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Pathology Physician Interview

20 Questions and Answers by Ryan Brown

Question 1 of 20

Would you be willing to serve on committees that are non-clinical, such as evaluating new equipment being considered for purchase?

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Pathology Physician Interview Questions

  1. 1.

    Would you be willing to serve on committees that are non-clinical, such as evaluating new equipment being considered for purchase?

      Progress much march on. That means keeping up with technology to offer patients the best there is. Such evaluation is mainly clerical and budgetary, so it's not the most desirable activity for a doctor. This can be tedious and no fun at all. You need to answer that if you're on board, you're there for the less glamorous roles, too.

      Ryan's Answer

      "Keeping my domain state-of-the-art is important to the work I do and the results I can offer patients. I know my input is crucial and want to dovetail my expertise with the budgeting experts so I can keep a state-of-the-art environment while making those financing me happy."

  2. 2.

    Pathologists are considered somewhat less clinical than they’re associates who see and treat patients. What would be your response to hearing a code being called, which is better attended by more clinically-centered specialists?

      Of all the specialists on staff of a hospital--except for Emergency Physicians--hospital-based physicians are probably less experienced in running or attending codes. This question is not asking if you are qualified, but if you are willing to make sure SOMEONE goes, even if it's you.

      Ryan's Answer

      "I'm a physician, so of course I would respond. That being said, it is not lost on me how infrequently I am called upon to do this, so it would be my obligation to drop out if I felt there were those better qualified to attend this emergency. If I were the only physician, I would run the code to the best of my abilities, which is probably good enough for the emergency until someone else can supersede me."

  3. 3.

    What invasive procedures are you planning to do?

      While pathologists traditionally are assumed to not interact directly with patients, this impression proves false when, for example, a patient needs a bone marrow biopsy for examination. The question really wants to know what your complication rates have been in the past, in hopes there will be no medicolegal risks for the institution in their future because of you.

      Ryan's Answer

      "My invasive procedures are limited, but I always follow my specialty guidelines to satisfy all criteria for such procedures, qualifying both to the need for the patient and to supporting my ability to perform them. And any of them are done in cooperation with the treating physician as part of his team for a particular patient. My complication rates are within acceptable standards, and I can cite the actual numbers, if asked, when I apply for the specific invasive procedures as part of your vetting process."

  4. 4.

    Do you have any lawsuits currently or in the past, including any settlements?

      They don't want someone who will lose them money or threaten their reputation. But it is true that all physicians are at medicolegal risk, whether actual suits ever come to pass or not. You won't be rejected because you have lawsuits (unless there are so many that it means you're the problem). Your interviewer knows that suits are usually filed for initiating discovery to see if there is merit to a case. He or she will also know that the frivolous ones go away or prescribe. However, a settlement is looked upon just as unfavorably as a lawsuit you lose, because settlements are made to mitigate the damage of a likely unfavorable outcome.

      So, what are you supposed to do you do if there are suits, losses, or settlements? 'Fess up, and because half of the story is your side, make sure you give it. Own it and don't blame your previous institution or group, because that looks bad. If you can explain why a lawsuit occurred due to a complication and not due to overt negligence, this is accepted as being part of the profession, so fear not.

      Ryan's Answer

      "I have two lawsuits, neither of them for any real malpractice. One of them was over a diagnosis I sent out for review for another opinion which changed the diagnosis, which justified the uncertainty that provoked me to seek another opinion in the first place. The other was due to a misfiled report that was found just a week later, and which did not exceed the reasonable window of opportunity for acting on it therapeutically. After discovery, I expect both of these to be dropped."

  5. 5.

    Are there any substance abuse, domestic violence, or other things that might be found in a background check that could impact the integrity of our hospital (or group)?

      Any positions of responsibility will be vetted with background checks. If you have such indiscretions in your history, take responsibility and give a detailed explanation about how you have removed any risk of it recurring: rehab, if applicable; therapy, if applicable; etc. Let the interviewer know why this problem is over, but also explain that you are comfortable with a probationary period or supervision as a gesture of good faith.

      The most desirable answer is 'No.' However, for the sake of example, our sample answer is of someone with a substance abuse history.

      Ryan's Answer

      "I had a problem with opiates as a teenager when I was prescribed them after an athletic injury. My rehab required that I successfully complete a prevention program, the completion certificate of which I have if you require that. I consider this part of ancient history and I have not had any problem with substance abuse since then."

  6. 6.

    As an institution, we embrace community outreach and diversity. Would we be able to count on you for participation in community events that are a part of our on-going commitment to the patients we serve?

      This is a question that asks if you plan to be part of the team which, as distasteful as it may seem, is really marketing--blood pressure screens, mammogram drives, etc. Like codes, it is just as much out of your personal professional territory. Your answer should be centered on what is best for the patients.

      Ryan's Answer

      "I certainly plan to participate in such events, even when they don't directly impact what I do in my specialty. Everything is interrelated, and the impact may end up in the testing and results that reflect the community health. You can count me in."

  7. 7.

    What can you think of that might improve the pathology services we offer?

      This isn't so much their wanting to pump you for ideas, but give you an opportunity to demonstrate your initiative in wanting to improve things--anywhere.

      Ryan's Answer

      "I would like to see the pathologists divvy up searches for new technology and offer a review of their discoveries at periodic meetings. No one can keep abreast of everything, so this looks like a great way to make sure something isn't missed that can help the lab, the patient, and the institution. Reports from such periodic meetings can then be furnished to Administration for consideration."

  8. 8.

    How do you do when confronted with the politics that sometimes consumes your valuable time at general staff and department meetings?

      The difference among agendas only increases when more competing factions take part within a bureaucracy. Competition can be among profit-making individuals/practices on the hospital staff who are fighting for market share or even for recognition and kudos pitting peers as part of a single group against each other. The fact that bureaucracy means lots of meetings, it doesn't help that you might have to withstand the uproar of battles that aren't even relevant to you. This question is asking you about your wisdom in picking sides, that is, choosing your battles carefully. You want to present as the model of common sense on this one. No fire needs gasoline, so don't come off as a fuel that only makes fires hotter and bigger.

      Ryan's Answer

      "Belonging to an organization means I must do what's best for it if I expect the best things for me and my patients. Some political battles are waged for self-interest, and these risk rifts that can only weaken an organization. Others are waged according to philosophical ideas and moral imperatives. My first inclination is to not get involved with anything until I can sort out the objective facts from the dramatics. Then I have to ask, is something better for my organization? because, if it is, then it's better for me in the long run. If the conflict is wasteful, only self-serving, and of no benefit to the group, I need to stay out of it because my participation will only make things worse for everyone and that includes, ultimately, my patients."

  9. 9.

    How timely is your practice to sign off on results gotten from automated testing equipment or ancillary personnel under your supervision?

      Getting behind can result in suspension, but it is not a 'hard' suspension, per se: it doesn't mean there are any problems with your medical abilities or expertise. These things must be done for the purposes of both reimbursements and accreditation of your lab and the institution itself. You need to assure the interviewer this won't be an issue.

      Ryan's Answer

      "Although I've been occasionally remiss in keeping current on supervisory verifications such as signatures, I appreciate the impact of staying current. It's a high priority for me. It is not lost on me how reimbursement by third-party payors can be affected by incomplete charts; but even more important to me is the need for completing the verification process since any results should be considered incomplete until that is done. Results are what I'm here for, from the simplest automated serum levels to the complex oncology calls, and incomplete results, because of failure to timely sign off on them, is unacceptable to me personally."

  10. 10.

    If you were to receive a communication from the Executive Committee about a practice issue that has clinical importance, such as underdiagnosing a malignancy, how would you address the members when you went to the meeting with them?

      This might seem like a challenge to your clinical abilities, so it can be upsetting. It is a question about personal challenges to your privileges. One of you is right and one of you is wrong, but even if you're the one who's right, you have to come off as being a good sport about the whole episode and that you are dedicated to the correction of any inaccuracies.

      Ryan's Answer

      "Underdiagnosing the malignant potential of a tissue happens all of the time, especially with frozen sections that tend to distort the tissue. If it's a matter of under-calling it on a frozen section, it is common knowledge that such preparations are only crude guides, and one must wait for the permanent mounts to be evaluated for a final diagnosis. If it's a matter of my underdiagnosing the permanent mounts, that would concern me, and I would report that I have learned from this and will be taking the right educational steps needed to prevent this from recurring. Please know that personally I take advantage of getting second opinions on such important calls when I feel there may be some room for subjective interpretation of what I'm seeing, so I don't expect to get such a letter from the committee; but if I do, I would make my case but tell them I will abide by their decision on this."

  11. 11.

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

      This tests your willingness to go along with current policy, so yes.

      Ryan's Answer

      "If I am part of this organization, of course. I want to be compliant with all of the protocols."

  12. 12.

    Pregnancy termination is a controversial subject. Would have any issues doing tests that might prompt a patient to terminate her pregnancy?

      Genetic, amniotic fluid, and serum tests are done as part of today's prenatal surveillance. Some may indicate risk of congenital anomalies or genetic abnormalities, such as Down syndrome. If this institution does any test that could be used to plan something you find personally immoral, albeit legal, you should know before you interview whether it will be a deal-breaker for you.

      Ryan's Answer

      "(Sample Answer with no objections) My role as a pathologist is as a consultant and, as such, advise on the implications of test results. The decision-making after that is within the patient-doctor relationship. Although I'm part of the team, my role is only as a consultant about the test and its results.

      (Sample Answer with possible objections) My role as a pathologist is as a consultant and, as such, advise on the implications a of test result. If I feel enough a part of the care team that I cannot in good faith take part in a test whose results could lead to something against which I'm philosophically opposed, I would simply recuse myself and ask that this particular philosophy in my work be honored or declined before even hiring me. "

  13. 13.

    Would you please introduce yourself and tell me why you’re applying here?

      Answer briefly and accurately. The interviewer is asking why you want this position and why you're leaving your current (or previous) situation. This is your opening volley, so you want to come off as sincere and ready to please.

      Ryan's Answer

      "I'm [NAME] and I have applied here as my next step in my professional vocation. I am married with no children, yet, but that may change soon. After finishing my residency, I joined the staff of my school for a year until I could decide where I wanted to go next. Next was a fellowship and that brings me here."

  14. 14.

    How do you feel about the various automated tests that are done? Do you feel you can rely on the results?

      Modern machinery for automated tests has created both better efficiency and accuracy. Standards for both their manufacture, interval testing, and quality control is strictly managed, meaning you're going to come off as some kind of Luddite if you say you don't trust them. However, good medicine implies a 'trust-but-verify' philosophy, so that should be the theme of your answer.

      Ryan's Answer

      "The automated clinical technology is very reliable, but I feel I owe it to a patient to verify all worrisome results by either repeating the test or manually performing it myself. In this way I can be assured I am providing the pathology--and clinical--service and accuracy a patient should expect. Although inaccuracies are uncommon, they do happen, and part of my work is knowing when the results are actually true or not and which ones need further scrutiny."

  15. 15.

    If you were to see a peer checking for results of lab tests of a patient for whom he or she was not the pathologist consulted, how would you respond?

      This is nothing more than HIPAA, about which institutions are very sensitive. Although pathologists in a hospital lab share testing and reporting responsibilities, the question is probably about that rogue person trying to pry into another person's personal life, e.g., looking for results indicating sexually transmitted infection or other personally sensitive information. As such, it is HIPAA-protected, with punitive fines indicated when it happens. Answer along the lines of following the law and following the institution's protocol for handling such problems. That's all you have to do.

      Ryan's Answer

      "First, I would make sure I saw or heard correctly, which is easily verified by the sign-ins and sign-offs on the electronic health records commonly used. But there are results that are accessible for the purpose of anyone on the pathology team contributing to the medical information related to the patient--to the benefit of both that patient and the doctor; in that way, it would require my asking the person in question the purpose of the suspicious inquiry, for it may be innocent and just good medicine as part of the team approach. However, if it were inappropriate, I would report it up the chain of command according to whatever protocol is in place for reporting HIPAA violations."

  16. 16.

    A pathologist traditionally does not see patients. Do you plan to interact with the patients whose tests are about them?

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  17. 17.

    If you’re not available when you’re scheduled to be on duty, how will your duties be done? Who will be responsible?

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  18. 18.

    Here we have a policy of our staff not moonlighting as a Pathologist anywhere else, since you’re paid an annual salary. Do you have a problem with that?

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  19. 19.

    What can you personally bring to us?

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  20. 20.

    What is it about [ENTITY REPRESENTED BY INTERVIEWER] that brings you here specifically?

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