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  The job is yours—but can you keep
  it?

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  cap today

July 2005
Feature Story

You’ve just landed your first job.

Time to pitch the CV, put your interview suit in mothballs, and relax—you’re on breathe-easy street.

But if finding a job is hard (see CAP TODAY, June 2005), keeping it may be even harder. If you want to keep your new post, your recent job-hunting skills can still come in handy, says Michael S. Brown, MD, president and medical director of Yellowstone Pathology Institute, Billings, Mont.

For starters, don’t pack your interview suit away just yet—you may still need to wear it to work. Take your cues from the group and the larger medical community—if they’re wearing suits, so should you. If they’re wearing khakis and polo shirts, then you can stuff the suit toward the back of your closet.

And just as you looked carefully at your group before you accepted their job offer, you need to continue observing your new colleagues. Take a good look at the generation gaps within the group. Each generation has its own attitudes toward work and problem-solving, and a little knowledge of their general styles can go far.

What Dr. Brown calls the mature generation—those in their mid-50s and older—tend to be command-and-control types, with regimented communication that follows a strict chain of command. Their focus is on job security. "They want to build a legacy," Dr. Brown says. They also tend to be loyal, fiscally conservative, patriotic, and faithful to their jobs, and they value high service and hard work.

Baby boomers share that same loyalty to their jobs. They also are political activists, pushing for change and ignoring the status quo. Less focused on chain of command protocols, they prefer diplomacy. They’re optimistic, competitive, idealistic, team players—and they question authority.

Gen-Xers don’t see work as their No. 1 priority in life. Many were latchkey kids, making them self-reliant and self-starters. They’re interested in results and want to be involved in making decisions. Career security is more important than job security, so they tend to switch jobs more frequently than older generations. Gen-Xers chafe at being micromanaged, and they prefer participatory, collaborative leadership. Gen-Xers can be direct, even blunt. "I’ve gotten myself into trouble with some of my senior partners by being a little too blunt," Dr. Brown says. They’re also skeptical, resourceful, distrustful of institutions, adaptive, and technology-savvy.

The Y’s (mid-20s and younger) who follow Generation X have high self-esteem and, like Gen-Xers, are concerned about work-life balance and prefer collaborative and participatory leadership. "They oftentimes question everything," Dr. Brown says. They tend to build parallel careers to keep their options open and aren’t reluctant to change jobs. They’re realistic and pragmatic, globally concerned, and technologically and cyber-literate. They have a sense of civic duty and appreciate diversity. They also have a "notably short attention span."

Dr. Brown knows firsthand the value of taking these different perspectives into account. Though he’s made plenty of changes to the Yellowstone Pathology group, they’ve happened on a slower timetable than he first expected. "It drove me nuts. And of course as time went on, I figured out they [the older practitioners] were right," he says with a laugh. "If it were just a bunch of young guys like me, we would have run ourselves into the ground. But at the same time, with me bringing up new ideas all the time and then going through the whole vetting process, we ultimately make changes that benefit our patients and the practice."

Networking, one of the building blocks of a job search, is also critical to keeping your job. Start by building relationships with your pathology colleagues and the medical staff. But don’t stop there—get to know your technologists, administrators, and office staff. "It’s important, because as a pathologist, you’re at the center of health care," Dr. Brown says. "So I recommend that as soon as you get your job, you start trying to learn all the names and faces of all the medical staffs at the hospitals you go to."

Yes, that’s hard to do. "It’s taken me more than four years, and I still don’t have everybody identified, but it makes a difference when you walk up to somebody and say, ’Hello, I know who you are, and I’ve received some specimens from you, thanks for your business," he says. Strong relationships mean better patient care and better laboratory service. Moreover, if you have a strong relationship with other physicians, "they’ll go to bat for you."

Make yourself available, and return calls and answer questions quickly. "Make sure that you’re always going the extra mile to take care of your clinicians." Talk to them clearly, and often.

At the same time, remember that even the best relationships, built up over years of time, can disintegrate with only a few bad words or one bad action. "Then you’ll never get that business back from that physician again," he warns.

Be cognizant of your limits. Expect to be a slow worker at first. Working hard doesn’t always mean doing the most work. "You need to make sure that you’re not working yourself too quickly, that you’re not making errors because you’re trying to get the work done and get it out the door." Remember, you’re a pathologist, not a banker, he adds. "Don’t be caught walking out to your car at 2:30 in the afternoon." Early on, expect longer days. Dr. Brown recalls that when he first started at Yellowstone Pathology, he typically worked until 6 or 7 PM, while one senior partner left promptly at 5 every evening. "He’s more experienced, he’s a lot more efficient than I was. I’m slowly getting to that point where I can walk out at 5 o’clock some days."

If you’re handed a new responsibility, welcome it—but don’t be afraid to ask for help, either. "It’s very important that you know your limits," he says. Also expect to show cases to other pathologists at first. In his first couple of weeks, Dr. Brown recalls, he was "showing around acute appendicitis [cases] to people, saying, ’Are you sure this is acute appendicitis?’ Simple things like that. But you need to kind of calibrate and make sure that you feel comfortable with what you’re doing."

You also need to become comfortable with the broader world of pathology—learn the basics of finance and reimbursement. "These topics are going to affect you directly or indirectly for the rest of your career, regardless of your practice setting." On a more personal level, hire a financial planner and make sure you have good disability and life insurance.

Widening the circle even more, Dr. Brown urges young pathologists to join ranks with organized medicine, even if only as a dues-paying member at first. That includes the CAP, local and state medical associations, state pathology societies, and the American Medical Association. It’s expensive, "but that money, year after year, is going to come back manyfold to help you with your practice."

Whatever your niche is, solidify it. Make yourself indispensable—that’s the "golden rule of employment," Dr. Brown says. "Make it so that nobody will ever want to get rid of you."

He concludes with a blessing and a curse, as if standing on Mount Sinai. There will always be a need for pathologists, he says. While the profession will change in decades to come, "Remember, no other physician can do what you do.

"But also remember: It’s very easy to send specimens to someone else. Our clinical colleagues see patients, and patients generally stay in the same region. But it’s easy to take a biopsy and send that clear across the country or possibly even around the world for a diagnosis. So you need to stay on your toes."

Karen Titus is CAP TODAY contributing editor and co-managing editor.