Setting yourself up for site visit success

If you’ve been offered the opportunity to be interviewed on-site at a hospital or practice, congratulations!

Not only have you made it one step further in your job search but also you’ve also reached a critical turning point. The job-site visit is the point at which hospitals and practice administrators have decided you may be a fit for the position they are trying to fill.

No longer are they trying to screen you out, as previous phone conversations, requests for your CV and emails were designed to do. Now they are trying to screen you in—to entice you to consider joining their team.

The site visit is the point at which the hiring power shifts subtly from the healthcare organization to you, the physician. That doesn’t mean you’re a shoo-in guaranteed a contract, but to be invited to interview in person does mean you’re closer to an offer.

Now it’s time to decide if you want one. Is this job right for you? Is this community one in which your family would thrive? Is this a good move for your desired lifestyle? Those are all important questions to be asking yourself as you embark on a job-site visit.

How to get invited for a site visit

A site visit is really just a fancy term for an in-person interview that happens on location at a healthcare facility rather than via video or phone.

To offer you such a visit, the recruiter or hiring physician has to have decided that you could be a valuable addition to their team. To get to this point, the following things have likely already occurred:

• You’ve submitted your CV in response to a job posting, or you’ve sent it to a recruiter who had reached out to you regarding a specific position.
• The recruiter has interviewed you by phone to prescreen you for the hospital or practice.
• You’ve had a phone or video interview with an administrator or a lead physician so that he or she could assess whether you would be a good fit for the position.

If, after talking to an administrator, you sound as though you would be a good match, it is likely you will be invited to interview in person on-site, explains Justin Sharpe, physician recruiter at Tallahassee Memorial HealthCare in Tallahassee, Florida.

Out-of-town interviews are common for site visits because “the vast majority of people post-residency are relocating,” says emergency medicine physician Matthew Krauthamer, D.O., national medical director of special operations of the East Group of TeamHealth.

The first site visit usually lasts one day and consists of three to five hours of interviews plus dinner, he explains. A second site visit may not be needed for a staff position but is typical for a leadership position.

Making a positive impression during your site visit

Because most of the major career questions will have been asked and answered before you touch down at a potential employer’s facility, the first day or two on-site will be your opportunity to make a positive impression overall. “

We know they’re clinically sound [at that point],” Sharpe says of prospective hires, “so now we’re checking more for a team and location fit.” During the site visit you should be asking yourself, “Can I see myself here?” Your potential employer should be asking the same thing.

To help answer this question, Sharpe pays a lot of attention to a candidate’s demeanor and personality. But he doesn’t want to spend time getting to know a persona you’ve created to match what you think they’re looking for, so be yourself. That’s critical.

Do be aware, however, that you are being evaluated. “Be on point from the moment you step off the plane,” recommends Sharpe. Dress professionally and show confidence as you interact with potential colleagues.

Sharpe also looks for social skills. “Do men open the door for women, or do they let people exit the elevator before getting on?” he asks. Nuances like these indicate the candidate’s social awareness.

Questions to ask during your site visit

A site visit provides the perfect opportunity to ask numerous questions about an opportunity. Some of the most important questions the physicians interviewed for this article asked themselves and others include:

• Do I see the ability to grow as a professional within this role?
• Are there opportunities to progress in my career here, or will I need to go elsewhere?
• What are the salary and benefits typical for this position? (Najm suggests international physicians ask how U.S. taxes impact total compensation.)
• What retention plans are in place to encourage top talent to stay long-term?
• How safe is the area?
• What neighborhoods are popular places for physicians to live?
• What schools are in the area? Do most children attend public or private school?
• What is the weather like? For cold weather climates, is the city well-equipped to handle snow and ice?
• How does the organization define full-time equivalent (FTE)?
• What is the average length of employment, and how much turnover does the organization have?
• What are the challenges that the medical director might see for me?
• What qualities would the ideal candidate for this position have—and what would that physician be expected to achieve in the role? (Krishnaswami says this is her go-to question. Whether the responses resemble you will reveal a lot.)

In addition to asking questions of the recruiter, request to speak with one of the organization’s current physicians. You can learn a lot from a candid conversation about another provider’s transition into the organization.

Though spouses often accompany physicians on site visits, maintain the appropriate level of involvement. Though rare, there have been cases in which spouses have dominated meetings or taken over casual dinners, peppering hosts with question after question.

That’s not the way to make a good impression. That said, recruiters are certainly aware of how integral spouses are in decision-making. “The saying goes, ‘You get the spouse, you get the physician,’” says Sharpe.

Use your visit time wisely

“Use your time wisely,” adds Sharpe, who suggests scheduling time to visit local resources that would be important to you and asking the recruiter to help connect you.

That might mean taking a look at real estate, meeting with local school administrators, checking out fitness clubs or running groups or visiting any other places of particular interest. “You only have so much time, so use it,” he says.

Tallahassee Memorial typically includes two site visits as part of the interview process. The first is generally filled with interviews and colleague discussions, as well as a community tour to help the candidate get a feel for the city. The second is used to introduce a partner or spouse to the area or to do some house-hunting.

“After the first visit, candidates will generally know if they’ll be made an offer,” says Sharpe, “but we try to get to 90 percent agreement before [bringing the candidate] back a second time. That way we are less likely to spend additional time and effort with a candidate who is not seriously considering joining our team.”

Your visit should be paid for

Site visits are effectively all-expenses-paid. The organization that is interviewing you should cover everything from airfare to hotel costs, meals, a car rental and even activities for kids who come along, says Sharpe. “We try to ensure the doctor doesn’t have to pay out of pocket for anything. We want them focused on the job and getting to know the location.”

Paying for such trips is expensive, admits Sharpe, who estimates that the average site visit costs a hospital roughly $3,000. “It’s an investment on our part,” he says, but it’s one hospitals and practices are happy to make for a chance to land a strong addition to their team.

What happens after the site visit

Though the time between a site visit and a signed contract varies greatly from case to case, Hani Najm, M.D., suspects the total time it took to bring him on board at his current position may be among the longest.

Najm, who is chair of pediatric and congenital heart surgery at Cleveland Clinic in Ohio, had no plans to leave the successful pediatric cardiology practice he had built from scratch in Riyadh, Saudi Arabia. He had said he would leave his practice only if he retired or if he received the offer of a lifetime.

Then Cleveland Clinic Children’s Hospital approached him about leading a new congenital heart program.

The hospital reached out in November 2013 to gauge whether he would even consider a move to head the new program. They had a phone conversation that got Najm thinking. The move “would add a lot to my career, put me at the next level of achievement,” he says.

So in January 2014, Najm traveled to Cleveland and spent four days there. On this initial visit, Najm toured the clinic, became familiar with the facility’s infrastructure, and saw firsthand how employees are taken care of.

Cleveland Clinic had assigned a staff member from the office of recruitment to assist Najm during his stay. “He got all my questions answered, found a realtor to show me the schools and neighborhoods,” says Najm. Having that one point of contact proved very helpful.

During the first visit, Najm’s priority was to see and spend time where he might work. But he also toured the suburbs, looked at schools his children might attend and explored areas just outside the city where he could bike.

He returned to Saudi Arabia seriously considering a move. There were roadblocks, however—including finding someone to take over his practice in Riyadh and securing work for his wife in the U.S.

It took several months, but by August 2014 Najm was ready to return for a second site visit, this time with his family. He stayed a full month as a visiting surgeon with all the privileges of an employed surgeon. Cleveland Clinic had arranged for a work visa and an Ohio medical license so he could get a taste of what life would be like there.

“They made me feel that they were not just trying to hire me, but that their intent was to transform the pediatric cardiac care program. They wanted me to succeed,” he says.

He returned to Saudi Arabia impressed with what he had seen. His wife had also fit well, so she was in favor of the move. In March 2015 they finally made the decision to accept the offer.

In November of the same year, after he had accepted the new position but before his family moved, Najm made a third site visit, which lasted five days. That time allowed him to complete all his employment paperwork and make housing arrangements for his family. “That last visit made the start at the Clinic easy,” he says. In January 2016 he officially started work.

How to narrow down your choices

Though Najm wasn’t looking for a new role when he was approached by Cleveland Clinic, Ryan Lawless, M.D., found his job after conducting a thorough search. An attending in Houston at the time, he and his family had decided it was time to start looking for a new position.

At the start of his search, Lawless and his wife made a list of geographic regions they thought would be a fit for them. All of the cities had to have a major sports team—bonus points if it was Major League Baseball—a good public school system and a reasonable cost of living.

Once his geographic list was developed, Lawless asked his mentors if they would send reference emails to their colleagues at hospitals in his desired areas. He also began his own searches online, and while he was at conferences, he took the opportunity to network with physicians from some of the facilities on his short list.

As a result of these efforts, Lawless was asked to submit his CV to a number of hospitals. He then narrowed his options to five, all of which he was invited to visit. Before traveling, however, he did a considerable amount of research to get to know each hospital. He wanted to be sure it was a potential fit before investing the travel time.

Lawless says that during his time on-site at each of the five hospitals, he tried to get a sense of two main things: the atmosphere of the hospital and the busyness of the trauma center.

To gauge how friendly a facility was, he took notice of what the physicians were doing—whether they were talking to each other and whether office doors were open, for example. He was used to a busy trauma center and knew that he wanted something similar, but finding one was a challenge. He had to be close enough to a major city to get the level of activity he was after and also close enough to a nice area for his family to live.

His wife, Stephanie, accompanied him on all second site visits (he had four), which are a bigger deal than the first, Lawless says. “That’s when you talk about salary and benefits and bring your spouse.”

Thanks to his successful and informative site visits, today Lawless is a trauma and acute care surgeon at the Denver Health Medical Center, as well as an assistant professor of surgery at the University of Colorado School of Medicine.

Good preparation matters

Janani Krishnaswami, M.D., MPH, would have been as proactive in her job search as Lawless was—had she been sure a position in her specialty of preventive medicine even existed.

Trained in internal medicine and preventive medicine, Krishnaswami ideally wanted a position that combined her interest in solving the root causes of diseases with her desire to teach and do community work. But she had resigned herself to taking a fully clinical primary care job with little opportunity for systems-level research when she says she “stumbled across a fellowship in community medicine in Los Angeles.”

This was a turning point for her and her career. Committed to continuing work in preventive medicine, Krishnaswami “aggressively” sought mentors at UCLA and Southern Cal to help her develop courses for students. She cold-called, she emailed, she networked liked crazy, and she found a mentor at UCLA.

Not long after she became an adjunct faculty member at UCLA and an associate program director of a new preventive medicine residency, Krishnaswami updated her LinkedIn profile to keep it current. Shortly after adding her new role, a recruiter reached out to her by email about a preventive medicine opening. “There aren’t many preventive medicine physicians in the U.S.,” she explains, “and I wasn’t looking for a position at that time.” She also wasn’t looking to leave L.A. But she did click on the link the recruiter sent and saw that it sounded like an ideal position for her.

Encouraged by her husband to at least consider it, Krishnaswami responded to the recruiter’s email about two months later, asking if the job was still available. It was.

They had a quick call, she sent him her CV, and he connected her with the dean in charge of the preventive medicine program at the University of Texas Rio Grande Valley for an informal phone interview. At the end of the call, she was told that the dean would love to have her come interview in person with the other physicians.

She was curious at this point and kept an open mind but “didn’t think the odds were good” that she would end up taking the position.

About three weeks later she and her husband traveled to Harlingen, Texas, to check out the opportunity. UTRGV flew her in to interview with about eight people involved with the program over a day and a half. “After the first day, I was exhausted,” she says.

She left feeling intrigued but still unsure she wanted to move. She was then invited back for a second round of on-site interviews, which included her giving a presentation at the Hidalgo County Health Department. During that presentation, she realized how well the opportunity matched her career interests and personal strengths.

At that point, she and her husband also knew she was pregnant, so they were considering what kind of community would be best for their family.

They spent more time driving around the area and visiting with potential colleagues. One physician invited them home to dinner, and Krishnaswami had the chance to ask his wife lots of questions about life in the small city, which was opposite L.A. in so many ways.

Krishnaswami ended up accepting the position and is now program director of the preventive medicine residency program at UTRGV.

By spending time on-site, Krishnaswami, Lawless and Najm were able to picture themselves in their new roles, get a feel for the organizational culture and ask many questions of recruiters, administrators and potential colleagues.

In the end, all three physicians landed jobs that were excellent fits for their career goals and families.