Medicolegal Issues

Time to Move On?


You’re unhappy with your workload or schedule.

Your spouse has been transferred to a different state.

You simply want a change of scenery.

Regardless of the reason, you’re looking for a new job. In hospital medicine, how and when is it appropriate to give notice? To maintain good relations with your current employer now and in the future, make sure you consider your departure from both sides of the desk.

Timing is Everything

Before you start skimming classified ads and phoning friends in the field to ask about job openings, consider how much time your employer needs to fill your position.

Help for Low Morale

The American College of Physician Executives (ACPE) offers a toolkit of resources for raising physician morale. The toolkit includes ACPE courses, as well as articles, such as “Physicians Offer Prescriptions to Boost Low Morale” and “Speak Up or Burn Out,” publications, videos, and more. The toolkit is available online at

New Networking Medium: LinkedIn

SHM has started a LinkedIn Group for hospitalists who want to network online. Use the group to connect with colleagues around the country and the world. LinkedIn is a free online professional networking site, and currently has more than 20 million users. Register for SHM’s LinkedIn Group from or at

Primer for New Committee Chairs

“Committees are like funerals. We all have to go to them and the older we get, the more there seem to be.” So starts the article “How to Chair a Committee,” by A.G.W. Whitfield, published in the British Medical Journal 30 years ago. Whitfield provides a concise, timeless overview of how to lead meetings. Access the article at

“When you’re thinking about leaving a group, you have to realize that the timing for getting your replacement is longer than you might think,” says Heather A. Harris, MD, a hospitalist who splits her time between the University of California, San Francisco and the Palo Alto Medical Foundation. “The traditional two-week notice in other jobs is tough for most [hospital medicine] groups to handle—unless it’s a really big group or already overstaffed, which is never the case.”

Dr. Harris, who hired many hospitalists when she was director of Eden Inpatient Services, Eden Medical Center, Castro Valley, Calif., recommends giving a minimum of two months notice. “That gives your group time to figure out what to do,” she says. “Otherwise, you’re putting the entire group in a bind.”

Other physicians suggest an even longer timeframe. “My preference would be that a hospitalist give me no less than six months notification,” says Fred A. McCurdy, MD, PhD, MBA, associate dean for faculty development, Texas Tech University Health Sciences Center at Amarillo. “That’s a best-case scenario for finding a replacement. It could take longer than that.”

The issue is workload for the doctors left behind: “The other hospitalists are going to have to cover the slack in the meantime,” Dr. Harris points out. “Keep that in mind when you’re giving notice; you’re putting everyone else in a position where they have to cover the work.”

A lengthy timeframe actually could dovetail with your own transition. “You’ll have to get credentialed at that new hospital,” Dr. Harris says. “It’s important to realize when you get that job offer that group might want you to start the next day, but you have to wait until the credentialing process is complete.” Depending on the hospital, that could take as long as three months.

It’s important to know the specifics of your new hospital’s credential process. “You don’t want to leave a job before you have the means to enter a new job,” Dr. McCurdy warns. “Make sure you understand when you can actually start the work.”

Meanwhile, your current employer will need time to move your replacement through the same process. “Some hospitals are slower than others,” Dr. Harris says, “but even if I have a hospitalist in mind who’s available to start right away, they won’t be able to step in until the hospital’s credentialing is complete.”

The traditional two-week notice in other jobs is tough for most [hospital medicine] groups to handle—unless it’s a really big group or already overstaffed, which is never the case.

—Heather A. Harris, MD, former director of Eden Inpatient Services, Eden Medical Center

Speak Up

When you decide to leave a job, tell your immediate supervisor directly and be open about your job search. “Ideally, the person who is leaving would sit down with me and tell me their intention to leave, where they intend to go, and the circumstances of their leaving,” Dr. McCurdy says. “I don’t want to hear about it third hand or through the grapevine, and I don’t want to find out that it’s some sort of negotiating tactic.”

If you want a new job because you’re unhappy with the one you have, consider whether the issues causing your discontent can be rectified. Dr. McCurdy says he would make every effort to keep a hospitalist in his group. “Obviously, there are some things I can’t help with,” he says. “I can’t change the weather, I can’t change the school systems, but I might be able to help with work issues.”

Build Bridges, Don’t Burn Them

It should go without saying that once you officially give notice, you should make every effort to maintain good relations with your employer and colleagues, by continuing to do your job well and remaining an active, positive member of your group, Dr. Harris says. This is particularly important if you stay in the same geographic area.

“There is a lot of fluidity in hospital medicine; people move from place to place,” she says. “It’s a small community and people know each other.”

If you feel comfortable doing so, offer to help your old employer find your replacement. Dr. McCurdy asks departing physicians for this favor. “I’d ask if they know someone who would be a good fit here,” he says. “The hospitalist community is small and pretty cohesive, so they may know someone.” Helping fill your position is a great way to stay connected and to show your good will toward the group.

If your employer asks you to stay a few weeks longer than you planned, consider whether you can jockey your upcoming start date to accommodate the request—but not at the price of being unhappy or risking your new job. “I might try to get someone to stay on a bit longer, but I’m not going to twist their arm if they aren’t interested,” Dr. McCurdy says. “It’s better to be without a physician than to have a disgruntled one.”

When you decide to move on to a new job, remember that you have a long career ahead of you. Be thoughtful and professional about how and when you leave. This small consideration can help maintain your reputation and connections for years to come. TH

Jane Jerrard also writes “Public Policy” for The Hospitalist.

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