Foo - People's opinion on hiring new doctor.

I figured I would go ahead and get the opinion of a group of people I highly respect and have found everyone on this forum quite thoughtful. Here is the scenario:

As some know I am senior partner in a small group practice of Internal medicine docs and also an associate professor of medicine. We are looking for another doctor and we have been interviewing and looking for 1 and 1/2 years. We have had numerous candidates but we have been quite choosy and picky.

The newest is a find. She is a MDPhd, Rhodes scholar....and actuallly got her PHd at Oxford, England and has great interest in living in the community and has a incredible work ethic per her residency program advisors. When we interviewed her we were blown away by her incredible personality, caring personae and wonderful people skills that we did not expect from an MDPHD (usually they are lab rats). She is more interested in clinical medicine and community service with a splash of academia and teaching medical students than to continue her field in bench research. (She has been first author published in over 20 journals studying angiogenesis of cardiac vessels using gerbal animal models...sorry Gonesh). We do divide our time between the hospital and clinic and teaching/research so it is definately not easy.
Her husband is a preacher and will become a stay at home dad for their only son as he pursues writing a book on some of his sermons and or religious philosophy (By the way, he was also a wonderful person.)

We were surprised she would "settle" for us since she obviously can go anywhere (Harvard, John's Hopkins etc.) but I suspect she wants to come back to her roots...she grew up in a small Georgia town. I also suspect she found our group'a overall work environment and practice atmosphere just spectacular and saw that all of us are still very enthusiastic about what we do and are not bitter or burned out and we work closely together. I also think that seeing me as the senior partner with a voice that is heard and respected makes her more confident about her chances of making a mark and general promotion without butting heads with some antiquated attitudes that I have encountered elsewhere.

She is actually making us her first choice and we have made her an offer.

So what's the problem? She sounds perfect? Understand this, I have already drafted the letter of intent and sent it to her and so have made the decision to hire her but she has yet to sign a contract.

Here is the catch, and I overlooked it due to her obvious qualifications...she is morbidly obese. Not mildly overweight mind you. Yet it obviously has not diminished her energy and competance. My slight worry is that our group of physicians practice what we preach....we excercise, eat right and maintain ideal body weight so we can be a model for our patients. (We have a large portion of obese patients due to our geographic area....we are the second most obese state in the nation). Much of our work is in the intensive care unit managing septic shock, ventilated patients, strokes etc. So as a rule, these patients are probably not going to care. An internist sees alot of sick, sick stuff, and with the exception of me , the majority of the population are not athletic. But still, it would be hard for me to tell a hypertensive or type II diabetic to lose weight and excercise as a cure or way of helping their disease if I could not show that I could find the time and energy to also do such a thing.

I feel I have made the right decision, in fact, all the partners have as well as our non partners. It was a unanimous vote but I can change my feelings anytime despite what the rest of us feels since I hold the ultimate say. What do you guys think?

This sort of reminds me of the difference between basketball coaches and martial arts/aerobics instructors. A martial arts or aerobics instructor is expected to be able to perform the activity being taught at a very high level of competence. What would you think of a Judo instructor who couldn't fall down without hurting himself or a TKD instructor who was winded after walking up stairs ? Most basketball coaches however are fat guys in suits. Nobody even expects them to shoot a free-thow correctly.

You say this lady looks wonderful (on paper) and you think she has a winning personality. The fact is the patients (customers, users, clients) will see her personality before they see the results of her training. This and her ability to support and be supported by the group of people she works with is most important. Her physical appearance is at best a secondary concern, and not really that important to her function. In fact very large people may actually feel more at ease with her because they will probably feel that she shares at least some of their problems.

I would not care about her size. However she probably is not what you think she is based on a short interview or two. There are things that you don't or can't put on a CV/resume. Since you have to take the good with the bad anyway, I don't think working around her size should be that big a deal.

Anybody who can't take medical advice to lose weight because the messenger is overweight, probably wouldn't listen anyway. They are most likely looking for an excuse not to even try.

Dan

I'd bring this legitimate concern up with the applicant.

To discriminate because of weight, which has no impact on her ability to perform her tasks, is illegal. If you have cajones enough to mention this as a concern and don't hire her it could expose you to legal recourse.

Rather, what you could do after you take her on, is to involve her in some low impact excersize adventures... leisurly rides down the local bike path, a bike pool to the office twice a week, etc. IMHO, this is what a compassionate physician would do :)

Dan, you are right in that I think alot of our patients will find her a motherly figure and feel more at ease.

I did not want to discriminate against her based on her size so I never used it as a criteria for or against her. The analogy to a coach is probably a great one. She was nominated as best teaching resident by her peers ( which the three of us have been lucky to recieve) which usually shows an ability to work well with others and yet still provide leadership skills (and usually good bedside manners are a prerequisite since interns and lower residents see your interaction with patients and use this as a nominating criteria.)

Ehnez, Stacey, I think we have got a win win situation but I will address the weight issue soon (now that she knows I want to hire her inspite of it) only because of my concern for her health.....afterall, we need our own health to be as good as possible to withstand the grueling schedule and lack of sleep....I don't want her to have a heart attack! In addition, our health impacts the health insurance rates we provide for our own office. One employee, who happens to smoke, has utilised alot of medical services due to complications of smoking and our rates jacked up. She is a good employee and I cannot fire her or let her go just because of this, as Stacey pointd out, that is discrimination. I offered her a $1000 dollar bonus if she quits smoking for three months. Soon, our small practice will have to have the employees incur more of the cost of health insurance if it keeps going up. This is an ugly aspect of considering future employees and hiring healthy ones are a definate must, but we don't want to hire underqualified ones.

CB

You already know the answer. You already wrote the letter. Yes the too fat isn't a good example for patients, but her qualifications are good for your patients. So go for her. Of course try to get her involved in biking or whatever and get her weight down after you've hired her.

Good Luck

Joe

My 2 cents... If she is that good, GRAB her while she is still interested. If her personality is as wonderful as you say, patience will flock to her.

After having a brother seriously ill and then my father, I have met too many Doctor's that are just looking at the bottom line and not looking at the patient as a human being. If we didn't care what the doctor's physical appearance was. We just wanted to find someone who cared and could help their patient(which we found).

Look how much money Dr Phil makes selling weight loss advice and he is fairly obese himself..

Thank you all, I guess I just needed to hear from people outside my own peers. As bab nicely reiterated, a patient is not going to care what a doctor looks like as long as they get the sense they care and are dedicated. I get this impression from her (we have turned down lots of other qualified candidates because we did not get this impression or had misgivings about their qualifications.) We take pride in the fact that all of us who have started are still together..exept one. (I fired one after 8 weeks for sexual advances on my 15 year old summer intern) but overall, our turnover is one of the lowest. I pay my nurses,office managers, secretaries, etc. very well and treat them with utmost respect, give excellent maternity leaves and we all are happy and work well together. What we lose in work revenue we more than make up for with content workers, patients and lack of quick turnover, that also costs any office alot of financial hardship. We have people in line waiting to work for us but it is a long wait. I want to keep it that way.

The only reason that obesity would be a legitimate concern in hiring this doctor is if it prevented her from performing her duties. Otherwise, to mention her weight, or to make it a factor in not hiring her is morally wrong and probably legally actionable.

Any way, I have had the contract written up and is ready to be sent to her. I was also able to get my dentist, who is board of directors at both the hospital and YMCA, (due to his generous contributions and active participation in the community,) to donate a free family membership to her and her family at the YMCA (three blocks from the office which is a rate of $650.00/year ) for 3 years as part of the signing bonus. I casually mentioned this and she was actually quite touched that we added this personalized package and felt we were looking out for her own health and well being and is excited about a place near enough to walk to and has great facilities for her son. I told her it's because our group is considered a family and we look out for each other. I will keep you updated.

...to donate a free family membership to her and her family at the YMCA (three blocks from the office which is a rate of $650.00/year ) for 3 years as part of the signing bonus.


Nice touch, that's exactly the kind of thing I had in mind. Now, do you have any openings for an office lacckey? I have R. T. equipment experience :-)

Great CB! As usual you got it riight!
Joe

She has been first author published in over 20 journals studying angiogenesis of cardiac vessels using gerbal animal models...sorry Gonesh.

No need to appologize to me, I'm not the one harmed by lab testing of animals. Also, I'm confident that any animal testing you are part of or condone is done as humanely as possible. Here in Portland we have the Oregon Health Sciences University, which has an extensive program dedicated to extremely disgusting and unnecessary testing on monkeys for various purposes, but mainly just to keep their precious grant money. I have seen it up close and personal, and can honestly say that there is minimal benefit coming from these experiments and tests, which consistently result in hundreds of monkeys' needless suffering. I do understand that there are infact some realistically reasonable benefits from animal tests in the right situations, I just hope they are treated with respect and compassion just as a human would be treated. Unfortunately, this is certainly not the case here at OHSU.

That said, I wish you good luck with your hiring. She sounds like a great person.

Sorry to chime in so late. Not that I have anything important to add. However, I am a Type II Diabetic. 227#s now. (down over 100#s from my max). My internist is also a Mountain Biker. It helps me that my doc. & I have cycling in common. I actually look forward to my appointments every 3 months. You know... Check the A1Cs, get the official weight, and give him a hard time for not getting out on the bike. :)

I am glad that everyone in your practice could see beyond her weight. I know how it feels to have your weight hold you back. :( Never more!