Working With Recruiters.

Physicians sound off in CyberForums about their experiences with recruiters

"I HAVE WORKED WITH various executive search firms over the last several years and have had both good and bad experiences with each. It is most important to remember that the candidate is not the client, and that the client pays the freight."

"During two job searches over the last 14 months, I have been at times impressed, and very unimpressed, with the average recruiter. Many will not give you the time of day once they find out you do not have 'previous experience.' ... A few are willing to talk and give some advice. ... The very rare recruiter will ask enough questions and listen long enough to see your value and is willing to take a chance."

"My experience with recruiters has been to pick one or two and stay with them. Once you develop a good rapport with those select few, then it makes the professional relationship much smoother."

These are some of the comments made by nearly 100 physician executives who participated in a recent ACPE CyberForum: "Dealing With Recruiters," that generated hundreds of pages of responses.

Both CyberForums provided an opportunity for physician executives to share their personal experiences and resources in working with recruiters and conducting job searches. The physicians who participated came from diverse backgrounds and settings, and had varying degrees of experience in dealing with recruiters. Some had no previous experience. Some were physician recruiters themselves.

The CyberForum was a follow-up to an earlier CyberForum "Navigating the Job Search Superhighway."

Their actual comments appear in italics throughout this article. Some have been edited for clarity.

Recruiter categories

Three categories of recruiters were identified:

1. Retained search firms

2. Contingency recruiters

3. In-house recruiters

Retained search firms are paid a retainer to begin a search, with the rest of the fee paid when the candidate is hired and placed. Often, more than one candidate is offered to the client.

Many retained search firms have long-standing relationships with their clients (hospitals, HMOs, large group practices,) and clear insight into their clients' needs.

Retained recruiters generally try to learn more about their physician candidates and their families. Some are involved in the actual offer, Many stay in touch with candidates after placement.

"That a search firm is retained to fill a position indicates a commitment on the part of the client to the recruiter to work together to find the best person for that position. Most want not just 'a candidate' but 'the one candidate' who most closely meets their client's needs and is available at the right time.

"For candidates, an initial interview with a retained recruiter is usually followed up with an interview with the more senior consultant who will play a ma]or role in deciding whom to show their client. ...

"Most of the time they are seeking someone with a strong track record, and with candidates who are currently performing the desired tasks and have a proven ability to deliver what is needed. If you have the skills their client is seeking, they will work closely with you. If not, they really cannot ... invest much of their time with you. ...

"If you do happen to meet their client's needs, then the details become extremely important, especially those that relate to your personal and professional satisfaction. Sometimes the person who better fits into the client's professional or community's culture is more likely to succeed than someone who is technically more qualified but needs a lifestyle not found there."

"The majority of recruiters do look for the round peg for the round hole -- that is they try to find the ... best fit for the employer since that is how they make their money. Retained search firms, which usually do searches for individuals with salaries over $90,000, tend to be very selective and deliberate about their candidates, because they are paid some percentage up front to do the search."

Contingency recruiters receive no payment until one of their candidates accepts an employment offer.

Clients often give contingency search assignments for a single position to more than one agency. Freelance recruiters tend to work these firms.

Contingency recruitment can be more of a "numbers game," according to Calvin Bruce in an article: "Remarks: Has a Headhunter Called You?" [1] Multiple candidates are often presented in order to get one hired.

"One thing to remember about contingency recruiters: Because they only get paid if you're hired they will probably NOT give you any feed back on why you were not considered for or offered the job. This can be very frustrating if you thought you had an excellent interview."

"A retained recruiter may work 'on contingency' on occasion. The only way they make their money is to be working on active searches and if they finish a retained search, they are looking for more business. Typically, retained search firms get paid 1/3 to 1/2 of their fee up front with the other 1/3 when they present suitable candidates and the last 1/3 or other 1/2 when they successfully place a candidate."

"To be successful, a contingency recruiter cannot spend much effort on any one referral since most come to naught. They must have the client do most of the work since they are paid for only a fraction of the referrals and must make a huge amount on the few since they lose on the many."

In-house recruiters are the third type. Today, most health systems and larger group practices have in-house recruiters. While most of their focus is on recruiting physicians for clinical positions, occasionally they play a role in recruiting physicians for managerial positions.

In one sense they function like contingency recruiters, except they are paid salaries and generally can get the attention of the executive decision makers fairly easily. For entry-level, part-time management positions they are often given an opportunity to identify candidates before they go to an outside

source.

The National Association of Physician Recruiters (NAPR) is an organization of recognized recruitment firms. It publishes information on:

* "Best Practice" standards

* Unethical practices

* Fundamental responsibilities of recruiters, clients, and candidates

These are all available on the group's website (www.napr.org).

How to connect

There are many ways to "connect" with recruiters.

Many journals include job ads in their classified section placed by recruiters. Many large recruitment firms have websites that list specific available positions or solicit direct contact from prospective candidates. ACPE offers "Career Link" on its website at www.acpe.org/career.

Networking can lead to contacts with recruiters. Many recruitment firms keep databases with lists of prospective candidates. "Cold calls" from recruiters to candidates occur frequently for many physician executives.

It is important to remember that many positions are obtained without recruiters. Hiring from within, networking, word of mouth and direct employment ads were mentioned by CyberForum participants as sources for landing a position.

"My present position was obtained through a recruiter All other positions were obtained through networks and newspaper advertisements."

"(Recruiters) have a job to do and many times mishaps are due to the corporations' (the recruiters' clients) poor communication skills and are not necessarily the fault of the recruiter. This is also true of corporations as they frequently lock on to one recruiting company to find that one 'perfect' physician executive.

"It may not he wise to be in a recruiter database. One firm I worked with made it clear that my CV belonged to a specific recruiter in the firm and that I had to deal with him even if someone else had the search. ... If one 'owns' you, then do they have to split the commission? If so, it makes you a very unattractive candidate unless the recruiter who owns you also has the search!"

Recruiter etiquette 

Physician recruiters are paid to make quality placements. They are the middlemen between candidate and client. The process works well when all the parties understand their respective responsibilities and everyone's expectations. Physicians who choose to work with recruiters should expect:

Accurate information concerning employment opportunities

It can be disheartening when a candidate realizes the recruiter has little or incomplete knowledge and information about a prospective position. You should also expect recruiters to make distinctions about the different experiences and skill sets required for various types of management positions. For example, the skills required for a health plan medical director may be quite different than a senior vice president for medical affairs or chief medical officer of a hospital system.

"I was so frustrated to discover that the recruiter didn't have a clue about the medical director position or the organization. She couldn't answer most of my questions about the hiring organization. She didn't even have a written job description. She didn't even have a salary range."

Enthusiastic and fair representation of your candidacy

Since it is likely that the recruiter will be offering more than one candidate for each position, it is important to get a feel for how your candidacy competes with others. You should be able to determine whether you are perceived as a leading candidate or a back up.

The recruiter should be willing to give you a candid response about this. If you are considered a leading candidate, you should expect the recruiter to represent you enthusiastically.

"According to my new boss, the recruiter was my strongest advocate."

"I had a recruiter take a real special interest in me and spend hours with me digging out my work history--which was extensive, but convoluted, because I had never done only one lob at a time. ... I thought that was above and beyond the call of duty. As a consequence, I have a CV that really reflects my experience and skills."

It is also important that recruiters do not send your resume or present your candidacy to a prospective client without discussing the position with you in advance.

"Unscrupulous contingency firms can 'float your CV,' i.e., sending it without your permission (and sometimes unsolicited to companies who did not hire them.) This puts the candidate at a disadvantage--you now have a price tag on your head that the company may not have been willing to pay for."

"Many firms, even the respectable ones, 'redo' your CV, deleting your phone number and address so that they have ultimate control over when the client company contacts you.... It has their stamp or logo on the top so there is no mistake about how you arrived to the client company."

Prompt feedback throughout the search process

This issue, more than any other, elicited the greatest number of negative responses from participants in the CyberForum. A key responsibility of the recruiter is to provide timely and accurate information to both parties as the search unfolds. This includes voicing misgivings the candidate has about the position, or serious client concerns about the candidate.

Candidates should be notified if they are not going to be seriously considered for a position. When a position is filled, the candidate should be informed promptly.

"A good number of recruiters in my experience do not let you know what is happening. You apply for a position and you are told that you are being considered, and then you hear nothing. If I am not being considered or was rejected, just a note to tell me that would be nice."

"Recruiters had no interest in me other than did I fit into the job they were peddling. That was it. I sent resume after resume. Most never replied. I went on several job interviews and never got any feedback after months."

Candidate etiquette

There is a flip side to the relationship between recruiter and candidate.

Candidates have responsibilities to the recruiter. In order to do their job effectively, recruiters should be able to expect honesty, cooperation and commitment from the candidate.

Honesty

Be candid about career goals and employment and relocation preferences. If your interest is marginal or you absolutely would not consider making a career move, then be honest with the recruiter.

If you're seriously considering many opportunities, you should be upfront about that, too. The recruiter will appreciate knowing these facts before expending considerable time and energy on behalf of a candidate who is only "kicking tires."

It is important for physicians to have discussions in advance with their families to determine if relocation is feasible. If you are highly selective about geographic preferences, it may limit your choices unless you are a seasoned, experienced candidate.

"Two questions recruiters will ask are: 'Will you relocate?' and if so, 'What geographic limits do you have?'"

"If you do happen to meet their client's needs, then the details become extremely important, especially those that relate to your personal and professional satisfaction. Sometimes the person who better fits into the client's professional or community's culture is more likely to succeed than someone who is technically more qualified but needs a lifestyle not found there."

Cooperation

Recruiters work hard to make placements. Their time is as valuable as yours. When a recruiter makes the effort to present your candidacy, you must cooperate by honoring times arranged for telephone and on-site interviews. You also have a responsibility to provide prompt feedback after interviews.

"This may sound 'Pollyannaish,' but my approach to recruiters is to treat them exactly the was I would like to be treated. I try to go the extra mile to be pleasant, respectful, prompt with information and accommodating to even what seem like unimportant requests."

Commitment

Nothing is more of a turn-off to recruiters than a candidate who is only half-heartedly going through the job search process.

Physicians who float their resumes as trial balloons to determine the viability of their candidacy or leverage their current positions are wasting a recruiter's valuable time.

Candidates who turn down offers for less-than-bonafide reasons will quickly lose the respect of recruiters and may jeopardize a future working relationship.

"I wouldn't recommend that an individual consider the recruitment process as you would "test-drive" a car that you have no intention of buying."

Strategies

There are many books on career management. One book mentioned by many participants was Rights of Passage at $100,000 to $1 Million+: Your Insider's Lifetime Guide to Executive Job-Changing and Faster Career Progress in the 21st Century by John Lucht. [2]

The book is a reference guide for navigating the job search superhighway. The new edition's focus on the Internet and technology is superb. It also offers inside information from a top executive recruiter on resume preparation, networking, interviewing, managing recruiters, and personal organization.

Once a relationship is initiated with a recruiter, the physician should feel free to ask about the recruiter's background and status. Competent and ethical recruiters should have no problem answering such questions as:

* How did you get my name, and what did that person tell you about me?

* What kinds of clients and opportunities do you represent?

* Is this a retained or contingency assignment?

* Tell me your background, and your firm's background.

* How many physicians in my category have you placed in the last year?

Finally, the outcome of a job search is often directly dependent on the quality of the recruiter-candidate relationship. Common sense tells you to be courteous and responsive in any contacts you have with recruiters. You never know when you will be looking for a job.

Some CyberForum participants suggested establishing relationships with recruiters before you launch a job search. This is good advice as long as you make it clear that you are not currently seeking a position.

At times the process of working with recruiters may be frustrating and daunting. The best way to try to minimize this is to take control of those aspects of the process that you can control.

Here's more sound advice from some of the CyberForum participants:

"Last year I had worked with a recruiter from a large firm for months, She had set up phone interviews with four health plans and had facilitated two different on-site interviews. When she finally offered me a position, I turned it down in favor of my current position. "Throughout the process I let her know how much I appreciated all of her hard work and advice. When I declined the offer she asked me to call her next time I was looking for a position. A short time after that, due to poor financial performance of my organization, I was hack in the job search process. I called her back and landed an even better offer than the one I turned down before."

"Advice: network, network, network."

"During my job searches, I found that my most useful resources were the relationships I have formed with physician recruiters. They are often tremendously knowledgeable and should be part of everyone's professional network. I refer contacts to them, update them on my status when I have found a position, and even send them Christmas cards. They take care of me when I need them."

"I have relationships with several recruiters who now are comfortable calling to see if I am aware of someone looking for a position. They know from our relationship that the positions are not for me. One could get a bit annoyed that they are using me to identify contacts, but I am certain if and when I need their help it will be there."

"I suspect the time when you REALLY-need a recruiter is NOT the time to start looking for one ... Send your CV to some of the bigger and better known recruiters, and get to know one or two on a personal level. The best way to bold onto a job is to go to bed every night knowing you can quit tomorrow."

Barry K. Herman, MD, MMM, CPE, FACPE is a board certified child and adolescent psychiatrist and health care consultant in Austin, Texas. He specializes in medical management, e-health, and behavioral health care systems. He is the creator and listmaster of MedNews List, a widely subscribed e-mail bulletin board medical news service.

References

(1.) Bruce, Calvin, "Remarks: Has a headhunter called you?." The Physician's Resource, Mar/April 2001, (11) 2: 54-63.

(2.) Lucht, John. Rights of Passage at $100,000 to $lMillion+ Your Insider's Lifetime Guide to Executive Job-Changing and Faster Career Progress in the 21st Century. Viceroy Pr, 2000.