As studies show, it’s a physician’s market. When you are in demand, and there are more jobs than there are physicians, the competition for you is going to be vicious.

Whether you are completing a residency and getting ready to become an attending, or have been around for a while and looking for a change, beware. You are a hot commodity. If you’re sought after, believe me, there are going to be some shenanigans.

I’m sure you’ve bought a product that didn’t turn out to be what you expected. In that case, you simply return it for a refund.

Jobs are a little more complicated.

Don’t undersell yourself, your skills or your training. Employers need you, and there’s no reason to not at least ask for everything you want.

Here are six steps to prevent buyer’s remorse on that promising new job you were just offered.

1. If the job looks at all promising, review the contract ahead of time. Before making any verbal commitments, before looking for housing, before closing your search, review the contract, preferably with an attorney used to looking at physician employment agreements.
2. Verify any statement made by the employer. If you’re told something will be coming soon, ask when. If it’s there, but they can’t get to it that day, come back another day. If they say something is done a certain way, is it in the contract, or another document that can be changed without your consent? If a statement or promise is made, what will happen if that doesn’t come true? (If it’s important to you, make it a contract term.)
3. Ask current employees about their jobs. Not just the ones they arranged for you to meet, but the ones they don’t want you to meet. Search their directory, and call some other employees at random. Ask how they enjoy being employed there. And not just other physicians.
4. As you and your family consider a place to live, what’s your list of “can’t live withouts?” Maybe it’s a vegetable garden and fantastic shopping within an hour. If so, that eliminates a lot of places. But if you can live with one out of two, that broadens your choices. Not meeting any of your “can’t live withouts” will make your life miserable, regardless of how much you love your job.
5. How are you reimbursed? Not just the contractual basis – that’s covered under No. 1 – but how are decisions made, who makes adjustments, what is the real income opportunity (as opposed to what you’re promising under “ideal conditions”)? Ask for the range for similar positions, not just for the next year or two, and verify what you’re told (as mentioned in No. 2). If they use formulas to calculate future income, ask what percent of the employed physicians actually meet or exceed what you think you’ll be worth in 2-3 years.
6. Define the cultural as well as the contractual obligations. Contracts can’t (or shouldn’t) be broken, but culture can change quickly. A friendly look and feel can change if a new CEO comes on board. Don’t get sucked into a good culture without contract protection for departure, friendly or unfriendly. Be wary of the severance clause or non-compete clause (aka, restrictive covenant). If six months’ notice is required for a friendly departure, that can be a very long time. Don’t count on the terms of a non-compete clauses not being enforced. Legal review here is critical. There are always options that can be written into a contract, but they can’t always be exercised if they exist only as promises.

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