Making a match: inexperienced physician executives and the job market.

Most recruiters and seasoned health care executives use prior track record as a predictor of success in the selection of physician executives. In the absence of a prior track record, other criteria have to be used to evaluate the novice physician executive. We believe that the following 10 criteria can be used to provide evidence in support of such a physician's candidacy for a management position:

* Clinical skills * People skills * Leadership skills * Preparation toward being a physician executive * Communication skills * Facilitation skills * Business acumen * Embracement of change * Values * Team orientation

* Clinical skills. Having never seen the physician perform as an executive, the medical staff will immediately judge competence by the level of the candidate's clinical proficiency. Almost all physician executives are board certified in their medical specialties. If the candidate does not pass the clinical skills test, there is no need to evaluate him or her under the other criteria. The candidate should be eliminated.

* People skills. Successful physician executives must be able to deal with all levels of people in an organization. A physician executive must be able to relate to and show interest in employees other than physicians. The physician executive must also relate to the board and to people outside the organization. An arrogant attitude will not lead to a successful career as a physician executive. Look for employment stability in employees who worked for the clinician and relationships with nurses as a way to judge the candidate's people skills.

* Leadership skills. The physician should have held elected positions on the medical staff, rising to president at some point. One can also look for election to leadership positions in civic organizations, the PTA, or a church. We do not add the term visionary to the leadership criteria. While it probably does not hurt for the physician executive to be a visionary, the CEO of the organization usually supplies the vision.

* Preparation toward being a physician executive. The candidate should have thought long and hard about the career change. Indications of preparation are attendance at ACPE courses or obtaining an MBA or other advanced management degree. One of the problems with physicians is that many of them are getting "burned out" in clinical practice and choose to present themselves as physician executives as an alternative. These candidates rarely make good physician executives. They are running away from something as opposed to running toward something. Being a physician executive will require at least as many hours as clinical practice, and probably more. One should pursue a career as a physician executive for the right reasons.

* Communication skills. Many physicians have poor writing skills. Their writing, if you can read it, is often too wordy and wandering. It needs to be concise. If a physician has spent extra time to develop computer skills, this is a plus. It means he or she can type (an essential skill for e-mail) and may understand or may have acquired visual communication skills from computer programs such as "Power Point" or "Harvard Graphics." Oral skills can be evaluated during the interview. Are the answers to questions too long, too short, or rambling? Did the candidate make the point?

* Facilitation skills. Physician executives usually do not have a lot of direct reports. They get their jobs done by getting agreement among people and within constituency groups. They must be both process and results oriented. Moving a group from point A to point B and solving problems indirectly are important parts of a physician executive's job.

* Business acumen. The health care field is becoming more financially driven. A person who doesn't understand how organizations work or how business decisions are made will be lost. In evaluating candidates, look to see if the candidate ran a successful practice. Were the candidate's bills paid on time? Was the candidate fiscally astute and conservative in his or her business affairs?

* Embracement of change. We are now in a period of powerful change that will not end. An embracer of change is a life-long learner. Look for continuing education as an indicator. Also a good indicator of embracing change is the candidate's attitude toward managed care. Is the candidate progressive in this area, or is he or she fighting it or resigned to it? Flexibility is also an indication of a change embracer. Does the person have rigid opinions, or can he or she see both sides of an issue? Can the candidate admit to making an error?

* Values. When the direction in which we are progressing is not clear, values help us make decisions. In the interview process, values can be discerned from how a candidate makes decisions. Are the candidate's values consistent with those of the organization? With those of the management team? Finally, can you trust this person?

* Team players. In an era of decentralized decision making, total quality management, and great change, teamwork is critical. Physicians in general are not good team players. Their training taught them the independence of thought and actions. The executive suite is a place where teamwork is essential.

If you determine that the candidate passes muster in at least six of the criteria, you normally have a good candidate. If only five of criteria are judged to be positive, one would usually continue searching. But remember, if clinical skills are not excellent, eliminate the candidate immediately.

Ten Candidacy Criteria

1. Clinical skills 2. People skills 3. Leadership skills 4. Preparation toward being a physician executive 5. Communication skills 6. Facilitation skills 7. Business acumen 8. Embracement of change 9. Values 10. Team orientation

J. Larry Tyler, FAAHC, FACHE, FHFMA, is President, Tyler & Company, an executive recruitment firm in Atlanta, Ga.

ABSTRACT

Hospitals and other health care organizations are adding physician executives at such a rate that demand is outstripping supply - there are more opportunities for seasoned physician executives than there are physicians will track records as medical managers. It is possible that hiring management will have to consider the employment of a physician who wants to be in management but has no track record as a physician executive. In some cases, it may even be preferable to employ a neophyte physician is a respected clinician already on the organization's medical staff. In selecting such a physician, however, an evaluation must be made of the probability that the physician will be successful in the new role. The author points to 10 criteria that the hiring organization should observe in hiring inexperienced managers.