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Pediatrician Interview
Questions

25 Questions and Answers by Ryan Brown

Question 1 of 25

If you see a child you suspect is suffering abuse from a parent, and that parent were very prominent in the community to the point of devastating your career, how might you take care of your patient while mitigating your political and professional risks?

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Pediatrician Interview Questions

  1. 1.

    If you see a child you suspect is suffering abuse from a parent, and that parent were very prominent in the community to the point of devastating your career, how might you take care of your patient while mitigating your political and professional risks?

      This is a trick question. No matter the stakes, professionally, publicly, and politically, you never hedge (or 'mitigate'!) when it comes to child abuse. Do not offer schemes to lessen the blow to the blameworthy, no matter what!

      Ryan's Answer

      "I can't take care of my patient and mitigate my professional risks by offering a 'pass' to the abuser. No warnings, second-chance offerings, or personal asides of reproach are a substitute to reporting this to the proper child protection services. Besides that, it's the law."

  2. 2.

    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?

      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. Even if you're right and they're wrong, you have to show you're willing to be a good sport about the whole thing.

      Ryan's Answer

      "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 tell them I will abide by their decision on this."

  3. 3.

    What invasive procedures are you planning to do?

      This is a matter of what exact privileges you're seeking in this position. They don't want 'mavericks' who are seeking privileges beyond their training.

      Ryan's Answer

      "My invasive procedure complication rate is within acceptable standards, and I follow my specialty to satisfy all criteria for such procedures, qualifying both the need for the patient and supporting my ability to perform them. I can cite the actual complication rates when I apply for the specific invasive procedures as part of your vetting process."

  4. 4.

    How is your attendance at general staff and department meetings?

      Running a group or a hospital, unfortunately, requires significant bureaucracy. The doctors are needed to make that run, which means taking responsibility for the clerical drudgery involved. This means meetings--lots of meetings. And they're always at night or 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.

      Ryan's Answer

      "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/group is, and will make every effort to improve my attendance."

  5. 5.

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

      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 or how you will interact with this demographic. Regardless of whether they take care of such patients, you should always state you have no personal problems seeing anyone who needs you--you 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. If a hospital, for example, accepts any federal funds (Medicare or Medicaid), no patient can be refused in their Emergency Department. If you're doing your duty serving on a 'life-and-limb' ED rotation, you will still be required to see such patients, as well as provide follow-up in your office, regardless of your practice preferences.

      Ryan's Answer

      "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, so taking care of them would be my obligation, if I am presented such a scenario."

  6. 6.

    Tell me a little about yourself.

      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).

      Ryan's Answer

      "I come here a few years delayed as medicine wasn't my initial goal--I had gotten another degree. So I had to go back to school to acquire some of the pre-requisites for my application to med school. However, I have since 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."

  7. 7.

    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.

      This is a test of your willingness to comply with policy. Most physicians have dismissed patients from their practice for failure to pay or a failure in compliance. If you're fulfilling an obligatory role and a dismissed patient is assigned care by you, you have to accept it.

      Ryan's Answer

      "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's parents chose not to accept me as their child's doctor for this episode, I would call the Patient Advocate and arrange a consultation with the patient to remedy the conflict."

  8. 8.

    If your 15-year-old female patient were to have a simple cyst on her ovary, how would you approach a disagreement with a GYN surgeon who seems anxious to remove it?

      Although this is an irrelevant question in one respect (i.e., an OBGYN outranks a pediatrician in determining which pelvic masses should be surgically removed), still, it is asked to explore how you might approach a legitimate professional disagreement with a colleague or consultant when the stakes are high.

      Ryan's Answer

      "This would simply require a frank discussion in which we each list the relevant points contributing to our rationales. If disagreement continued, as the patient's primary physician I would ask for another opinion by consulting another pediatrician and another GYN surgeon."

  9. 9.

    If a patient were to present to you with headache and a rash, what would you do?

      At first blush, this would seem like an inappropriate question, especially if the interviewer were not a physician. Essentially, however, it seeks out your 'panic' criteria for acting in the best interests of the patient. Here, specifically, the morbidity and mortality of meningitis or meningococcemia is so high that all patients with even a couple of hallmark signs or symptoms should be treated immediately until a definitive diagnosis is available via culture. Most deaths from this come from misdiagnosing it as a simple viral illness, causing a delay in an appropriate treatment. These are high profile deaths that will affect a group's or an institution's reputation, not to mention the bottom line, from a legal defense or settlement. Your answer is a barometer of caution.

      Ryan's Answer

      "The morbidity and mortality of a misdiagnosis is a very concerning outcome and should be avoided at all costs, especially in a child. Whether it's meningitis, H. flu epiglottitis, appendicitis, or other diagnoses with narrow windows of timeliness and accuracy, an abundance of caution augments the usual risk-vs-benefit considerations. Therefore, adding another consideration--the weighing of the upside-vs-downside of aggressive management--must be considered and acted upon in the best interests of the patient."

  10. 10.

    An insistent parent can be a problem when treating a child. An example is one who insists on antibiotics for a viral illness you have diagnosed. How do you typically approach this parent?

      This is a question that centers on a common problem in pediatrics. For example, not only viral illnesses in which antibiotics are being demanded, but even the more controversial debate on antibiotics for otitis, which the literature is now citing the correct approach to be not to prescribe them. A sick child is a powder keg for disagreement between a parent and a provider. How you answer will portend accurately to the interviewer about your ethics and diplomacy.

      Ryan's Answer

      "In the case of a viral illness, I would explain the difference between viruses and bacteria and why they call for different medications. I would also explain dangers to the child, such as allergies, adverse effects--GI--or igniting a superinfection and initiating resistance. If that failed to convince him or her, I would suggest a time period to determine if my recommendation was effective and leave the question open regarding adding antibiotics at that time. In the case of controversial conclusions in the literature, such as otitis, this is only an amplification of the same problem and I would act similarly."

  11. 11.

    Are you going to be doing any chronic pain care?

      This answer is simple if you don't plan on managing chronic pain, but if you do, your interviewer will want to know to what extent. The opioid crisis makes for bad press from overdoses, and institutions and groups want to steer clear of the whole controversy--not to mention scrutiny from the DEA and your state board. Before your interview, you need to know that you are being asked this to see if you're overstepping into controversial practices.

      Ryan's Answer

      "As a primary care doctor, I know that I have a responsibility to believe my patient's report of pain. In an acute setting, I plan on prescribing according to my patients need, implementing safeguards such as drug screens. With chronic pain, although I won't be seeing many pediatric patients as such, if I do, I feel it best to refer the patient to a rheumatologist, physiatrist, anesthesiologist, or other pain management specialist."

  12. 12.

    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 attending a patient?

      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 responded.

      Ryan's Answer

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

  13. 13.

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

      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 recur. 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's right.

      Ryan's Answer

      "There is no 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 possibly 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."

  14. 14.

    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?

      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, the only thing lighting a fire under them to get these clerical loose ends tied up is often suspension. 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.

      Ryan's Answer

      "Although I've been occasionally remiss in keeping all sign-offs and dictations current, I feel it is important for me to be diligent in keeping current. 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 attempting 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 strive to do that."

  15. 15.

    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?

      This pits you against the hospital to come up with a solution for everyone's benefit. UR actions are usually based on dollar issues, protecting the hospital bottom line from insurance denials.

      Ryan's Answer

      "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 parents of a child just the want the child to stay for their convenience, I would explain that he or she has satisfied criteria for discharge, but I would also offer home health follow-up, if the parents desired and it were allowed/authorized."

  16. 16.

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

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  17. 17.

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

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  18. 18.

    Are you going to be doing pre-term neonatal or NICU care?

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  19. 19.

    How do you feel about telemedicine?

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  20. 20.

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

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  21. 21.

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

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  22. 22.

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

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  23. 23.

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

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  24. 24.

    What can you bring to our group/hospital?

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  25. 25.

    What is it about this group/hospital that makes you want to be a part of it?

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