Preparation is key to successful job interviews.

Imagine you are applying for a physician executive position in the pharmaceutical industry. After reviewing two-dozen employment applications, the hiring manager is able to narrow the field to you and three other candidates, all of whom previously worked in the managed care industry. Here's how you stack up against the other candidates:

* Candidate #1 (You): Double-boarded in internal medicine and cardiology. Experience in utilization, quality, disease and network management, contracting and credentialing. Served on pharmaceuticals and therapeutics committee and consulted directly and through medical advisory panels to pharmaceutical, biotech, and device companies. Interests are in combining clinical knowledge with strategic marketing.

* Candidate #2: Physician executive highly experienced in health care management. Strong analytic, implementation and communication skills; success in a wide spectrum of health care organizations, focusing on clinical care, provider relations, disease management, patient and physician education, sales and marketing and consumer satisfaction. MPH in health service management from a well-known university and physician executive certification from ACPE.

* Candidate #3: Physician executive with strong analytical and leadership abilities who empowered teams to develop and implement programs focused on quality, disease management and administrative issues. Proficient with HEDIS and NCQA accreditation processes, all aspects of quality management.

* Candidate #4: Senior managed care medical director, MBA degree, with leadership in quality management and research, and utilization and network management. Experience in health care policy research and legislative and regulatory affairs. Provided consultation to pharmaceutical organizations in marketing strategies to ethnic markets and development of disease and health management program strategies.

The hiring manager will be hard-pressed to determine the best candidate. Presumably everyone in the first cut has, on paper at least, the tangible qualifications for the job. That is why the interview is so important. It provides an opportunity for the employer to differentiate candidates on the basis of character, rather than content, and allows the prospective employee to ask questions relevant to the job. Interviews also provide an opportunity for candidates to collect information that will help formulate their impressions of the company.

While interviews typically involve a mixture of questions, many companies use a process known as targeted selection, or performance-based hiring. Targeted selection is based on the premise that past behavior is the best predictor of future performance.

By collecting examples of a candidate's past behavior, an interviewer can better understand a candidate's work history and experience and relate the information to the target job or role.

With targeted selection, all aspects of the selection process are built around job requirements; inconsistencies are eliminated; decision points are clearly defined; all applicants are treated equally; government regulations are followed and the best possible candidates are hired.

Under the targeted selection process, you will be asked specific behavioral questions designed to assess certain competencies required for the job--leadership, political, decisiveness, financial, resource allocation, conflict resolution and other competencies.

Here are a few key questions you're likely to be asked:

* Can you give me an example of a time when you successfully took charge of a group and helped guide it into getting a job done?

* Tell me about a time when you had to make a tough strategic decision. Why was the decision tough and what did you do?

* What strategies have you used in the past to make sure that your department got what it needed?

* Tell me about a time when you had to make a decision you knew would not be popular. How did you convey the decision to subordinates and senior leaders?

* Please describe a time when you successfully persuaded a group to your point of view and tell me how you went about it.

* Tell me about the most successful project that you ever worked on. Why was it successful and what was your specific role?

* What was the most difficult budgeting challenge you ever faced and how did you handle it?

In addition, be prepared to answer the perennial question--Why are you interested in this position?--and explain why you left previous jobs. Responses that signal you're underpaid or you're only interested in a relocation package are immediate turnoffs and usually can be detected no matter how cleverly they're disguised.

Your reply should indicate the position is the best match for your background, experience and future aspirations.

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It is illegal to hire candidates on anything other than the applicant's ability to do the job. That's why it's crucial to prepare for questions like those above. You should not be asked questions with answers that are likely to generate non-job-related information, but it may occur with inexperienced interviewers.

I remember being interviewed by someone who said I "looked good" on paper, but he needed to see me in person to make sure I "didn't drool." His remark could have cost his organization a lawsuit, but his point was well-taken: the interview may be your only competitive advantage.

The latter part of the interview is usually reserved for the applicant's questions. If you have no questions--nothing at all to ask--a warning flag may go off in the interviewer's head. Even at the lowest levels, potential hires want to know about the compensation package and benefits.

Physician executives will want to know these things as well, but they should have more detailed questions. Just make sure the answers haven't already been covered by the interviewer or in the company literature.

Questions you may want to ask the interviewer include:

* If you had to identify the perfect candidate for this job, what qualities would he or she possess, and what skills and abilities would be beyond your expectations?

* Is this position vacant because it is newly created or did someone leave? Why?

* What are your favorite and least favorite aspects of your job and what are some aspects of the position I should be aware of?

* Can you describe your policy on promotions and performance evaluations? Who conducts the evaluation and how often?

* Please describe what a typical day or week would be like.

* Are employees cross-trained so they can pitch in when the workload is heavier than normal?

* Can you tell me some of the company's strategies to remain competitive and how I would figure into that equation?

Of course, there will never be enough time for one person to answer all your questions. Therefore, be judicious and spread your questions among all who interview you. With input from several people, it's more likely that answers to your questions will be balanced.

This also allows the interview team to make connections, draw conclusions and uncover candidate strengths and weaknesses that otherwise would be missed with only one source of information.

Remember, years of work experience are not necessarily a strong indicator of your potential. Past performance is absolutely the single best indicator of future success. The hiring decision depends largely on activities and behaviors exhibited during your interview rather than the number of years of experience you have as a physician executive.

This leads to a final comment about body language. The employment interview is one of those rare occasions when it may be necessary to consciously alter your body language to send a specific message, namely, "I'm very interested in what you have to say." So keep these points in mind:

* Sit attentively and appear interested in the interviewer.

* Lean toward the person as if you want to make sure you don't miss a single word.

* Maintain eye contact when you're not taking notes. Try to convey your interest with your voice.

* Consider taking notes as a prompt. When you hold your pen ready to make a note, you are signaling interest, and the interviewer will want to give you something to write.

Even if you have to fake it, use your body language to convey interest. The interviewer will be flattered and more likely to come away with a favorable impression of you.

It is the responsibility of the interviewer to bring the interview to a graceful close. Do not break off the interview at will. Only the interviewer can give you permission to leave or signal that the formal discussion is over. When that moment comes, thank the interviewer for taking the time to talk to you and for being so responsive to your questions. Inquire about the next steps in your process.

Good luck!

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The interview may be your only competitive advantage in a field that has become increasingly crowded with talented physician executives with diverse experience and post-medical graduate degrees.

By Arthur Lazarus, MD, MBA, CPE, FACPE 

Arthur Lazarus, MD, MBA, CPE, FACPE, is director and regional medical research specialist for Pfizer, Inc, based in Prospect, Kent. He is a frequent contributor to The Physician Executive and editor of MD/MBA: Physicians on the New Frontier of Medical Management (American College of Physician Executives, 1998). He can be reached at 502-228-2480 or [e-mail]. His opinions are not necessarily those of Pfizer, its management or employees.

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