Are you willing to back up midwives doing deliveries?

"I would be committed to backing up any midwife delivery on the premises of the hospital. For home births I would have a problem, because medicolegally, I would be putting myself at the mercy of someone else I don't work with. However, should someone land in the unit from a complicated home birth situation and I was assigned to cover for such admissions, I would honor it."

Another love-hate relationship. Home births and natural childbirth are constantly in vogue with varying percentages of a hospital's demographics. When you appreciate that the only reason you'd become involved is when a serious problem came up, you will realize that being a part of this scheme means accepting that increased liability. This shouldn't bother you if it's part of the hospital service, but home deliveries are a different liability altogether. You can accept this or not in your personal practice, but if the policy of the hospital is to support them, it is most likely a dollar decision and you should state that you will comply with policy.

"Absolutely. I will be willing to back up midwives who are delivering at hospital premises but for home deliveries, it would be difficult because of the medicolegal obligations."

How is your attendance at general staff and department meetings?

"I may have missed meetings from time to time--usually due to my being occupied in clinical duties or vacation. However, I realize how important the business of the hospital (or group) is, and I will make every effort to improve my attendance."

Running a group or a hospital, unfortunately, requires significant bureaucracy. The doctors are needed to make that run, which means a responsibility to the clerical drudgery involved. This means meetings--lots of meetings. And they're always at night or worse, during office hours which can cut into your income. Note that the question doesn't ask whether your attendance will be good, but how it has been in the past. This implies that your answer may be verified by a phone call or two, so tell the truth. (Most likely, no one will be checking up on your answer, so even if you've been truant in the past, pledge to do better.)

"I try to attend General staff and department meetings most of the time except when I am on call and busy in emergency patient care."

What would be your response to hearing a code being called in the middle of the night as you're getting ready to go home after a delivery?

"Unless I was managing a clinically unstable situation or in the middle of a procedure, I would respond, and then only drop out if there were colleagues there who I felt were more qualified to attend the code."

This is a no-brainer question. Of course you would respond. It is tempting to assume that certainly someone else would be there to respond, and that is typically true, but you don't want to be seen as the type of person who would need to hear the code called repeatedly before you would respond.

Would you be willing to serve on a committee investigating an issue with one of your colleagues?

"There is not an easy answer for this, only a difficult one: yes, I would have an obligation to do what's right when it comes to patient care and safety, even if that means being resented by a colleague. If it were a close personal friend being targeted by the investigation, I would ask to recuse myself, but I would be prepared for that not to be granted. The only thing I would want is to not be the only one making a judgement. Having more than one investigator, I feel, is necessary to take politics out of such an inquiry and give it additional objective credibility."

Internal affairs and investigation are just necessary. Things happen, and when patient care is affected or jeopardized, they must be explored and dispositions made so that they don't reoccur. Besides Joint Commission accreditation and insurance reimbursements, a public reputation is jeopardized by uncorrected omissions or errors in care. The interviewer wants to know if you'll have the courage to step up and do what is right.

"Well, this is a difficult question although I would avoid being on a committee if the issue is against one of my close friends because I don't want any factors to affect my judgment. But if it is required as a part of my duty and has something to do with patient safety I will definitely be ready to serve for the committee."

How timely is your practice to sign off on chart entries and make all of your dictations current? Have you ever been suspended from a staff for failure to do these?

"Although I've been occasionally remiss in keeping all sign-offs and dictations current, I feel it is important for me to do so. It is not lost on me how reimbursement by third-party payers can be affected by incomplete charts. Just as important--to me--is the need for accuracy and trying to remember specifics from a procedure or rounds can become spotty if too much time has passed. For these reasons, I agree that keeping current is important, and I strive to do just that."

This type of suspension is not a 'hard' suspension, per se; it doesn't mean there are any deficiencies in your medical care or expertise. Most physicians get a little behind from time to time, and it could be that the only thing lighting a fire under them to get these clerical tasks done is suspension. However, although this is frowned upon but not necessarily condemned, it does impact the hospital or group's bottom line, so the question is one of fiscal importance.

If you were to receive a communication from the Executive Committee about a practice issue of yours that it seems could have clinical repercussions, how would you address the members when meeting with them?

"Prior to my meeting, I would research the literature about what I was doing in this particular practice, be it off-label prescribing or using protocols not considered to be evidence-based. My authority allows for some latitude. If in researching this I discover a serious problem that justifies their concern, I would report that I have learned from this and will not be repeating the practice(s) of concern. If I found that I can defend the practice based on my research, I would make my case, but communicate that I would abide by their final decision regarding the practice."

This is more than just hospital policy, but a challenge to your clinical authority, which is traditionally up to the physician alone. Therefore, this can be upsetting. It is a question of how you handle personal challenges to your privileges.

How would you handle a problem in which Utilization Review wants you to discharge a patient who you feel isn't medically ready for discharge?

"If I felt it would be dangerous to send a patient home, I would write a note of necessity for continued admission, on medical grounds, so that UR could submit it for approval from a third-party payer. If the patient just wanted to stay for his or her convenience, I would explain that he or she has satisfied criteria for discharge, but I would also offer home health follow-up, if the patient desired and it were allowed."

This pits you against the hospital, but you want to propose a solution that is safe, while considering insurance complications. UR actions are usually based on dollar issues, protecting the hospital bottom line from insurance denials.

Would you be willing to accept whatever electronic medical record process is in use here?

"Of course. If I am part of this organization, I want to be all in as far as my compliance to all the protocols."

Another test of your willingness to comply with policy, so you should agree.

"Of course, I will be willing to accept any electronic medical record process being used in the institution."

If you're on a rotational call for indigent patients or patients without a doctor, how would you feel about having to see a patient in the ED whom you had dismissed from your practice?

"Although I would not choose to do this electively, I would follow policy and accept, without any personal asides to the patient. If the patient chose not to accept me as his or her doctor for this episode, I would call the Patient's Advocate and arrange a consultation with the patient to remedy the conflict."

This is a test of your willingness to comply with policy.

Are there any substance abuse, domestic violence, or other background items that could impact the integrity of our hospital (or group)?

"I have a DUI arrest in my past as a teenager. I do not have a problem with abuse, but my arrest required I partake in prevention programs, which I completed successfully."

Such situations are a reason for running away from a current situation. If there is such a damaging component in your history, own it and explain the steps you took to eliminate the risk of it recurring, i.e., rehab, successfully completed therapy, etc. Let the interviewer know you are comfortable with a probationary period or supervision, if deemed necessary. The most likely answer, of course, is 'no'. However, for the sake of example, here is a sample answer of someone with a DUI history:

Tell me about yourself.

"I come here a few years delayed, as medicine wasn't my initial goal--I initially earned a different degree. So, I had to go back to school to acquire some of the pre-requisites for my application to med school. Since then, I have been on track. I am married with one child. After finishing my residency, I joined the staff of the school for a year until I could decide where I wanted to go next. That brings me here."

This should be answered briefly and succinctly, and it should include why you want this position and the circumstances behind your leaving your current situation (they will want to know--and will ask, if you don't say why).

How do you feel about VBAC (vaginal birth after Cesarian)?

"I personally would rather not manage a VBAC because it requires more in-person surveillance which would limit my office hours and negatively impact my productivity. If I were to inherit one in progress, I would honor the commitment of the doctor I'm covering for and follow the established standard of care and local protocol."

Since VBAC is fraught with liability (higher morbidity and mortality), hospitals have a love/hate relationship with it. They love to advertise they do them but hate the extra liability. You should know the hospital policy on them and agree with it. Even if you refuse to do them, you should state you have no problem with doing them according to hospital protocol and safeguards, should you 'inherit' one from a colleague for whom you're covering.

What is your C-section rate?

"My C-section rate has fluctuated over the last few years. My total rate is at the mercy of repeat C-sections that have presented to me as new patients. My primigravida rate is about 24%, and I am taking steps to bring that down, such as modifying the timing of epidurals and aggressively assuring a functional labor. Also, continuing medical education opportunities have always focused their efforts on ways to bring this rate down, and I keep current on the subject."

This topic has always been controversial, but it does impact considerations of your being on some insurance panels. Regardless of your rate, you should quote your primigravida rate. Do not include repeat C-sections; otherwise, it will be higher.

If you were to see a peer doing or saying something inappropriate, how would you respond?

"First, I would make sure I saw or heard correctly. Depending on the transgression, I would either confront him or her discretely to resolve it vs. report it up the chain of command. I would report up if I felt it compromised patient care, would reflect poorly on the hospital (group), or be unethical, immoral, or illegal."

A situation like this is not your problem to fix. You can't go wrong answering this question by saying you would go up the chain of command. A hospital or group wants something like this handled a certain way, and their best assurance that this will happen (when you're involved), is to pledge yourself to that chain of command, i.e., up the ranks to department chairman, Executive Committee, administrator, etc.

Do you have any personal problems with our seeing or our assigning you indigent or "charity" cases?

"Having issues with seeing anyone would go against my own values; I will see anyone who needs my services. I know that the demographic here is weighted toward the underserved and taking care of them would be my obligation. I also have researched the demographics enough to know that LGA babies are a problem here, and that attracts me because of my special interest in gestational diabetes."

Before you interview, you should learn the demographics of this group or hospital. You should be comfortable with the demographic distribution because that will determine the type of practice you will have. Regardless of whether they take care of such patients, you should always state you have no personal problems seeing anyone who needs you--you just can't go wrong saying this! Many groups and hospitals are required, for example, to have a 'life-and-limb' list of doctors who rotate turns seeing uninsured emergency patients. This might also give you an opportunity to plug your special interest again.

"I would not have any issue seeing any charity cases because it's absolutely against my core values. I strongly believe in providing equal healthcare to all irrespective of their ability to pay and would oblige to see every kind of patient."

If you're not available, due to illness or vacation, for example, how will your patients be cared for?

"I plan to serve on committees within your department so that I can enter into some reciprocal call agreements with other staff members as soon as possible. However, I won't be taking much time off as I build my practice, because the low numbers will not be too taxing before it gets built up over time."

This is a straightforward question and its answer is always part of the by-laws of any institution. If you're not new to the area, you should identify others on staff with whom you expect to have a reciprocal on-call relationship. If you're new to the area, you should state you intend to be full-time responsible until you can establish such reciprocal relationships. An extra overture would be to say you plan to serve on many committees in order to meet others in your specialty.

Here we have a policy of _______. Do you have a problem with that?

"I would not seek a position here if I had a problem with that policy. My only professional stipulation is that I am able to treat any person who needs my services, and I am allowed to do what is best for him or her."

You should never have a problem with any policy of the place to which you're applying. A good example is a Catholic hospital that won't do pregnancy terminations, vasectomies, or tubal ligations. Before your interview, you should decide whether you can practice under such constraints. Luckily, seldom are there any stipulations that will ruin your life.

Were you involved in any lawsuits, in the past or currently, including any settlements?

"I have three lawsuits, each one of them is due to a complication--one was an allergic reaction to surgical tape, another was due to a bowel injury during a surgery for a frozen pelvis, and another was due to the need for a transfusion in an obese patient having surgery. After discovery, I expect all three to prescribe without incident or settlement."

This is a straightforward question. No one wants someone certain to lose them money or jeopardize their reputation. However, it is a truism that all OBGYNs are at one time or another the target of malpractice suits, whether these actually come to pass or not. The interviewer will not dismiss you for lawsuits--he or she just doesn't want someone who is sued so frequently, as to suggest there's a problem. That being said, not all suits come to pass, and a lawsuit filed is not a deal breaker. Many are just filed for the purpose of initiating and accomplishing discovery to see if there really is merit to a case. If there isn't merit to a case, these lawsuits go away or prescribe, and your interviewer will know this. A settlement, on the other hand, can be just as bad as a lawsuit you lose, because most settlements are made to mitigate the damage of a likely unfavorable outcome. If there are suits, losses, or settlements, be truthful, but half of the truth is your side of the story, so make sure you give it. Do not blame your previous institution or group--that just looks bad for you. Take ownership, but if you can explain why a lawsuit occurred due to a complication and not overt malpractice, this is something any hospital administrator will understand.

What can you bring to this practice/organization/hospital?

"I want to be here because of the pursuit of excellence and state-of-the-art medicine you're known for. Also, your continuing education fits well with my needs for growth. This organization makes an excellent foundation for my special interest in gestational diabetes and perinatal morbidity that your unique demographic offers--and the challenge to manage it even better within your maternal-fetal department."

You don't just want to say that you're an expert or have a lot of experience, but you can be a little bold here by stating that, although you find it very impressive here, you have noticed that there are some gaps in the total picture of care rendered, and you feel you can fill these gaps. This is a way of saying that selecting you will not only fill a position, but even add value. You can further state that you can bring additional resources that most hospitals don't have, which would make this organization stand out above the rest. (These are the offerings that will make you particularly attractive, where you tout your special interests; special interests are specific aspects of one's specialization that do not have the bureaucratic designation of certification by a board. For example, you may be board certified or board eligible in OBGYN, or even further (for example, in reproductive endocrinology), but you might say you have a special interest in gestational diabetes. This would sound very fortuitous to a hospital struggling with an unacceptable neonatal morbidity due to the percentage of large-for-gestational age babies in its demographic.

Why do you want to be a part of this practice/organization/hospital?

"I know that the values of this practice align with my own. I have done a lot of research and I especially resonate with your dedication to community interaction and embracing diversity. I think I'd be very happy here with the professional mindset, and I'd be a good fit."

You must assume the interviewer thinks his or her hospital or group is absolutely wonderful...or potentially wonderful with the addition of the right person. You can stroke the corporate ego and begin endearing yourself to the interviewer by invoking the Mission Statement and/or Vision of the hospital or group. Most hospitals will have these, prominently displayed on the landing pages of their websites; they are brief and easy to imbue into your interview strategy. You can tell the interviewer that the values you saw in the Mission Statement and/or Vision Statement align with your personal views of how you want to lead your professional life. Don't actually refer to the Mission Statement and/or Vision when you answer, just state that you find this group's values align with yours, and you can paraphrase the values you saw displayed.

"I want to be a part of your hospital for 2 reasons-First of all the level of clinical training at your hospital will allow me to get exposure to a wide breadth of clinical volume and gain good clinical experience.Secondly, I have strong family ties to this area so this program is a good fit on both the professional and personal front."

OB GYN Interview Questions

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1. Are you willing to back up midwives doing deliveries?
2. How is your attendance at general staff and department meetings?
3. What would be your response to hearing a code being called in the middle of the night as you're getting ready to go home after a delivery?
4. Would you be willing to serve on a committee investigating an issue with one of your colleagues?
5. How timely is your practice to sign off on chart entries and make all of your dictations current? Have you ever been suspended from a staff for failure to do these?
6. If you were to receive a communication from the Executive Committee about a practice issue of yours that it seems could have clinical repercussions, how would you address the members when meeting with them?
7. How would you handle a problem in which Utilization Review wants you to discharge a patient who you feel isn't medically ready for discharge?
8. Would you be willing to accept whatever electronic medical record process is in use here?
9. If you're on a rotational call for indigent patients or patients without a doctor, how would you feel about having to see a patient in the ED whom you had dismissed from your practice?
10. Are there any substance abuse, domestic violence, or other background items that could impact the integrity of our hospital (or group)?
11. Tell me about yourself.
12. How do you feel about VBAC (vaginal birth after Cesarian)?
13. What is your C-section rate?
14. If you were to see a peer doing or saying something inappropriate, how would you respond?
15. Do you have any personal problems with our seeing or our assigning you indigent or "charity" cases?
16. If you're not available, due to illness or vacation, for example, how will your patients be cared for?
17. Here we have a policy of _______. Do you have a problem with that?
18. Were you involved in any lawsuits, in the past or currently, including any settlements?
19. What can you bring to this practice/organization/hospital?
20. Why do you want to be a part of this practice/organization/hospital?

OB GYN Interview Questions

1. Are you willing to back up midwives doing deliveries?

2. How is your attendance at general staff and department meetings?

3. What would be your response to hearing a code being called in the middle of the night as you're getting ready to go home after a delivery?

4. Would you be willing to serve on a committee investigating an issue with one of your colleagues?

5. How timely is your practice to sign off on chart entries and make all of your dictations current? Have you ever been suspended from a staff for failure to do these?

6. If you were to receive a communication from the Executive Committee about a practice issue of yours that it seems could have clinical repercussions, how would you address the members when meeting with them?

7. How would you handle a problem in which Utilization Review wants you to discharge a patient who you feel isn't medically ready for discharge?

8. Would you be willing to accept whatever electronic medical record process is in use here?

9. If you're on a rotational call for indigent patients or patients without a doctor, how would you feel about having to see a patient in the ED whom you had dismissed from your practice?

10. Are there any substance abuse, domestic violence, or other background items that could impact the integrity of our hospital (or group)?

11. Tell me about yourself.

12. How do you feel about VBAC (vaginal birth after Cesarian)?

13. What is your C-section rate?

14. If you were to see a peer doing or saying something inappropriate, how would you respond?

15. Do you have any personal problems with our seeing or our assigning you indigent or "charity" cases?

16. If you're not available, due to illness or vacation, for example, how will your patients be cared for?

17. Here we have a policy of _______. Do you have a problem with that?

18. Were you involved in any lawsuits, in the past or currently, including any settlements?

19. What can you bring to this practice/organization/hospital?

20. Why do you want to be a part of this practice/organization/hospital?

15. Do you have any personal problems with our seeing or our assigning you indigent or "charity" cases?