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 Do They Really Need You?

As a resident or recently trained physician, you have probably received numerous solicitations from various parties trying to recruit you to a practice opportunity. As you review these offers, you should ask yourself a key question—is this an opportunity where my skills are truly required?

As you consider various practice opportunities, how can you tell if you are truly needed in a particular practice or community?

This is an increasingly important question for any physician testing the employment market to ask. Why? Because the physician practice model is shifting once again. This time it's shifting toward hospital employment of physicians and away from smaller, independent practices. If current trends continue, chances are that you will be employed by a hospital or medical group. In either case, a hospital will probably recruit you and you will likely receive a salary or an income guarantee for the first year or two. After that, much of your income will be based on your production, which will be generally measured by how many patients you see.

Even in your first year, production may be an important part of any bonus you receive. Of course, if you are receiving an income guarantee, then the number of patients you see will directly determine your ability to "earn back" the guaranteed amount (for more information on income guarantees see the "Contracts" section in our Resource Library.)

In other words, it will be important wherever you go that you have enough patients to sustain a viable practice. Unless you are working on a straight salary, as you might in a staff model HMO, whether you are "needed" in a new practice will matter as much as whether you are "wanted."

And it's not just a matter of securing a viable practice. The federal government has various regulations regarding the types of recruiting incentives hospitals can offer to physicians and the types of incentives physicians can accept. In many cases, hospitals have to demonstrate that they are recruiting to fill a true community need for a physician, rather than merely competing with the hospital down the street. Physicians should feel comfortable that they are being recruited in a manner consistent with the law. For more information on federal physician recruiting regulations see "Complying with Recruiting Regulations."

Last, but not least, are the political implications of "being needed." You will be joining an established medical community, and whether or not you are accepted may depend on the extent to which a new physician in your specialty is needed. Rarely are established physicians unanimous in their support of recruitment, but in some cases they are more supportive than others. Regardless, it's good to know where you stand.

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