Bringing reality to the job hunt process.

Executive search firms work for the organizations that pay them fees to find physician executives who have the appropriate experience and fit well with the organizations, cultures. These recruiters do not receive money from you, the physician executive, and they cannot guarantee you that they can find you a job. If your experience matches what an organization wants and if the chemistry is right when you interview, you will get the job. I called several of these recruiters and asked them, "What do you wish potential physician executives already knew before they start to work with you?" Following are their answers.

John S. Lloyd, Witt/Kieffer, Ford, Hadelman & Lloyd, Oak Brook, Ill.

Contact more than one search firm. Physician executives seem to think that, if they call you, you will get them a job. I wish they understood that the search firm works for the client organization. When they call, we can only be of assistance if we happen to have an opportunity for which their skills and qualifications are appropriate.

The second thing that I find fascinating is that most physicians, if they have had one year of management experience, believe they could be president of an organization. They are naive. I wish physicians were just a little more realistic about what their training really qualifies them for, because gaining management experience takes a lot of time. You just have to go through problem solutions in a management process over time.

I wish they would be able to articulate their management accomplishments. I've been amazed that, when I say, "Pick the four or five most significant management accomplishments that you,ve had in the past three years, the response is, "Wow, that's a good question. I never thought of that." They need to think of it in advance of meeting with the search person or even talking with him or her. When that search person says "What have been your major management accomplishments?" you need to be able to tick them off quickly. You may have successfully completed JCAHO accreditation or computerized the whole credentialing process. If someone tells me, "I was the head of the compensation committee of our IPA," I want to know that person has really gotten his or her feet wet. Anytime you have to deal with compensation in a group of physicians and have done it successfully, that is the kind of accomplishment that I think is important.

It amazes me that physicians call and haven,t wrestled with the question of whether they will relocate. In many of the calls I receive, they haven,t given thought to whether they would pick up and move. They say, for example, "No, I want to stay here in Chicago, because my kids are in school." They will have to make some career decisions that require physical relocation. They have decided they want a management job and they want it where they are, so a recruiter should help them realize that objective. Thinking in advance before working with a search firm about their parameters for relocation would be helpful. I must say they are usually pretty realistic about time frames. They are not saying that they want a job in the next month but in the next 6-12 months. Dalton Boggs, Dalton Boggs and Associates, Edmond, Okla.

My main goal is to find physicians who really want to make job changes--that's the big issue. There are a hundred reasons why anyone changes, but they truly have to be ready to change, not just thinking about changing. The next things I need to establish are where will they consider living and what kind of salary requirements they have.

We don't worry about whether or not they have a resume, because we do that ourselves. They send us CVs, and we are able to talk to them to gain any kind of additional information to make it adequate. That's just part of our service.

Some people just have the talent to interview well; it's an innate skill in most cases. Interviewing is like going on a date. For some people, no matter what their story is, you might not like them. There are things in the interview process that make the person feel happy, comfortable, wanted, desired. Before the interview takes place, you know the person is technically qualified to do it. Larry Tyler, Tyler & Company, Atlanta, Ga.

We want physicians to look like executives, have a professional appearance-have haircuts, wear suits. Instead of wearing suits, they will come in sport coats. If you have a really overweight executive, his or her clothes have to be tailored to fit that physique. Many physicians just don,t know how to dress, and. even when they do, they are just not used to having to look professional.

I also want a degree of sophistication with regard to how they answer questions. Most of us have a standard format of questions we ask. A lot of them haven,t interviewed with professional recruiters before and they haven,t done anything to try to prepare themselves for the questions we might ask. Most (60-70 percent) of what a recruiter asks would be asked by every recruiter. Tell me your strengths, tell me your weaknesses, your leadership style. They should already have the answers to those things in their minds. They shouldn,t stumble over them.

Physicians will come in cold for an interview and, in many cases. will have not done any homework on the employer other than the material we sent them. They will not have called any people they know that worked at the hiring organizations. They will not have networked with their peers that could be working at the organizations. They will not have called hospital associations. They will not have gotten information from the chamber of commerce. They are asking us to spoon feed them everything. Professional recruiters and clients appreciate candidates who have done their homework. One of the ways we judge candidates is not only by their answers but by the questions that they ask. Candidates who ask the better questions are the ones who have done some investigation of assignments and have some questions about information that didn,t appear on the client profiles that we sent them.

Physicians are not used to networking with strangers. They are used to talking to other doctors, but they don,t know how to take it to the next step--talking to those persons in order to get referral to strangers that they don't know. Not everyone does networking naturally, but most of us had to get a job that way. Physicians did not. They missed that developmental side. Most of the time, when nonphysicians are younger, they change jobs every two or three years. That means that, by the time physicians get out of medical school, their are peers are in their second or third jobs and have had to go through the exercise again and again. Physician executives are learning networking very late in life, and they are very much novices at doing it.

Many physicians rely heavily on letters of reference. That's another indication that they don't really understand what the process is about. Letters of reference are noted for what they don,t say, not for what they say. Physicians come in with four or five letters of reference, and most professional recruiters look at those things, say "Thank you," and put them in the trash. What we want to do is talk with the references directly. We don,t even care to see letters. Someone may have written something very flowery about a physician, but they usually don't give any weaknesses whatsoever and the weaknesses can be overwhelming. Jennifer Grebenschikoff, Physician Executive Management Center, Tampa, Fla.

I wish physician executives knew that they should look at several jobs at once. They have the idea that they should look at one job at a time. They concentrate on one position for six or eight months, and then, if that doesn,t happen, they start looking for another position. They need to look at all opportunities, regardless of where thev are geographically and what the titles are.

They need to understand the importance of networking. They think, "Someone will come to me and knock on my door and I have to just sit back here and wait for that to happen." If you are looking for a job and you really want to make a move, you have to do the work. No one else is going to do it. I wish they understood the need for that and what that actually means. I am happy to describe that process each time I talk with them. But they have to buy into it and realize that this is the business world and favors go both ways. Try starting to network on the phone. That way you are not in a face-to-face situation. Call a few other members of ACPE whom you think might be in situations to help you and say, "As a fellow ACPE member, I thought I might pick your brain for 20 minutes. Can we schedule some time?"

Some surveys have shown that recruiters are responsible for only three or four out of every 10 searches that are going on at any ume. When physicians do start to buy into the concept of networking, they think only, "Which firms should I call." If we recruiters are doing only a third of the work, think of all the other opportunities that are out there. There are search committees that sit down and look at each other and say, "Who do we know that could do this?" That's when you want your name on someone else's mind, which is what happens with effective networking.

We are constantly struggling with trying to describe for physician candidates the difference between a list of responsibilities and a list of accomplishments. Imagine that you are getting ready for your performance evaluation, and you need to put a list of things together to justify to your boss that, for the past two years, you were wonderful and you did all these terrific things. You want a raise, and the only way you can get it is to put together this list of accomplishments. What programs did you develop? What services did you improve? What budget did you decrease? What utilization did you affect?

Some will say, "Isn't it an accomplishment that we had a successful Joint Commission survey?" That is probably a responsibility. You wouldn,t have your job if you couldn,t get through that. I'm looking for more. What was the result of having that happen? I hear candidates say, "We expanded the services in the outpatient area." Well, what services? What was the volume before you expanded? What's the volume now? A resume needs to be a marketing piece and sell your accomplishments, not just list your job responsibilities.

I do a preinterview conversation with candidates just to make sure everything is okay and to give them some further background on the itineraries that they have in their hands. When interviews are over, they need to remember to give some feedback to the interviewers. Don,t leave an organization at the end of the interview without letting some key person that has interviewed you know how you feel about the day. It could be, "This was great. I loved it. This is something I want to pursue. What is the next step?" or "I'm not sure I have enough information yet. I'll need to think about this further, and I need such and such information to help me know if I'm going to go ahead with this." If somebody really feels strongly that this is the worst thing they have ever been through, they can say, "I'm not sure that this is the right thing for me. I'll need to think about it and get back to you."

Constantly, clients will call in and say, "Well, what did he or she think?" If you really want the job, you have to show your enthusiasm while you are there. It's not good enough to tell me and have me tell the client two days later. An enthusiastic response would be, "I really enjoyed meeting everyone. Your programs are great. I think this is something I'd really like to pursue. What's the next step?" Let the interviewers be able to walk back to the search committee the next day and say, "This person thinks this job is great."