“In case you haven’t heard….There are No Anesthesia Providers Available.”

That title and many like it have graced the ASA newsletter over the last year or so.  The shortage of quality anesthesia providers is at its highest level in 10 years.  For the hospitals, surgical centers and groups that employ Anesthesiologists, this is the worst job market they have seen in a decade.  For Anesthesiologists looking for jobs, that’s a different matter altogether.

Consider the supply and demand

We all learned a long time ago in the school cafeteria at lunchtime the basic rules of supply and demand.  If a friend had something that you wanted and he was the only one who had it, then you were going to have to give up a lot to get it.  As adults, we understand that those rules have not changed any.

Today, as a practicing Anesthesiologist you are in great demand.  Sometimes, though, being in demand isn’t the same as being able to name your price.  Many times I receive calls from candidates who at first blush should have a plethora of job offers at top-notch rates to decide between; yet they are asking me this one question:  “Why can’t I find a job?”

Some physicians’ stories

Take John for example.  He is an Anesthesiologist coming fresh out of residency.  John approached us like most residents.  He wanted to know what his options were.  He had heard the job market was great, and a lot of his friends had received job offers of over $200,000.  John had been looking for over a year and had received a number of job offers but none for over $150,000.  He was confused and hoped I had some answers for him.  In his own mind, he had as good, if not better, credentials as some of his friends did.  Furthermore, he was personable and had great references.  But he continually wondered, “Why can’t I find a job as good as what my colleagues have been offered?”

Once we started talking, the cause of his problems became very apparent.  John’s colleagues had been looking in areas of the country less affected by managed care.  The practices they were considering also had smaller groups and longer work hours—with plenty of call.  John, on the other hand, wanted to move to more suburban areas.  Unfortunately, the areas he wanted to go to all had high managed-care penetration and thus lower reimbursements.  Also, John did not want to take a lot of call and was not willing to do any weekends.  Put all of those things together.  Even though John’s credentials may have been excellent, his demands for location and schedule made him a less desirable candidate for many practices.

Now let’s talk about a more extreme example.  Richard came to me with 25 years of experience.  He was extremely confident in his abilities as an Anesthesiologist.  He had trained at an Ivy League school, done his residency at a prestigious hospital up North, and was a partner in a very lucrative group in the area. 

His wife, however, was from the South and her parents were ailing.  Richard had agreed to try to find a position in the Southeast so that they could be closer to her family.  He had been searching for a job for over two years and didn’t have one offer to show for it.  She was growing impatient with him, and that’s when he decided to solicit the help of a recruiting firm.  He was frustrated and confused, and also asked, “Why can’t I find a job?”

When I began to question Richard about what his requirements were for a new job, this is what he told me:

• A major metropolitan area in the Southeast
• A base salary in excess of $350,000
• Immediate partnership.

He would not be willing to consider a practice with a large amount of call, if any.  According to him, he had “paid his dues” at his last practice and didn’t think he needed to do so again.

That completed, I asked him one question.  “If someone came to your group and voiced the same requirements you told me, would you hire them?”

His response, after he thought about it for a minute or two, was, “No, of course not.”

My reply to him was, “That is why you don’t have a job yet.  You need to hold yourself to the same standard that you would hold someone applying to your group.  If you are serious about relocating, then you are going to have to be willing to take a step back.”

Lessons to learn

These are wonderful examples of candidates who apparently should not have any difficulty finding a suitable position, but who are, nevertheless, unable to find a job they really like.

What should they do to improve their chances to secure suitable employment?  The basics of a good job search are not different in a good market than they are in a poor one.  Think of them in terms of the Five P’s:  “Prior Planning Prevents Poor Performance.”  Here is a good basic plan for conducting a job search.  

1.  For those of you who have purchased a home before, this should sound familiar.  Start with a list that has three columns.  Column one:  must-have items.  Column two:  like-to-have items.  Column three:  probably can’t-have items.

2.  Now is the most crucial part.  Look at the columns and decide how realistic the list items are.  Do you want immediate partnership?  (Would your practice grant immediate partnership?)   Do you only want a job with no call?  (Would you hire someone who didn’t want to take call?)  Adjust your list accordingly.  Evaluate what you want by the same criteria you would use if someone with similar demands approached you about joining your group. 

3.  Next, take a critical look at your CV.  Is this an accurate representation of who you are?  Does the information jump off the pages and make someone want to call you?  The best resource you have to help you with this is an experienced recruiter.  Give one a call and ask for some help with your CV.

4.  Decide where you want to go and why you want to go there.  One of the first questions any practice is going to ask you is why you want to move to the area.  If you don’t have a good answer to this basic question, it will likely put you far down their list of desirable candidates.

5.  Call your references and ask them what they are going to say about you.  It never hurts to refresh their minds on some of your more outstanding accomplishments.  Plus, it’s good to be prepared to offer an explanation for something less than totally positive that might surface during reference checking.

Once you have done the above and identified a position that you are interested in, make sure to put your best foot forward.  I can’t tell you how many qualified candidates lose the job of their dreams because they appear too confident in an interview.  Remember, you may be in demand but no group wants to hire anyone who has an over-inflated ego.  Do some mock interviews with colleagues to help master your interviewing skills.

Above all, be open-minded.  Many people pigeonhole themselves into locations, practice types, size of groups, etc. to their own detriment.  Every group has plusses and minuses.  By showing yourself to be open-minded, you will stand a better change of finding your ideal practice.

Lastly and most importantly, be realistic.  If you look at what you are demanding and if someone approached you with those same demands and you would not hire them……It’s time to re-think what your demands are.