Assessing the Fit of Physician Recruits

It's often said that physician retention starts with a good recruit — a candidate that really "fits" into the practice, hospital/health system and community. That's truer today than ever before as supply and demand challenges create the anxiety to "fill a slot," rather than waiting for the right physician that adds value to the community.  

Recruiting for "fit" means matching interpersonal attributes, clinical skills and care management practices. As an industry, we have become pretty adept at assessing clinical abilities. Education and training locations, along with board certification and professional references, are fairly reliable barometers of a physicians' clinical aptitude. The on-site interviews give the clinical team the opportunity to further assess a physician recruit's care management practices. Our area of greatest vulnerability is evaluating interpersonal "fit," which serves as the most critical piece in determining retention potential.

Defining fit
The challenge in assessing organizational fit is that it requires more forethought and attention than typically given. Before you can assess how a physician candidate's attributes will match, you need to understand the culture of the organization and community. That means knowing the distinct values, beliefs, underlying assumptions, attitudes and behaviors — or the unspoken, unwritten rules of the practice, hospital and community at large. As an outsider, I learn these features during meeting discussions, through email and telephone conversations, scheduling practices, stories and other simple ways of being.  To do that as an internal team, consider the following questions to uncover the qualities of physician candidates that will fit your environment:

  • What types of physicians tend to succeed here?
    • Fiercely independent or team player?
    • Authoritative or consensus driven?
    • Formal or casual?
    • Outgoing and highly interactive, or quiet, subdued and maybe a bit introverted?
    • Community leaders or participants?
  • How do they differ within the practice? Within the hospital?
  • What is critical for working with the target patient population?
  • What characteristics were exhibited in physicians that didn't fit well?  Why did they fail to fit?
  • What would a physician performing a peak level display?
Assessing fit
Including as many perspectives as possible in physician candidate interviews puts the organization in the best position to assess fit.  In his book "The Wisdom of Crowds," James Surowizcki notes that a group can be smarter than even the "single smartest member" if the group is diverse (including extreme opinions) and independent (no one influences another). Site visit itineraries should include as many of the following as possible: 

  • Practice partners (both formal and informal title)
  • Practice staff (those that will work with the physician most closely and/or significantly impact their practice)
  • Referral sources (specialists) and resources (primary care)
  • Call coverage colleagues
  • Medical staff (formal and informal leaders)
  • Hospital administrators (most influence the practice or are familiar with the organizational strategy and community needs)
  • Community representatives (really has a "pulse" on the locals)
To do this successfully, each interviewee recognizes his or her specific role and the context of participation. For busy people, interview participants need to understand their purpose for involvement, as well as what it is that you want them to learn during their session with the candidate. For example, asking a general surgeon to interview an OB/GYN will be about assessing their ability to fit into the current operating room dynamics. Or, asking a Chamber of Commerce director serves to assess the candidates' ability to attract patients as well as their likelihood of becoming personally engaged in the community. It doesn't hurt to offer some suggested questions as well — giving them further direction and understanding. 

Mixing in group activities with one-on-one conversations can uncover the potential synergy, or lack thereof, of the physician candidate with your group. The goal is to get a sense of their interpersonal connection with a mixture of organizational representatives. This could be in a group meeting, over a meal or even an activity which reflects the culture of the area (hiking, skiing, golf, etc…). The recruit's non-verbal cues can suggest enthusiasm or disengagement. When there is good synergy, the candidate will be energized by questions and comments from the team. And if not aligned, they will appear uncomfortable, puzzled or distracted.

Broader site visit participation only has real value if feedback is solicited about the candidate and considered in decision-making. Whether using a formal intake form or simply asking verbally, the key to getting the information needed is asking specific questions such as:

  • Does the candidate exemplify ________ (attributes desired i.e. teamwork, informal orientation, independence)? In what specific way did that come through to you?
  • On a scale of 1-5 (1 is low and 5 is high), how attracted will our patients be to this physician?
  • If we agree that for a physician to succeed in this practice, they need to have the energy and drive to build a new practice; did you sense that in this candidate? How?
Summary
Finding the right physician candidate who is the best cultural fit for your organization can be challenging. It takes much more effort than "finding a body." Good forethought is necessary to understand the unique cultures in which the physician will interface — in the practice, the hospital and the community.  Knowing the specific characteristics of what works and what doesn't provides the benchmark in which to compare the candidate's personality and work style. Maximizing opportunities to learn more about the recruit through both formal and informal interactions can ultimately give the team greater confidence in selecting the right physician for the opportunity.    

Allison McCarthy is a principal with Barlow/McCarthy.  Her consulting practice focuses on medical staff development, physician recruitment, on-boarding and retention, and practice development.  She can be reached at amccarthy@barlowmccarthy.com or by calling 508-394-8098.

More Articles by Allison McCarthy:

Hospitals' Role in Recruiting Physicians Into Private Practice: 4 Touch Points

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