John Shufeldt, MD, JD, MBA, FACEP
It was March, and third-year residents all over the country were sending out applications for employment. It was, as Charles Dickens penned, the best of times, it was the worst of times, it was the age of wisdom, it was the applicant’s spring of hope, most had everything before them’ James and Ashley were no exception.

James, from a prestigious East Coast family practice residency, learned during his first year as a resident that he really loved his emergency medicine rotations. Instead of switching programs, he decided to focus his interest on urgent care medicine while still in his family practice residency. He did all the “right” things. He spent as many of his electives as allowed in emergency medicine, pediatric emergency medicine, and orthopedics and attended different “procedure clinics” at conferences. On paper, James was an “A-gamer.”

Ashely found her way into urgent care medicine on a slightly different path. Since childhood, Ashley dreamed of practicing medicine in a small town. She wanted to be the quintessential family practice physician and imagined rural life as a series of Norman Rockwell depictions. Ashely did well in medical school, and was completing her residency in a program whose graduates gravitated to rural healthcare. She completed her required emergency medicine rotation and although she enjoyed the pace, she wanted more continuity. During residency, Ashley met the love of her life, married him, and was soon pregnant. After her son was born, she realized that a full-time practice with all of the attendant responsibilities was going to be very difficult with a toddler, so she found her way to urgent care. On paper, Ashley was not as marketable as James.

James was “gung-ho,” he hired a search firm that blanketed urgent cares in the West with his curriculum vitae. He made multiple interview trips, always insisting that he be reimbursed for his travel. He hounded the search firm’s representative to find more potential employers and made multiple calls on his own. In short, he was like a dog with a bone. James “cold called” our recruiter and forwarded his curriculum vitae via e-mail.

As our recruiter was setting up an interview trip, James – obviously not understanding the implication – casually mentioned that he was represented by a search firm.

During his phone interview, the focus of James’s questions revolved around: time off, benefits, pay, and how hard was he expected to work? He spent the other half of the interview recounting, in laudatory terms, his academic and professional career to date. By his own description, he may have been the “lost Mayo brother.”

Ultimately, he knew little about our company and then blamed the search firm for his lack of preparation. Most disturbing was his palpable arrogance toward our recruiter. When asked if he was a “team player,” he responded somewhat incredulously that he was – provided he was “in charge of the team.” His final question, was “So when can I start?”

Ashley looked for employment opportunities in the back of JUCM. She contacted a number of potential employers and did enough of her own research that she narrowed down the field well before she made any preliminary contacts. She negotiated with prospective employers to cover her travel only is she was hired. She had a firm grasp of the market dynamics and demographics and asked very intelligent questions during her interview. She was most interested in the environment of the centers, the focus of quality, and the commitment to customer service. Her final question, was, “This may be premature, but would you have any objections of I volunteered a day or so a month providing care to the indigent?” She followed up her interview with a handwritten letter thanking us for our time.

James was dumbfounded when told that we would not be offering him employment. He insisted on being told why, since in his mind, he was “all that.” Employers are under no obligation to provide this analysis to prospective employees; however, since James had his whole career in front of him, I decided to make an exception and agreed to have a candid discussion with him about his interviewing and communication style, if in fact, he was truly interested.

Why James was “un-hirable.”

  • He did not do any research prior to making calls. This demonstrated, to me, a lack of diligence and a complete lack of respect for other’s time. He could have done some basic research simply by looking at our website. He could have also evaluated the market by looking at other centers in our area using something as simple as Dex Online. The answers to the few questions he asked were easily found online.
  • He discussed salary, etc. before learning anything about the job – meaning, the only thing he really cares about is how much money he will make. While money is obviously important, generally speaking, it should not be discussed until an offer is being proffered.
  • He was rude and arrogant to our staff. As I mentioned in an earlier article, this is a BFRF*! Arrogance and rudeness are diseases not easily cured and I have no interest in employing a person who demonstrates these traits. Also, arrogant providers get sued, treat the staff and patients poorly, and are generally “uncoachable” since they already know everything.
  • He hired a search firm and then immediately broke his agreement with them by doing his own search. Moreover, he was not bright enough to realize the implication of his actions. Unless the entity is recruiting for very scarce specialties or to remote areas, search firms are typically only necessary if the applicant has a history colored by questionable actions. Measured against like-trained peers, search firm-generated applicants are at a distinct disadvantage.

At the end of the day, providers garner a tremendous amount of respect and earn a significant amount of money and benefits. My quid pro quo is that this level of remuneration mandates professionalism, hard work, integrity, and great interpersonal skills. In these areas, James met his Waterloo. Unfortunately, if history is a predictor of future performance, James will have a career punctuated with frequent job changes, medical malpractice suits, board actions, syphilis, and a generally negative experience as a medical professional.

Ashley, on the other hand, can look forward to a career that has both meaning and financial rewards and will ultimately realize that, to paraphrase, it is a far, far better rest that she goes to, than she has ever known.
* Big f-ing red flag; see Health Law, JUCM, March 2009; available at

A Tale of Two Applicants

John Shufeldt, MD, JD, MBA, FACEP

Chief Executive Officer at MeMD, LLC, Mentor and Author at Outliers Publishing, Principal at Shufeldt Consulting, Founding Partner of Shufeldt Law Firm