business to hire you as the end all be all of podiatry, you have to think instead about fitting yourself into what they need and/or showing them that you bring something different. Let’s consider a few examples.

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If you’re planning to enter private practice as an associate to an organization, consider what they need. They will want someone well trained who is able to handle a busy clinic, give great customer service (yes, medicine is a service industry), help patients, and, here it comes, at the end of all that, bring in income. That is, you have to be able to get paid for your services. In the United States, that means knowing how to code properly for those services. You must know ICD-10 and CPT coding. Can you properly bill evaluation and management codes, procedure codes, and apply proper modifiers? Do you know the proper wording to put into your chart notes so as not to have to repay your reimbursement if you get audited?

If the answer to those questions is “I’m not sure” or “no”, then get trained now! ACFAS holds a surgical training course and ACPM publishes a coding textbook. I’ll bet you have attendings in private practice. Follow them in the office whenever possible and learn. Ask a lot of questions. Often, the staff can teach you as much as the doctor about best coding and billing practices. Take other courses. Thinking of this from the hiring practice’s standpoint, if I as your boss must take my time to train you on how to code and bill, then you are no longer worth as much to me, and I will want to pay you less to compensate for the extra work I will have to do to get you up to speed.

What else do potential employers want in new hires? They want an absence of ego. They don’t want to hire a prima donna who thinks they’re the best thing ever. They don’t want a doctor who hides their lack of confidence behind false bravado. They want someone who will work hard, not complain about little frustrations, work independently and confidently without wasting a bunch of time on nonsense, and spend as much time as they can marketing the practice. And they do not want drama. Running a practice is already hard; the last thing a physician wants is someone that disrupts the function of the office.

Of course, everyone wants to see a well-trained physician and surgeon who can handle themselves independently in the operating room and clinic and achieve great outcomes. If you’re being hired as a surgical podiatrist in an organization such as Kaiser Permanente, this will be very important. However, even surgical podiatrists spend a lot of time in the clinic. Can you see a lot of patients without being overwhelmed?


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How can you show that you are the person they should hire? Most of the time being hired into an organization occurs by some combination of verbal review (AKA interview), recommendations from those who’ve worked with you, and possibly some kind of basic demonstration. My suggestion is to actively exceed the possible expectations of those who will be interviewing you by concretely demonstrating your knowledge, skills, and behaviors. Don’t say it; show it. Here’s how to do that.

Create a Portfolio

If I were hiring an associate for a podiatric practice, I would ask for a written portfolio that shows me what he or she is capable of doing, what they know, and the administrative skills they have that make them a perfect fit for my organization.

This portfolio would include concrete examples of past actions and behaviors proving that you are the best candidate. Let’s break this portfolio up to see what you could present.

Knowledge - Include your In-Training examination scores showing your knowledge base compared with your contemporaries. Don’t forget to add in your podiatry school transcripts and any clinical examination scores you might have gotten during residency. Did you receive training in billing, coding, and practice management? Include it. Include specific examples of cases you’ve billed (without violating HIPPA) and be ready to discuss them in detail.

Skills - Include clinical logs showing the thousands of patients you’ve seen and the variable pathologies you’ve treated. Show a number of surgical cases you’ve done that clearly exemplify your qualities as a surgeon, including basic patient information and pre- and postop radiographs. Yes, you had an attending for those cases, but this would be an opportunity to demonstrate what you did during training. If you did a fellowship, which is usually a bit more independent, this is a chance to show your extra training. If you had clinical skills examinations as a resident, include those as well. Include your surgical logs and your MAV reports. Since thinking and writing are skills, include any papers you wrote during podiatry school and residency. Showing the extra work you did, above and beyond the minimum also demonstrates a strong work ethic.

Behaviors - You must show you’re going to be a leader, an independent doctor who can work with the staff and your new boss in a mutually beneficial relationship. Include rotation evaluations from residency, your biannual performance reviews, and anything else that describes your strong work ethic and administrative skills. Were you the chief resident? Show proof of this but also make it clear what you did as chief to improve the program. Did you start new educational programs for your coresidents? Did you create the schedules and deal with resident issues? Clearly demonstrate that your past actions demonstrate your strength as a candidate.

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It’s not enough to say you’re a hard worker who is ethical and motivated, and you’re going to do a great job. Words are meaningless in these situations since anyone can say anything. Instead, demonstrate from your actions that you’re all of these wonderful characteristics. Anticipate the questions of your interviewers and include them in the portfolio. The less uncertainty I can experience during your interview, the more likely I am to hire you, and a portfolio is a great way to eliminate that uncertainty.

Best wishes on your job search.

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]


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