 Signed, sealed, and delivered, we are officially employed. Episode number three of Doc for Hire. Your doc is hired. Let's get into all of the updates. Hey friends, welcome back to channel. In case you're new here, my name is Lakshman, internal medicine resident and physician and now officially employed, attending internal medicine physicians. Feel so nice to say. If you're new to the channel, this is episode number three in my Doc for Hire series where I basically go through the entire process of looking for my first full-time job outside of residency. So if you haven't checked those out, you'll link those down below in case you're interested. As a quick synopsis in the very first episode, we're doing our first ever interview and talking about the process of preparing for that. And then episode number two, we've got not one, but two contract offers and talking about the entire process of how I got there as well as how I was going to make my decision going forward. But now we're in the exciting part where we are signed. Like we are officially employed by one of the groups in central Texas, where I'll be moving to in just a few months after finishing residency. So in today's episode, I really want to talk about how I made that decision, what type of things I had to think about when actually signing the contract, what's included in the contract, including money. But of course we have to talk about next steps because signing the contract feels really nice, but there's a lot of things between now and my first day as a full-time doctor. And before I get into how I made my decision, one of the questions from one of the last episodes was essentially what type of questions I was asked during my interviews and what kind of questions I asked on my interviews to my employers or future employers. So I thought it would be a good time to talk about all those things before I forget. Now usually on interviews, there's less questions asked to you and typically more so about them selling you on whatever place you're going to. But usually the two questions I always came across was why do you want to come here? And again, that can be that you're coming to a very large hospital, very small hospital, a small clinic, big clinic and really being able to parse out like, does this person fit? Does this person actually want to be here? So knowing more about that institution, how they work before you go into your first interview is going to be super key. And then the second thing is really about understanding what do you want out of your career? So I got a questions of, what's going to be a teal breaker for you? Like what are you hoping to get out of your first two to three years on this job? And essentially being able to explain like what type of environment would be my ideal scenario? Would I want to work with a big group, a small group, lots of patients, little patients make as much money as possible would be super stressed out or be okay with a smaller salary but also not a big patient load. Now those were two of the common questions that I always ask on the interviews but a quick list of the things that you should definitely consider asking to your interviewer on your first phone call or your in-person visit includes like what is your schedule going to be like? How many patients or census should I be seeing on a daily basis? If you're a surgeon, how many operations should I be expecting to be doing? What are my hours like? When do people start? When do they leave? In addition to salary, you also want to ask about things such as bonuses. Are there any? If so, how do you obtain them? How much are they? As well as things like benefits, things like your health insurance, your life insurance, 401K plans, et cetera. But a few things that I had to ask that not everyone shared included things like how big is your group? Are you a big group or a small group? How happy are the people there? What's the turnover like? And if so, why are people leaving? How often? What are common reasons? As well as what type of examples can you show me that people are upset or frustrated by something and a change was made? Again, most people may not want to go to a job where you feel like your concerns aren't really heard by your upper level administrators. So all of those questions on this list for things that I asked my employer, as well as going to step number two of how I made my decision. Now, in episode number two, I talked about getting four to five actual interviews, going in person for three of them, and then getting two offers relatively quickly, and then ultimately, I took one. So how did I make that decision? Now, the first thing I talked about in that episode is making sure I talked to different doctors who were working with both groups and really asking them the same questions that we talked about in the first part of today's episode. And that included things like, can you tell me about your schedule? How many patients are you seeing compared to what I was told that I should be seeing in the same role? How happy are you? Can you tell me something that frustrated you that ideally they helped fix or address in some form or fashion? And I realized that between the two offers, the doctors and both of the groups tended to be pretty happy with where they were, but I could realize that in one of the groups, people were staying for seven, 10, 15 years, and they had spoke highly, like without me asking any questions of the administration, of the change, of the hospital system, of the patients, that's usually a good sign that I'm going to naturally be able to fit in with those people. And it also just felt very welcoming, saying if I have any questions, feel free to call or text them again. These are people with busy lives and kids, and still they're able to talk to me at eight to nine o'clock in the evening when my schedule is free. And that overall warm reception really helped me understand, like if I joined this group, I'd feel very comfortable with the people I'd be around. And so overall, it was a good decision. Now, in addition to talking to providers, I also had to consider what kind of role I wanted to really play. Some of the positions that I'd offered, it was really flexible of what I would be doing. I may be working as a hospitalist or I'd be admitting very common medical problems to the hospital and admitting them and discharging them. That's overall what I'm comfortable with right now as a resident, but also I would be included in doing things like taking care of patients and like post-req rehab centers or SNFs or nursing homes. And that's not something I have as much experience in, but would be part of my role if I joined their group. And on the other end of the spectrum, one of the contracts was purely, this is where you're gonna do, you're gonna be admitting patients that have DK, asthma, pneumonia, all of those medical problems, as well as taking care of some patients who may be having an orthopedic surgery, a neurosurgery, and you're just gonna watch them before they go home. And so for me, one of the biggest decision-making points was where can I make the easiest lateral move where the hospital system that I work at, the style of how I work with patients, the type of the patients I admit would be very similar to what I'd be seeing later in the fall once I'm done with residency. That's ultimately the job that I ultimately took because that's also where the providers seem to be the happiest and the most warm to me personally going forward. And so for me, the question ultimately became where can I make the easiest lateral move where the hospital system that I work at right now, the size, the type of patients, how sick they are, how I take care of them, and what patients I do take care of would be very similar to my upcoming job. If there's a lot of discrepancy with how I practice medicine now and the type of medicine and care I'd be providing in a few months from now, that can really increase the amount of stress. And for my first job, I wanna make sure it's very similar to what I like doing and what I'm doing at the moment. So after going through those pros and cons and talking to the various providers, I realized that one of them tended to be the easiest lateral move for me. And that's ultimately the decision that I make. Now that we've made our decision, let's actually talk about signing and negotiating a contract, which is not as simple as it seems. I was given a contract by both of the groups that I had and essentially the first thing like I mentioned in the past episode is I hired a lawyer, paid about $500 to $400 for him, but it's highly worth it because the lawyer essentially went through every single line of the contract and said, this is normal, this is a little odd, this is actually very nice compared to what other people in the same field get. Here's what your salary is compared to other people in this area, other people that do your same job. And I was able to understand where things were fair, really fair and probably not in my favor. And like everything in life, everything is negotiable. So once I made a decision that this is the group that I ideally wanted to end up with, I essentially gave them a list of everything that the attorney had brought to my attention and saying, is this possible to change, including things like salary, which we'll talk about in a second, bonuses, et cetera, as well as some of the language that was in the individual contract that they found to be a little hot. Now a few of the things that attorney goes through in the actual individual contract included how it was getting paid, was it a normal rate, was it too low, how the bonuses worked out and how the overall numbers for the entire year was it too high or too low, as well as things like non-compete. Again, you don't ever wanna leave a job you just signed, but you do wanna make sure that if I have to leave a job for personal circumstances, I don't like the job, et cetera, like what are my options going forward? Can I still work in the same city? Can I still work in the same hospital? Can I still work in the same role? And you'll find that between each and every different contract, some may say you can't work in that city for like nine months or 12 months or two years. And that forces you and your family to have to move where on the other side, a non-compete may be very general to say you just can't work in this hospital but you can work anywhere else in the same city, in the same role. And so you have to really understand is my non-compete going to restrict me if this job ultimately doesn't end up being formed? Then finally, a few other things that some of the contracts had as well as didn't have, included things like my responsibilities, what type of things would I be doing? Again, it's nice for people to say you're gonna be doing A, B, and C, but if it's not in writing, they can always slip those things on you. So again, the attorney was super helpful saying, yeah, this is what they told you, that looks pretty appropriate, as well as additional perks that are included in the contract like a signing bonus, which I usually attribute to somebody who's gonna be an NFL or an NBA star, but I guess doctors are stars too when they're signing contracts. But it does make sense. When you finish your residency, there's going to possibly be a month or two months before you start your new job, and you may be out of an actual salary and health insurance, et cetera. So getting some kind of income that can give you a nice buffer, especially when residency doesn't pay you a lot, to be able to transition into your life as a tending is gonna be super important. So comparing, do they give me a signing bonus? So how much is that negotiable, as well as other things, like if I have to move between cities, which I'll have to do, are they gonna be able to reimburse any of it or all of it, which one of the companies did? On the other end of the spectrum, you have an RVU model, which basically says that everything you do as a doctor gets like a unit or a Lego block. And each unit or each block essentially will pay you a certain amount. So the more patients you see, the more you get paid. And in the middle, you have hybrid models where you may get paid per shift or per month. And then if you see more patients than their quota that they're expecting, then you may get a little bit more of a bonus. So really understanding on that spectrum, how you're getting paid, how predictable is your income going to be, as well as how well it compares to the natural and kind of geographic area you're in. All of those decisions were brought to my attention by my attorney. And the first thing that I did before signing the contract is just saying like, here are all the things that I'm hoping that you'll consider to renegotiate. And I would say out of the six things that I brought to their attention, four of them were pretty much non-negotiable, which is fair, it's contract. But two of those things actually managed to change. And that actually made it much easier to sign the contract going forward. So so far we talked about interviewing, making the decision, and then finally negotiating and signing my own contracts. The next thing we wanna talk about are next steps, what I actually have to do. In the second episode I talked about applying for my Texas medical license, which I'll need before I actually start working as a full-time physician. And I'll actually need before I start my credentialing for the individual hospital. So so far in the last two weeks since the last episode I made, I've done pretty much everything I need to do for the medical license. And now I'm just waiting for the board to say you're approved, which may take another week or two. Now after I'm done with my Texas medical license, then I have to apply for a DEA license, which essentially gives me the ability to prescribe certain controlled substances, things like narcotics and opioids and stronger pain medications that patients may need. Now, once I have my Texas medical license and my DEA license, which if you saw in my last video on me working as a moonlighting doctor, I easily spent just two grand applying for those things alone and there's still more money to be spent. So they're not easy on my wallet before I've made any money. But after I've done those two things, the next step is to then start the credentialing for the individual hospital they'll be working at. So making sure I have my permission, getting background checked by them and all the other modules and like trainings you have to do. So overall this next few steps are gonna take the next maybe two, three, four months and hopefully I'm ready to start my job in July or August or at least at the latest in September. But that is all the administrative and logistics things I have to do. Step number four is probably the most exciting for myself and my wife, which is finding a new home. Right now we live in Dallas, Texas, which is where I've been making these videos for you guys over the last seven years. But finally we get to go back home and find a new place. Ideally, instead of making videos in this kind of living room studio that we've been doing for the past few years, I'm gonna have my own room, being able to make my own studio for the YouTube channel for the podcast. I'm super excited for that. So in addition to getting a job, we'll have a new place, a new environment and hopefully I'll be able to take you guys on that journey as well. If you listen to this on a podcast, definitely consider hitting that subscribe and follow on your favorite podcast listening platform. And as always, my friends, thanks for being a part of my journey. Hopefully you guys have been able to see me go from all the way from being a medical student to now being an officially and employed internal medicine doctor, super excited. I really appreciate you guys being on my journey. Hopefully I was a little helped to you guys on yours. I'll see you guys in the next one. If you did enjoy this video then check out this video right here on how to study for step one, pass, fail, step by step, as well as this video right here on how all of the techniques that I used to learn medicine as a full-time doctor. I'm sure you guys will enjoy that. Until then, I'll see you guys in the next one. Peace. We're employed.