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Interviewing from the organization's perspective.

An organization's first task in attempting to recruit a physician executive is to form a search committee. "It should meet ahead of time to talk about the mission of the organization, what tasks will be included in the position, the kind of individual you're looking for, what specific talents and management experience you are looking for, and how you will advertise the position. Later it should meet to review resumes, bring up questions the committee has about the resumes, and talk about the people who have been invited for an interview."[1]

Candidates can be selected for an interview through various sources. Generally, a search firm sends them or colleagues can recommend them, but in some cases you may read resumes and check with colleagues about the candidates before they come. It's a good idea to check references before you invite someone for an interview. Questions you might ask are: "How are their people skills? How do they function in a board meeting? How good are they at public speaking? How are they in a discipline situation? Can you tell about any problems they had while working at your place?"[2] "When the candidate arrives, there should be an informal meeting with the main person responsible for coordinating the interviews. Go over a printed agenda with the interviewee, describe the people he or she will be talking to, give directions for how to get to all places he or she should go. I give them insight about the people they are going to be talking to. I want them to feel comfortable and perform as well as they can. They will be making a substantial move, and I want them to be able to put their best foot forward."[1]

The candidate is usually interviewed by one person at a time, but there may be three to four interview sessions, each lasting from 30 minutes to an hour. The person who will work most closely with the candidate may need more time.

"The best way to keep the interview on schedule is to let the candidate be in a central room and have the interviewers come to that room. However, in some situations candidates have to go from one building to another. Allow transit time, because the next interviewer will not be impressed with any excuse if the candidate keeps him or her waiting. The interviewer may already be prejudiced against the candidate. If it is necessary to move around, assign someone to escort the person from place to place."[1]

At the beginning of the session introduce yourself and try to put the person at ease. "Start with a tone that shows you are an interested, friendly person. Ask questions such as:

* Do you want coffee?

* Did you have a good trip?

* Did you sleep well?

You can talk about a common interest, a geographic location you have in common, or a common ethnic background. Don't focus on the job immediately. Some executives do not want to do this because they are busy. I think that is wrong. You are not just trying to find out if they are capable. You want to find out if this is an appropriate match. It involves not only capabilities, training, and skills, but also geographic compatibility and family satisfaction with a move."[1]

Let the candidate do most of the talking. You are trying to learn as much as you can about the person in a short time. If they are from Chicago, don't talk a long time about your relatives in Chicago. The person should have seen the job description before he or she gets to you. When you start the main part of the interview, you will describe more of what the job entails and probe for evidence that the candidate has experience and skills that meet your needs. Which to do first will be your judgment call. Some say talk about the position first. Others say don't talk about it first because the interviewee will learn on the spot the right answers to make you think he or she has the appropriate experience. At some point, though, particularly if you are interested in the candidate, thoroughly define the role and describe the culture of the organization.

Use open-ended questions. "I'm most interested in what they think of the job. I might begin, "You have looked at the job description. What is it in the job that excites you?' If the first part goes well, ask about gaps in the resume. If the person does not have enthusiasm or wants the job for the wrong reasons, you do not need to talk further about his or her background."[3] One person should be designated to ask about gaps in the resume, and it should not be done early in the process.

You want to know how they will perform in difficult situations. You can ask, "'How would you deal with doctors if they disagreed with you? Can you tell me an example of how this happened in the past.' The more concrete they are, the better. If they are hypothetical, they probably do not have a real experience or they had a bad experience and do not want to talk about it."[3]

"Try to find out if the interviewee has a vision of how he or she can transform the organization or if he or she is just tired of practicing pediatrics. You can ask, 'What is your vision for this position? Where do you want to be 5 years from now?' Look for buy in or motivation. Then go for information about skills, remembering you can give them skills, but, if they are not motivated, there is nothing you can do."[3]

Here are some other questions that can help you find out about professional experience:

* What do you consider your most significant accomplishments on the job?

* Why have you decided to leave your present position?

* Can you describe a situation in which you solved a problem?

* How can you help the medical staff and administration understand each other better?

* What are your strengths? Weaknesses?

* What would you like to see this organization doing that it is not doing now?

There are questions you are not supposed to ask. "You are breaking a federal law (and often a state law as well) by asking any questions directly or indirectly relating to the following aspects of the candidates background:

* Religion

* Race or color

* National origin

* Age

* Sex

* Marital or family status

* Handicaps

* Criminal record

* Financial affairs"[4]

Even though you cannot ask questions about family, "one major hurdle to appropriate adjustment to management role is family adjustment. If the candidate has a high school senior, Mom and the kids might stay at home. That does not help the physician settle in. They are loathe to buy a home, establish roots, join a church. You might ask, 'What do you think about living in a southern climate?' If they react, they probably react with reference to family. 'I think I'll be fine here, but I don't know about my wife.' If they bring it up, you can talk about it. If you express a concern about their well-being, in general people respond openly."[1]

"If the candidate's spouse is employed, it can become your organization's problem if he or she cannot find a job in your town. I've had better results when I addressed the issue up front rather than implying that it is irrelevant. This is an issue that is difficult for the applicant to raise, so the interviewer should bring it up. Sometimes I have helped find the spouse a job if I needed the physician badly enough."[1] Some search firms "interview the spouse of the applicant, since family life-style and personal needs must be considered for a good match."[5]

You cannot ask questions about a person's health, but you can describe the physical demands of the job. "The physician may be tired from the demands of clinical work and think management is going to be different. Describe any ways it is not a 'nine to five' job. There may be a lot of night meetings or weekend work."[2] "Some days will be long, there is significant travel. You will have to hit the ground running. Do you think you are up to it physically?"[1]

You need to describe your organization to the candidate-- good points and bad. Good--Are you the biggest in your geographic area? Are you a financially prosperous organization? Bad--Is your medical staff at odds, with little or no leadership? Is your affiliated medical school relationship a weak one?[6]

Listen carefully during the interview. "Listening is not something that comes naturally to most people, particularly in an interview situation. Because there are usually many questions you want to have answered and you're interested in the answers to these questions, there's a natural tendency to look ahead at what you intend to ask, or look back to reflect on a previous answer. You need to fight the tendency. When you're interviewing someone, you must discipline yourself to focus not only on what is being said but on how it's being said."[4] You are looking for confidence and good speaking skills as well as knowledge of health care management.

It is important for you to control the direction during the first part of the interview. You ask most of the questions, but near the end of the session be sure to ask the candidate if he or she has questions. Sometimes the questions the person asks are as influential as any answers given to interview questions.[7] You can find out how much they understand the demands of the job, how much they have researched your organization, how good they are at thinking under pressure, for instance.

"Make sure all of the interviewers can answer questions about the position and the policies of the organization. The most common question is, 'What amount of authority goes with the job?' You might answer, 'You have the authority to hire and fire, change the curriculum, etc.' Most candidates will not take a job if they have responsibility without authority to match it. Another common question is, 'Who pays for moving expenses?"[1] You don't know when the interviewee will ask these questions, so everyone should be prepared.

End the interview. "It's up to you to let the candidate know that the interview is about to end. You can give this indication in several ways: by closing your notebook, or removing your glasses, or simply by announcing, 'This will be my last question,' or 'We only have a couple more minutes, is there anything else you want to discuss?' You should then stand up, thank the person for coming in, and walk the candidate to the door.[4]

Try to close the interview without encouraging or discouraging. If you do either, you may make an enemy if you later tell the candidate the opposite. Aterwards, "caucus all people who interviewed the person. Check with the receptionist. If someone is mean and arrogant with a person of a lesser station or is demanding, that may be a signal that he operates in two personality zones."[3] "People can be different in an interview than they will be on the job. Having a second interview helps to find out more about who they really are. During the second interview, ask what they thought of the people they met in the first one and what they learned about the organization."[3]

"When you wrap up, tell them as much as you can. 'We will be interviewing several other people, and it is the intention of the search committee to make a decision in two weeks. We will get in touch with you about our decision then.' It's important not to be sloppy about this part of the interview and the decision making process. If you take a very long time to decide, the candidate, worrying about how long it takes you to make other decisions such as adopting the budget, may reconsider the merits of working for you."[2]

Salary will certainly be discussed in the second interview if it has not already been brought up. The candidate should not have to be the one to bring it up. If recruiters are involved, they have probably already given the salary range, but you will offer a specific amount to begin the final negotiations.

After you have finished all interviews," give serious consideration to candidates who:

* Show proven capability to do the job.

* Show achievements.

* Demonstrate interest in the job.

* Radiate enthusiasm.

* Ask logical questions.

* Prove how past experience and special knowledge will help your company.

* Get to the interview on time.

* Dress appropriately.

* Have good manners and are not condescending.

* Appear able to get along with co-workers.[4]

One of the most devastating things to do to a physician manager is to put him or her in a position to fail. It is important to make an appropriate match. How can you tell?

* Try to determine the degree of their commitment to management. If they ask about continuing clinical practice part time, I try to find out why they are asking. If they just enjoy practicing, that is usually all right. If they view it as a fallback position if management does not work out, I question their commitment. They will not be evaluated on clinical skills but on how well they can manage. I want to know if they are willing to put everything into the job.[1]

* Judge their ability to work with physicians. What kind of personality, ego strength, personal confidence do they have? If they don't think they can do the job, it may be a self-fulfilling prophecy. I lay out the roadblocks, the problems with the previous person, then let individual respond as to whether they can deal with the job. I clearly lay the job out before they sign a contract. Then if they say they can do it, but they can't, at least you have done your part."[1]

How do you finally decide? "Once, we developed a rating system, and it totally didn't work. It got too quantitative. We hired someone that the scale said was wrong, and he was terrific. Go with your gut. If you feel the person is not going to work, even though everything looks fine, listen to that feeling and trust it most of the time."[3]

People tend to hire clones. One has to make a conscious effort to do otherwise. If you don't feel good about the person, ask yourself some questions. Does he or she threaten me? Might he or she take my job? Does the person come on too strong? Then think about your own weaknesses and consider whether this person could fill in some gaps for you. What do you not like to do or are not good at that the person could do?"[3] If you avoid conflict, you might hire someone to deal with it, but remember he or she may not be as naturally cordial as you are.

After you have been as objective as you can be, if your instincts still tell you this person is not right for the job, it's best not to make the hire. Almost everyone has an example of when they did and how it did not work out.


1. James E. Hartfield, MD, FACPE. Personal interview. Oct 7, 1992.

2. George E. Linney Jr., MD, FACPE. Personal interview. Oct 29, 1992.

3. Robert H. Hodge Jr., MD, FACPE. Personal interview. Oct 8, 1992.

4. Half, R. On Hiring. New York, N.Y.: Crown Publishers, Inc., 1985.

5. "Investment Scene." Medical World News 33(8):35, Aug. 1992.

6. Kirschman, D., and Grebenschikoff, J. Physician Executive Guide, Everything You Need to Know About Creating and Filling a Physician Executive Position. Tampa, Fla.: Physician Executive Management Center, 1992, p. 18.

7. Roger Schenke. Personal interview. October 1, 1992.

Further Reading

Wendover, R. Smart Hiring. Englewood, Colo.: Management Staff Press, 1989.

Hiring medical professionals is an expensive process. It is important to conduct an effective interview to help you determine the qualifications of a candidate and to persuade the candidate to join your organization if that's what you decide you want.

Barbara J. Linney, MA, is Director of Career Development, American College of Physician Executives, Tampa, Fla.
COPYRIGHT 1993 American College of Physician Executives
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Article Details
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Title Annotation:Career Management
Author:Linney, Barbara J.
Publication:Physician Executive
Date:Jan 1, 1993
Previous Article:Antitrust concerns in managed care provider negotiations.
Next Article:Ensuring technological competence and leadership in medicine.

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