October 1998 Bulletin

Recruit without regrets

'. . .it's a good idea to assess your own needs, objectives, goals, short- and long-term plans for your practice and culture

Hiring a physician takes time and a lot of research

By Sandra Lee Breisch

Last January, Bruce Schwartz, MD, put an ad in the Academy's Practice Opportunities listings for a board certified general orthopaedic surgeon to practice at the Ketchikan, Alaska-based Southeast Alaska Orthopedics.

A simple ad, it read, "Could consider less than full-time candidate. Salary excellent and time off." Ads also were placed in The Journal of Bone and Joint Surgery (JBJS), Ketchikan General Hospital and in fly fisherman magazines which reeled in some "interesting" responses.

Dr. Schwartz wanted a "skilled and seasoned" veteran-not just "someone interested in the money or who wanted to get away from their ex-wife," says Dr. Schwartz, who migrated from Oregon to tap into an "unmanaged care" market.

Although Dr. Schwartz interviewed many applicants, he "wasn't going to let anybody have it," he recalls. "I wanted somebody who knew his limitations and how to stay out of trouble; somebody who's had a fair amount of experience with trauma because you base your reputation on good results. If we don't get good results then everybody goes to Seattle."

Alan E. Wolf, MD, a 19-year California practitioner who dreamt of relocating to Alaska for years, spied the ad and contacted Dr. Schwartz. After a thorough review of his resume, references and chats with Dr. Wolf's partners, Dr. Schwartz did an additional scouting report. He spoke to the OR nurses and anesthesiologists who worked with Dr. Wolf. "I wanted to find out how they liked working with him, if he's skillful, belligerent and what his style was like."

The reports were favorable, so he made a further investment. He paid for Dr. Wolf's expenses to and from Alaska to do two locum tenens several months apart. To observe his surgical skills, Dr. Schwartz lined up some patients, including himself. "He does upper extremities…we operated on patients together," says Dr. Schwartz. "It worked out great. Everybody loved him…and now [after my shoulder surgery], I can play the fiddle again."

Yet, Dr. Wolf's family needed reassurance that it was a good move for them. So, the local hospital's recruiting arm spent time with them, as did Dr. Schwartz' family and health care associates.

Last August, Dr. Wolf was hired. "I knew he was stable, had a good attitude, loves orthopaedics, taking care of patients and also had a high skill level," says Dr. Schwartz.

In turn some of the elements of Dr. Wolf's "carefully calculated" move involved "looking at Dr. Schwartz' patients and X-rays of his fracture reductions." He says, "I was very favorably impressed."

Hal Patterson, MPA, president of the Denver, Colo-based Patterson Enterprises, LTD, who provides career planning sessions and workshops for various organizations, says, "Choosing someone who will fit into your practice professionally and on an emotional level is very important.

"After doing your homework, you should be able say to yourself, 'Yes, I could work with that person and that person could work with our group.'"

When recruiting physicians, Harvey P. Insler, MD, Metro Bone and Joint, Bronx, N.Y., clearly identifies his expectations, what his practice wants and offers to the candidate and the community. He looks for physicians who've done fellowships. "I need people who are confident and can work independently," he stresses.

All too often, though, Patterson says, physicians who recruit don't spend enough time to assess candidates from the standpoint of being a good fit within their group. "Many times [after hiring] he or she will lament, 'This orthopaedic surgeon wasn't really what I had in mind,' says Patterson. "But then it's too late, the contract's been signed."

To head off problems in the future and find someone who'll meld into your practice's culture, Patterson says it's a good idea to assess your own needs, objectives, goals, short- and long-terms plans for your practice and culture. "You should know enough about yourself and your practice to know what you do or don't want in your candidates," says Patterson. "Then think: 'How does that translate into the type of person you should hire?'"

Put together your wish list which tallies everything you want in a candidate, says Patterson. "You may want someone with a certain specialty of orthopaedic interest, formerly in a group or solo practice or whatever is similar to yours, partnership skills, years of OR experience or someone who completed a fellowship," says Patterson.

You may also want to find out what your potential candidate's opinion is on health care affiliations you have or potential group affiliations or mergers, notes Patterson.

Since physicians in the hiring seat do not interview on a full-time basis, they should not expect to be experts. "But they should be prepared to ask about 15 to 30 questions," says Patterson. "Ask the right questions-specifically, behavioral-based questions to get a good sense of the skills, competence, abilities, past work experience and background of the candidates."

For instance, Patterson says the questions could include: "Tell me about a time when you were doing reconstructive surgery and things didn't work out the way you wanted them to. How did you handle that? Or, tell me about a time when your diagnosis was incorrect and when you got into the OR, what did you do? What did you tell the patient?

"This technique encourages the candidate to really talk in depth about a particular experience, tell how they handled a certain situation and open up the communication channel. It also shows different behaviors related to that particular circumstance."

Patterson suggests inquiring about any past conflicts with other health care professionals, difficult partners or patients and "find out how they resolved them."

Be sure your candidate is a good match for your practice's culture. "Your definition of culture can include a person's values, work ethic, personality, interests, commitment and loyalty," says Patterson. "You need to know if your recruit has the same customer service focus and definition that you or your partners have."

There are many sources to find orthopaedic surgeons such as in the local or national newspapers, hospital's placement service, referrals from colleagues or recruitment firms.

But be wary for job hoppers, says Dr. Insler. "Spend some time with the Academy's Placement Services [publications]," he says. "There are people who go from job to job. By reading the ads regularly, you get to see certain names that keep cropping up. That's information you can't always get," he says.

Although many practice administrators recruit for physicians, many times recruitment firms will contact you. "They're an excellent starting point," says Dr. Insler, "But you still have to make the effort to weed [bad candidates] out."

Dr. Insler takes the initiative in his search by writing letters or e-mailing candidates. He also does a thorough reference check. As he points out, "Everything you find out on reference checks makes a difference."

10 tips for recruiting

  1. Read the resume carefully.
  2. Do a thorough reference check.
  3. Talk to candidate's partners and the staff he or she works with.
  4. Have a "wish list" of the attributes of the ideal candidate.
  5. Assess the candidate's work ethic, personality, values, interests, commitment and loyalty. Will he or she fit your practice?
  6. Determine if their personality is compatibile with you, and your partners.
  7. Learn the candidate's views on important issues.
  8. Meet the candidate's family and determine if the move is good for them.
  9. Learn interviewing skills such as asking open-ended behavior-based questions.
  10. Inquire about past conflicts with other health care professionals, difficult partners and patients

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