Questions to ask a potential dermatology employer
Searching for a new job is a cause for both excitement and apprehension. Finding the right practice is critical, and it’s about much more than just the job description. It’s about finding a place where you can thrive, grow as a physician, and build a fulfilling career.
As you consider potential employers, think of your conversations as an opportunity to interview them, as much as they are interviewing you. Asking thoughtful questions will help you gather important information and show you are engaged.
To help you prepare, we’ve collected a comprehensive list of questions. You won’t actually need to ask every question below, because the employer will address many of them, either directly or through documentation. However, the questions can serve as a checklist, so you can have confidence you’re covering every topic of concern. They can help guide conversations with the potential employer about everything from compensation and work-life balance to staffing and long-term partnership opportunities.
In this article:
Duties and work schedule
What days and how many hours are included in the schedule?
The employer should be able to provide the days of the week you’ll work and the number of anticipated hours. They should also tell you the number of patients you’ll be expected to see during clinic hours.
Is there a requirement to be on call or to do hospital consultations?
Understand whether the employer will require on-call hours. If so, find out how many on-call hours the employer expects you to work. If you will not have on-call hours, ask about supports available to patients who have needs outside of office hours.
Will the work be at a single location, and is that subject to change?
If the employer operates more than one location, be sure to clarify expectations around where you’ll work and whether this may change. If possible, have this specified in your contract.
How long will it take to have a full patient schedule?
Your employer should have a good sense of how long it will take for you to build a full patient load. This likely has an impact on your compensation, so plan accordingly.
How much scheduling flexibility will there be in the future?
For example, if you start at 5 days a week but eventually hope to move to 4 days, will the employer allow your schedule to evolve? Are there waiting periods or other process requirements?
Is there a requirement to provide care via teledermatology?
Some employers may require teledermatology hours. If so, learn whether the employer’s policies require you to be in the office for teledermatology, or if it can be offered from home.
Compensation and benefits
What is the base salary?
Employers typically offer an early-career dermatologist base salary plus additional compensation based on productivity. A base salary is especially important during the first 1-3 years of a dermatologist’s career, when they are still establishing a practice.
Is compensation based on production? If so, what is the target for production for the first year? And in subsequent years?
Dermatologist compensation is often based in part on production, meaning the revenue the doctor generates for the employer. There are different production compensation models. For example, a common approach offers the dermatologist a percentage of net collections. Another offers a base salary with a productivity bonus for collections above a threshold.
Will there be a sign-on bonus, and if so, what is the amount? What is the associated service obligation?
Dermatologists may be offered a sign-on bonus to compensate for moving and other expenses, especially for employment in rural or geographically remote areas. However, be aware that the sign-on bonus is often structured as a forgivable loan, with a service obligation for a certain number of years before the loan is forgiven.
What type of health insurance does the employer provide?
Commonly offered health plans include PPOs, HMOs, and high-deductible plans. Learn about how much both you and your employer contribute to each plan. Your costs and coverage may vary considerably between these plans.
What other types of insurance does the employer provide?
These may include dental and vision insurance. The employer may also offer life insurance, disability insurance, and more.
Does the employer offer a 401(k) retirement plan?
Today, most employers offer a 401(k) plan, typically with an employer match up to a certain percentage of your income. The employee selects from among a variety of retirement investment plans.
Is a pension offered? When does it become vested?
Although it is less common than in the past, some employers still offer pensions. As with a 401(k), you should learn about your contributions versus the employer’s contributions. Importantly, you usually have to pay into a pension for a set number of years before it becomes vested. After the pension is vested, you are entitled to the benefits when you retire, even if you change employers in the meantime.
How many days off are provided each year?
The employer should explain how many vacation days you can take each year. These may be a set number of days or days that accrue at a fixed rate. Similarly, you should have an allotment of sick days, though these are sometimes lumped in with vacation days. Employers may also offer time off for continuing education and similar activities.
Is there paid maternity or paternity leave? If so, how many days?
Learn whether the days off are in addition to other paid time off, and if there is a minimum employment period to qualify. If compensation is based partly on productivity, how is that accounted for in leave?
Is there reimbursement for the state medical license, DEA license, and state controlled substance license?
Dermatologist employers almost always cover these expenses. However, they may not be covered directly, instead coming out of an overall CME stipend. If so, you may want to negotiate for these to be paid in addition to the CME stipend.
Does the employer cover the cost of malpractice insurance? Who is responsible for tail coverage?
Employers almost always cover the cost of malpractice insurance as part of your employment. This coverage is typically based on claims made during your employment. However, you will need coverage after your employment ends. Ask whether the employer pays for tail coverage. If your employer does not pay for tail coverage, you may have to make a large lump-sum payment for coverage after your employment ends.
Is there reimbursement for society dues? for annual meeting expenses?
These expenses could include the cost of dues, meeting registration, hotel, and travel. Employers vary in their coverage of these expenses. Also, these expenses may come out of an overall CME stipend.
What is the amount of the CME stipend?
Employers typically offer some form of CME reimbursement. As mentioned above, employers may dedicate the CME stipend to a variety of expenses, so keep this in mind when evaluating whether the amount offered is attractive.
How billing for consumables handled?
Consumables are the disposable products used in the course of patient care. You may be billed for consumables directly or indirectly, through higher overhead or via deductions from net collections.
How frequently will the employment contract be up for renewal?
An employer may offer a contract lasting for a year at first, to ensure a good fit between the dermatologist and the group. Contracts of 2-3 years are the most common. Contracts of 5 years or more are less common but may apply when partnership is involved, or in academic settings.
Learn whether your contract renews automatically or has a fixed term. Contracts that renew automatically will extend the existing terms, so in that case you will need to be more proactive to renegotiate terms. The best window for negotiating new contract terms is typically 6-12 months ahead of renewal.
Does the contract include a non-compete clause?
Non-compete clauses have become common in physician contracts. A non-compete clause prevents you from working for a competitor or starting your own practice. Be wary of non-compete clauses with overly broad time or geographic restrictions.
Office and staffing
How does the employer manage patient workflow?
Dedicated staff who manage office processes efficiently can reduce burdens on the dermatologist.
Ask the employer about their target volume for patients per day. Ask about average appointment lengths. What is the average turnover time between patients?
Learn about how the front desk handles patient intake. Is the process digital or paper-based? How is scheduling managed?
How much support is available from staff?
Will you have sufficient support from nursing and medical assistant staff? How many such staff are available per physician?
Will you be working with nurse practitioners (NPs) and physician assistants (PAs)? If so, how much oversight will you need to provide?
How is billing and collection handled? Are there dedicated staff to help with prior authorizations, quality reporting, and other administrative tasks?
Prior authorizations and similar tasks can add up to hours of extra work each week. The more the employer helps you manage this administrative burden, the more time and energy you can dedicate to patient care.
What electronic health record (EHR) does the employer use? What onboarding support does the employer offer?
You will spend many hours documenting patient care in the EHR. Ease of use and customizable workflows are important to clinicians but are not always well supported in the EHR. Ask other dermatologists for their opinion of the EHR. Learn more about how the employer will onboard you into the EHR system.
How do dermatologists use the EHR in the exam room? What supports are available to reduce documentation burden?
Is the EHR accessed through desktops, laptops, or tablets? Are you able to use voice recognition software or other digital aids to help reduce documentation burden?
How many hours each week do other dermatologists spend on documentation?
Some EHRs are notorious for their contribution to administrative burden, often through a labor-intensive documentation process. Get a benchmark for how much time dermatologists spend documenting care in the system.
How many dedicated exam rooms are available for seeing patients? How many are allocated to each dermatologist?
Are there sufficient rooms for efficient patient workflow? Exam rooms have “downtime” after each examination as they are cleaned and readied for the next patient, which can reduce time dedicated to patient care. Are the exam rooms all adequately equipped?
What other equipment is available for use?
Available equipment could include dermatoscopes, microscopes, excimer lasers, PDT lights for photodynamic therapy, UVB lights, vascular lesion lasers, and more.
Is there a dermatopathology lab onsite?
An onsite dermatopathology lab allows for quicker turnaround time for diagnosis, improving patient experience and clinical communication. Dermatopathology also has business importance because of its impact on overall collections and costs.
If the employer does not have an onsite lab, where are dermatopathology specimens sent? What is the typical turnaround time?
Is there a Mohs surgery department onsite?
The availability of Mohs surgery is also important for patient experience, along with providing opportunities for referrals, collaboration, and professional growth. Mohs surgery can also have a significant business impact, allowing for a larger revenue pool.
Business considerations
How is access provided to data on production and collections?
Transparency on this information is essential because of its impact on compensation. In the ideal scenario, you are given access to a dashboard for real-time updates pulled from the EHR and practice management system.
If a dashboard is unavailable, the employer should be able to provide monthly reports. These reports should show an aged accounts receivable (A/R) report, denial by CPT code, and CPT code volumes. This information is important because compensation is based on collections, not charges.
Is there a path to equity or partner status?
Not all employment includes a path to ownership, but if that is part of your agreement, it should be specified in detail. First, the terms should be written into your contract. Second, you should know long you must wait before becoming eligible for partnership. Third, what are the performance milestones? Fourth, who makes the decision?
You may need to explore the amount of the buy-in price for equity and how the price is determined, governance, buy-outs, and more. If equity or a partnership is in your plans, be sure to consult with a health care attorney.
What is the marketing plan to support a new practice?
The employer should have a marketing plan both for the larger organization and for you individually, to help establish your dermatology practice. Ask for their digital and social media marketing plan. What percentage of patients come from referrals versus digital marketing? How will the employer include you in the referral stream?
If a practice includes cosmetics, what are the terms?
Cosmetic procedures can significantly impact the patient mix and potential income growth of the organization. Ask for the share cosmetics make up of overall procedures and revenues. Learn about the menu of services and related overhead, including for specialized equipment. Ask about support for mentorship and training. Finally, how are the profits distributed among physicians?
Does the employer have a right to any independent business activities?
Look for an “outside activities” clause in your contract. Outside activities can be defined variously and may apply to medical activities (such as working for a medical device company or writing a skin care blog) or more broadly, to investments and passive income. There may also be limits on outside time commitments. Be wary of expansive limits on outside activities, and consult with a health care attorney if you have concerns about your contract.
Are there restrictions on social media activities?
Your contract may include provisions related to your social media presence, marketing activities, and outside endorsements. It’s important to understand any restrictions on how you represent yourself and your employer online, and whether you need prior approval for sponsored content.
Ask for clear, reasonable guidelines that allow professional social media use, require approval only for relevant endorsements, and clarify ownership of online content.
Related AAD resources
Employment guide: See our other resources on employment contracts and negotiation with employers.
Employment contracts: Read our guidance on contract language and red flags.
Negotiate like a pro: Learn tips for negotiating the terms of your employment contract.
This content was created with the particular needs of early-career dermatologists in mind. See the rest of our Career Launch resources for young physicians.
