The Dark Mark

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Following Content Also Features as a Guest Blog Post from MDObvious.

It’s the cusp of October and the time of year when things are meeting their end and days give way to early darkness. I’m often reminded of the literary meanings of darkness and all its negative connotations, be they macabre or mysterious. We all recall Lady MacBeth struggling to wash her hands of the “damned spot” during our requisite high school or college English classes. My contemporaries will recall the nefarious opponents of Harry Potter working to hide their intentions as well as their marks of affiliation with evil. Exemplifying the phrase that “life imitates art,” these dark marks are analogous to how a physician will carry the stigma of layoff. It is something that no doctor would ever seek to disclose, but despite carrying the affliction one does not need to succumb to it.

The 2020 pandemic has certainly increased the number of physicians who have been laid off, and even a quickly performed internet search can give evidence of them. Earlier this year, an experienced trauma surgeon in Jackson, Mississippi was let go from his job after the University of Mississippi Medical Center faced a massive budget deficit 1. Approximately a dozen other physicians in the Mercy Health Hospital System in Missouri were let go, much to the chagrin of their patients 2. One of them, a beloved pediatrician, reached the front page of his local paper, a loss now lamented in the public record 3. Notwithstanding, physician layoffs are not restricted to the time of COVID, and further investigation is able to find these as well. In late 2019, over a dozen Chicago-based physicians were laid off from their Urgent Care jobs in favor of the cost savings of midlevel providers 4.  Perhaps the most extensive physician layoff in recent history involved Hahnemann University Hospital and Drexel University in Pennsylvania. In 2019, years of poor finances and ownership changes led to the downfall of the hospital and its affiliated residency programs, resulting in over 500 resident physicians and faculty losing their jobs 5. In all of these stories the theme is evident—financial difficulties. Based on these stories physicians that appear most at risk are the young and the old. They may be early in their careers and without an established patient base to make their retention financially attractive to an employer. Likewise, some are late in their careers and assumed to be close to retirement and thereby “expendable.” Though the physicians lose in scenarios like this, ultimately it is the patients that suffer most. They are the ones who lose access to bright young minds, the hands of a surgeon with years of experience, and the relationships they cultivated with their primary care physician over a lifetime.

Seeing any of these stories as more than a brief snippet in a news reel on any given day is unusual, if indeed they are even mentioned at all. If a physician never hears about others enduring this career change it can lead to a sense of isolation and the assumption that they are the only one to experience such a tragedy. Though the reason for layoff is most likely to be a financial one, downsized physicians will have to carry the stigma that calls into question their professional behavior, clinical knowledge and practice skills. As they go to search for new work, potential employers can see a tarnished reputation before the physician is even able to establish one. By showing you that you are not the only physician who has gone through this painful process, I hope that we are better able to help you cope with this isolation and make a plan for overcoming the negative assumptions about your skills and character.

Almost inevitably the first question in most job interviews will have something to do with why you’re looking for work. What you need to do now is prepare your answer for this completely understandable query.  In addition to knowing why you’ve applied to the location where you’re interviewing (proximity to family, weather, lifestyle, etc.), be up front and honest about your experience. I was quite worried before my first few interviews that I would be interrogated about why I had lost my job. I did not find this to be the case, even after giving the very direct response, “I was laid off.” Oddly, the most common reaction to this answer was at least several seconds of stunned silence. After the first few times seeing that the questioner was just as uncomfortable with this response as I was, I decided to take the opportunity to move my interviews in a more positive direction. During the few seconds of that pause, I explained that I was one of over two dozen physicians downsized by my organization. Subsequent to making that statement I felt my job search was viewed with much less suspicion. In fact, most of my interviewers were sympathetic to my plight and that of my family and wished me well.

That being said, I think there are a few things you can say to change the impression that a layoff leaves with an interviewer. First, it is often easier to explain away a layoff when multiple providers were let go at the same time—it shows that financial or systemic problems existed with your organization and not with you! After all, most prospective employers understand why you’re looking elsewhere for work when your organization just dumped another dozen or so physicians looking for the same job in the same area in the same short time span! Job markets—even for physicians—can become inundated. If it was just you that suffered job loss, be prepared to explain the rationale. Perhaps you were employed by a small group with limited finances or your seniority was lowest. Second, if your layoff was related to COVID-19 do not be afraid to mention this! This is an unprecedented time in human history and the job market for everyone has undergone vast fluctuations in a short period of time. Third, if your layoff was without cause, please be certain to state this. This magic phrase shows that there was no deficit in your performance that contributed to your job loss. If there were concerns about your practice ability contributing to your layoff and your previous references are likely to mention this, bring up what have you done to address those deficits and lay out the process you took. Do your best to take ownership of your own shortcomings and try your hardest not to place blame on others, but at the same time be sure to exalt your new-found capability.

Finally, though you should be prepared to defend yourself, I would refrain from being so defensive during an interview that you start to look derisive, untrustworthy or lacking in confidence. In the rare circumstance that you do find yourself faced with an interviewer that is less than understanding, chalk it up to a learning experience and walk away from a potential employer that does not appear to respect you and what you have to offer them. After all, you are looking for a new job that will be a good fit for both of you—not one where you feel like you’re constantly having to prove you’re worthy to walk through the front door.

Treat every interview you receive with gratitude–each is a chance to become better at promoting yourself after your downsizing. The dark mark of layoff may never leave you, but it does not always have to remain a source of shame. Eventually you’ll be able to wear this as a badge of hardship you’ve overcome and a tool you can use to shape your future.

Blog Post Excerpt from MDObvious.

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