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Emergency Medicine News:
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Say ‘No’ Like a Pro

Katz, Barbara

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Ms. Katz is the president of the Katz Company, an emergency medicine consulting firm dedicated to providing expert physician recruitment services and training emergency medicine residents in effective job searching.

Most emergency physician job candidates excel at accepting offers, but unfortunately, many are clueless about how to decline one. It's important to understand that how you say “no” can affect your career as much as the “yes” you give to your eventual employer.

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There is a double mandate when turning down an offer of employment: Leave a good impression as a physician and a person, and leave the door open for future offers. The consequences of a badly delivered “no” can be multiple and serious. Employers put a significant amount of time and expense into hiring a physician. Most employers foot the bill for interviewing each candidate, and they absorb the cost of travel, hotel, and other expenses for three to eight candidates on average. Many also pay fees to a professional recruiter.

The average graduating resident does not thank employers for interviews, which is professionally unacceptable

The time commitment involved in reviewing CVs, conducting telephone interviews, and hosting one- to two-day site interviews is considerable. A standard recruitment campaign can cost an employer between $15,000 and $30,000 depending on the number of candidates interviewed. The time expended by the director and staff is incalculable. Because the average emergency physician changes jobs six times during his career, the potential for burning a bridge or two in the process is quite strong. In a nutshell, the director you offend this year with an unprofessional turndown could easily be the director you want to work for at another hospital in five years. Emergency medicine is a small world, and news of bad behavior travels.

Unless you are completely lacking in the most minimal of social graces, you will have sent a thank you letter to every employer with whom you interviewed. If you receive an offer, you should give that department a time frame for your decision. Once you've made a decision, you have an obligation to inform the other employers. The average experienced physician sends an e-mail; the average graduating resident does absolutely nothing. Neither is professionally acceptable. Even if you have interviewed with 25 prospective employers, each and every one, whether they made you an offer or not, deserves the courtesy of a formal letter or telephone call. Many physicians believe they have no obligation to contact an employer whose offer they are declining if they were referred by a professional recruiter, and the recruiter indeed will make the initial phone call for you. If, however, you want to make a good impression and leave the door open for the future, it is up to you to follow up with a phone call or letter.

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Follow Up with a Letter

Emergency medicine is still a relatively small community in the wide world of health care. ED directors and physicians talk to each other. When a physician candidate has been unprofessional, word gets around. Saying “no” is uncomfortable. Few like hearing it, and few like having to say it. But there are ways of softening the blow that leave you looking like a pro.

If you received an offer from an employer, you need to tell them your decision as soon as possible so they can move forward with the hiring process. Call the hiring authority, and thank him for the opportunity and the offer. Tell the hiring authority that you have accepted another offer, and provide the details of where you are going and why you chose the offer you did. The information you provide could help that employer fine-tune its recruitment process. Employers are usually quite grateful for any feedback you can provide. Later, follow up with a formal letter reiterating your thanks for the opportunity to interview and the kind offer, and saying what you liked about the opportunity. Also include the name of the employer's whose offer you accepted and the reason you accepted that offer. This letter will be filed, and you will be remembered as a professional.

You also should send a formal letter of your decision to employers who provided a site interview but not an offer. You won't thank them for an offer, but the rest of the content points should be included. Be target-specific when writing so your correspondence doesn't sound like a form letter. Use names, dates, and observations to let them know you actually remember the experience.

If you are like most graduating residents and seasonal job searchers, you may have already accepted a position back in December or earlier in the year to start this summer. If you haven't done the “pro no” process, it's not too late. Don't be shy; this is a textbook better-late-than-never scenario.

Fulfilling these mandates will make employers feel good about you, make you feel good about yourself, and leave the doors of opportunity wide open for the future.

© 2006 Lippincott Williams & Wilkins, Inc.

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