The Art of Interviewing

The Art of Interviewing

From rural to urban and from big city to academics the goals of interviewing are exactly the same.  That is, evaluate the candidate, discuss the candidates fit, and decide if an offer is justified.  There are obviously a lot of moving pieces in between but the goal of an interview should always stay the same.  Having worked in large and small markets it has become clear to me that what throws off an interview more than anything is a lack of planning. 

In a healthcare environment candidates are often interviewed within the confines of a group.  Often that group is as diverse in intellect and personality as the United Nations.  Subsequently, getting everyone on the same page is a difficult task and one that generally falls in the lap of the physician recruiter.  Every organization has a bandwidth of interviewers who know everything (or at least they think they do).  Then there is the bandwidth that has to be assisted in their interviewing skills by having questions provided to them beforehand.  Yet another group knows enough to be dangerous until they step over the HR line by asking a question to a female candidate about having a baby (yikes!).  A part of each one of these bandwidths is present on your interview team and whether or not they sit in a room together or individually the task at hand is to evaluate the candidate, discuss the candidates fit, and decide if an offer is justified  so the organization can make the best decision possible.

Many healthcare organizations do a poor job of interviewing especially practice settings.  This results in disruption when a less than appropriate candidate finds his/her way into an existing department or team and fireworks ensue.  In a matter of months that candidate resigns and the cycle of recruiting that position begins again.  Many times a forensic analysis of the interview process illuminates several areas that are problematic and ultimately result in a poor outcome.  In analyzing these interviews several traits have been identified that make some interviews more successful than others.

1)      Set aside some pre-meeting prep time.  You should be able to arrive at the interview having read the CV, assessed areas of strength & perceived weakness, experience, and background.

2)      This is an interview not an interrogation.  Put the candidate at ease by engaging in small.  Talk about your hobbies, your job, your last vacation, what is there favorite color or what cool new thing is happening at your hospital. 

3)      Interview as a team.  Everyone involved in the interview should know their respective role.  Each should have a portion of the job/candidate profile they are required to cover.  This does not require everyone to be on the same room.  The goal is to assemble the pieces into a coherent whole candidate so a decision can be made.

4)      Structured topics should be closely tied to the organizations goals and mission.  Questions about things like, stewardship, patient satisfaction, fiscal responsibility, community involvement, motivation, decisions making, cultural fit, communication and teamwork are all vital to building an accurate picture of the candidate and their fit with the organization.

5)      A structured interview has a beginning, middle, and an end.  30 minutes to an hour is not a lot of time to gather enough data to know whether or not someone is a fit for your organization.  Therefore, managing time is crucial to the integrity of the interview.  “Old doctor so-and-so always goes over his/her time” should not be the norm.

6)      Decide which questions have more weight based on the need of the organization, practice or department.  If an answer is not optimal but was satisfactory the weight will determine how important it is to the overall process.

7)      Create a post-interview evaluation form.  Each interview participant (minus the interviewee) should fill out a detailed evaluation for their portion of the interview complete with their recommendation to hire or not hire.

8)      Create a post-site visit evaluation form for the interviewee.  This gives you a way of evaluating the process and ways to tweak it if necessary.

9)      Decide who makes the final decision.  Either as a team or by committee someone has to make a decision.  Remember if you are struggling with too many decisions it may be time to tweak the process, questions, or team members.

10)  Use interview answers to customize on-boarding.  Areas of strength and weakness can be used to tailor the process of on-boarding and identify areas where new employees can add value or use additional training.

The framework of this article is a skeleton by which you can customize your own interviewing process.  No two interviews are ever the same and no two organizations interview the same.  However, every healthcare organization is looking for the next great member of the team. 

Social Media Strategy for Effective Conversation with Physician Candidates

Physician recruiting, like a flowing river, is always moving.  Fishing in the river (sourcing candidates) is equal parts timing (arriving on the riverbank), resources (how many fishing rods you put in the water), and patience (how you tend to your rods). Many of the tools we use in today's recruitment market are similar to those used 10-15 years ago.  The old tried and true methods still have merit but in today's socially active society the landscape for conversations and interactions has changed dramatically.  The ability to reach millions of people is now easier than ever before. Social media is shrinking the world 140 characters at a time.  Here are some startling points to ponder:

• If Facebook was a country it would be the 8th largest country in the world just ahead of Japan
• 3 out of 4 Americans use social technology
• 13 hours.  The amount of video uploaded to YouTube every minute
• 100,000,000. The number of YouTube videos viewed per day
• 3,600,000,000.  The number of photos archived on Flickr.com (6/09)
• 5,000,000,000. The number of minutes spent on Facebook each day
• 93% of social media users believe a company should have a presence on social media

Social media is the art of making media (pictures, video, blogs, microblogs, conversations...) a socially interactive experience.  In physician recruiting that ability amplifies information about our jobs, our organizations, our culture and the things we do everyday to impact our communities.  Many strategies can be employed by an organization to amplify their message for a variety of reasons through a variety of social outlets.  In the case of physician recruitment the key element is harnessing each of these outlets and weaving them into a coherent narrative.  Once developed, the narrative is used as an advertisement to which prospective candidates can be directed to gain vital information about the organization we are so eager for them to see and join.  The end result of putting together such a carefully constructed narrative is hopefully well informed hires. Social media outlets are not the place to connect with potential candidates.  Instead, they are the conversation starters we can use to engage candidates who seek information. In addition those conversations will lead to other conversations with colleagues, friends and family who, in return, will spread the message and elevate your brand to new heights.

The process of weaving a narrative together takes more than just a physician recruiter and a phone.  It will require administrative support and marketing support.  However, even if you are a house of 1, fear not, you can put social media to good use.  Here are some suggestions from some experts on social media:

• Start small.  Manage up your connections to encourage with content they will like, comment & share
• Share your story in a way that attracts prospects
• Pick one or two social media outlets and master them
• Include images in your content
• Keep it simple
• Identify your goals and then make a plan
• Steal ideas from others. Don't reinvent the wheel

I hope this has been a helpful read and that it encourages you to dip a toe in the water.  

Building A New Recruiting Program

I have been a recruiter for 14 years and in my last two positions I have been tasked with building two physician recruitment programs from the ground up.  The trials and tribulations of building a physician recruitment program are many but the rewards are so fulfilling that you forget how you got there.  Like any project, the developer, creator, or designer goes through a process of giving life to something that did not exist before.

That process is guided by a few simple, yet very important principles.  Here are a few points to consider:

• Discover why a physician recruitment program makes sense for the organization
• Why now?
• What was done in the past?
• What worked and did not work before?
• Find out who the key stakeholders are
• Are they the right stakeholders?
• Are there additional ones?
• Discuss with the stakeholders what it will take to recruit successfully
• Organizational mobilization (everyone recruits)
• C-suite support (commitment)
• Recruitment strategy
• Medical Staff Development Plan/Community Needs Assessment
• Budget 
• Competition (local & national)
• You as the content expert (trust)
• Policies/Procedures/Forms
• Technology
• Networking (ASPR, Cass, career fairs...)
• Onboarding
• Retention
• Implement your recruitment program and strategy
• Launch the initiative
• Create an atmosphere of success
• Create an atmosphere of cooperation
• Promote team building
• Analyze successes and failures
• Provide feedback and opportunities for growth
• Continue to grow as an organization
• Attend seminars, conferences and workshops
• Stay current on industry trends and new advances
• Maintain a strong network of colleagues
• Try new things

No two organizations will have the exact same physician recruitment program and never will.  It is up to us to maintain acceptable standards of practice that allow us all to do the best job we possibly can.

It's A Great Big Recruiting World Out There

I have been working with a consulting group at my new Hospital and I have been introduced to the concept of a "content expert."  As we discussed the utlization of these people in the structural reorganization of our medical group practice I was suddenly struck by the fact that I am one of those content experts.  In my everyday dealing with all things physician recruiting I am constantly called upon to offer my expert opinion of matters ranging from successions planning to networ development.  I dare say that any of my fellow recruiters who have been on the job 5+ years are also content experts.  Globally we can add to the chat banter by offering expert advice on content areas such as immigration and budgets.  Locally, we are also content experts in our own markets offering expert advice to CEO's, COO's and the rest of senior leadership.  Of perticular interest to me is the fact that the content expert constantly evolves and grows in his/her role.  We attend conferences, write, lecture and pontificate about the world of medicine and the struggles of recruitment therein.  Content experts can also be harnessed to push projects forward, restructure organizations, and maintain best practices.  In healthcare today our roles are more vital than ever.  Our knowledge is of worth to our employers and we are continuously needed to provide substance and credibility to everything from medical staff development planning to network growth and market share capture.  I am grateful for my place in this wonderful industry and I take this moment to share that gratitude with all of you who are grateful also.

CEOs & Other Healthcare Executive See Easy Money In Hospital System

In this age of public scrutiny about financial wrongdoings and at a time when Occupy Wall Street sends a strong message to corporations about greed there is a segment of the financial sector that still manages to break the rules day after day, healthcare.  In a day and age when a piece of newsworthy material can make it from Beijing, China to Los Angeles, CA in a viral second the headlines are full of hospital executives, accountants, CFOs and physicians stealing.  We call it embezzlement because it sounds nice as it rolls of the tongue but it is stealing no matter which way you roll it. 

Consider the case of Paul Cardwell, the former CEO of Powell Valley Healthcare in Powell, WY who is accused of embezzling nearly$850,000 from the organization¹. Cardwell authorized the spending of $847,934 for recruiting physicians, monies which were found to have been funneled to a straw company owned by Cardwell’s friends and then transferred to Cardwell by way of electronic transfer.  Cardwell is currently believed to be living in Thailand even though he has no ties to that country.

Consider the case of Carol Maultsby the former VP of Corporate Risk Management for Novant Health in North Carolina².  Ms. Maultsby plead guilty to eight state counts of embezzlement, admitting to stealing $620,000 from Novant.  Maultsby had set up a dummy company and authorized 50 checks of amounts between $12,000 and $13,000 apiece over seven years to be deposited into a back account under the dummy company’s name.

Consider the case of Richard Crabtree, Senior VP, COO for Christus St. Vincent Regional Medical Center who billed and collected $3.2M for claimed services that were never provided or grossly overestimated³.  The Great American Insurance Co. filed the lawsuit last month against former hospital executive Crabtree, Loretta Mares, her two brothers and five of their companies, according to the Associated Press. The lawsuit, which calls the fraud "a pervasive scheme," alleges that Crabtree and the other defendants engaged in the plot to misappropriate money from the start of his employment in 2002 until his termination in 2008. Although St. Vincent officials didn't comment on Crabtree's departure in 2008, the executive's termination coincided with St. Vincent's merger with the Christus healthcare group.

Further consider the case of Susan J. Morrison a former accountant for Michigan’s Munson Healthcare who in September plead guilty to charges of wire fraud and money laundering that totaled $1.1 million⁴. She transferred the money from Munson's Regional Healthcare Foundation's bank account to her former business, Great Lakes Bear Factory, between October 2007 and April 2011. She also made up false receipt accounts to cover up the theft.

If you think physicians are immune then consider the case of University of Louisville medical school physicians inappropriately used $4.8 million in Medicaid state funds for their own personal bonuses, diverting money away from indigent care⁵. Even more, the physicians used another $5.2 million for electronic records that would earn additional bonuses, according to the article.  Known as the repeat of the "Passport scandal," the accusations against University of Louisville physicians are similar to claims that nonprofit Medicaid managed care organization, Passport, transferred $30 million in funds to University of Louisville, University Physicians Associates, and other board members, according to the article. The groups repaid most of the funds to settle allegations by the Attorney General, who established the Passport transfer was illegal.

Lastly, consider the case of Marlene Rice Hoyle, 45, who was charged with embezzling $1.2 million from Jones Family Practice, where she worked for nearly 20 years, most recently as office manager⁶.  Hoyle, who pleaded guilty to five felonies on June 6, has been sentenced to four to five years in prison, according to the superior court clerk's office, with at least five years supervised probation following her release. Judge James J. Morgan also ordered Hoyle to pay more than $1 million in restitution, $100,000 of which she has already paid voluntarily.

The lure of money is a powerful thing when people face foreclosure, medical bills, dependant parents and trying to live a more “comfortable” life.  The occurrence of such theft marks us all and reminds us that those of us who work in healthcare are keepers of truth and decency within our organizations.  The crimes committed her are shocking not only because they violate the public trust but also because they are brazen and because they are only about money. 

Sources:

1.  Ilene Olsen.  “Former Hospital CEO Accused of Embezzlement.”  Powell Tribune [Powell, Wyoming] September 29, 2011.

2.  Michael Hewlett.  “Former Novant Executive Pleads Guilty To Embezzling Nearly $620,000.”  Winston-Salem Journal [Winston Salem, NC] February 21, 2012.

3.  Phaedra Haywood.  “Insurance Firm’s Lawsuit Alleges $3.2 Million Embezzled at Hospital.  Santa Fe NewMexican [Santa Fe, NM] December 29, 2011/

4.  James Russell.  “Munson Embezzler Gets Prison.”  Traverse City Eagle [Traverse City, MI] December 8, 2011.

5.  Deborah Yetter.  “Medicaid funds allegedly misused: U of L doctors used $4.8 million in Medicaid money for bonuses.” Courier Journal [Louisville, KY] September 29, 2011.

6.  Rebecca Clark.  ‘Woman Pleads Guilty to Embezzling $1 Million From Doctor’s Office:  DA Says She Has Nothing To Show For It.”  Shelby Star [Cleveland County, NC] June 7, 2011.

Can Social Media Expand Hospitals and Groups Presence

Many Hospitals and Group Practices are beginning to look at Social Media as a lifeline to patients and customers.  Clearly the use of social media in the health sector has increased overt he last five years and as interest grows so does the risk/reward equation.  Patient identity, patient records and employee interface all make the social media forum a place where risk management and marketing co-exist.  As we look out across the internet we can see several applications that social media has for hospitals.  Most prolific is sharing organizational news and services.  This allows hospitals and groups to engage in social media without creating any new content.  Sharing general news is a feature that allows healthcare organizations to post links to stories from local or national media outlets.  Most hospital also host community event and social media is a great way to promote an upcoming blood drive.  Success stories promote health and happiness and social media is an excellent outlet for stories about triumphing over illness or the success of an employee.  Lastly, customer outreach and awareness shifts the hospital's focus to being aware of what patients and other consumers are saying about the facility and their experiences and then responding appropriately.  Keep in mind social media can be used for so much more depending on the audience.

If you are thinking about entering the social media arena here are a few things to consider:

1)  Develop a social media plan that outlines the organization's goals and intended audience in using social media.

2)  Assign an individual or group accountable and responsible for posting content, monitoring usage, ensuring overall execution of the social media plan, and monitoring policy violators.

3)  Define which staff other than the accountability group or individual may participate in the organization's official social media.

4)  Identify which social media tools will be used to support the various goals listed in the social media plan.

5)  Include social media in all HIPPA privacy training.  Consider having staff sign a form after completion of the training.

6)  Ensure that privacy policies specifically address the use of photos of patients, staff, volunteers, and visitors, and that use without authorization is prohibited.

7)  Monitor social media for mentions, positive and negative, of the organization.

Hospitals and other healthcare organizations have begun to use social media in ways that attempt to meet consumer demand.  In doing so, they must create and enforce social media plans that define how engaged the organization will be, who its audience will be, and who will be responsible for managing social media outlets, as well as establish policies and procedures for managing risks related to privacy, reputation management, and employment issues.

Social Media and Physician Recruiting

There is no doubt that the advent of social networking has been nothing short of prolific.  The world has grasped on to the network and friendships have been spawned all over the globe.  People meet on-line, in organized dating forums, people get married from those encounters, and people exchange ideas which spawn other connections.  There are no more agoraphobics thanks to the web because no one is afraid anymore.  Just look at the human statement that is YouTube and you will see for yourself everything that is the human condition.  So where do the networks go from here?  In my world they start to creep around the edges of how people find jobs and specifically how doctors find opportunities.  Nearly 90% of physicians reported that they used at least one social media site personally, according to a survey by the online physician learning collaborative QuantiaMD.  By those numbers, physicians are well ahead of the general adult population -- 65% of the general public use social media, according to a study published in August by the Pew Internet & American Life Project.  According to QuantiaMD, 87% of physicians make personal use of social media, but a lesser amount, 67%, use it professionally. And one thing that hasn't changed during those 18 months is the lack of patient-physician communication on social media.  One-third of the QuantiaMD survey respondents said they had received a friend request from a patient on Facebook. Three-quarters of the physicians declined those invitations. 


So how do physicians look for jobs?  Zeldis Research Associates was commissioned by the New England Journal of Medicine (NEJM) to do a survey in December 2010.  4,008 Surveys were sent out and 376 usable surveys were returned.  The results were as follow:

§

• 89% rated professional/personal referrals as useful in finding a job  
• 15% rated social media as useful during a job search 
• 50% used classified/recruitment sources in print 
• 50% used classified/recruitment sources on-line 
• The most important factor online was job quality 
• 60% rated print and online versions as equal 
• 70% use a mobile device & 67% of them are interested in using a job app 
• Interest is highest for permanent positions at a hospital or group 
• 97% of respondents were 40 years old or younger 
• 50% were practicing physicians 
• 88% started looking just prior to or during their last year of training.

As you can see the social networking "medical edition" is not a mainstream construct yet.  Physicians don't friend you, they don't invite you to their LinkedIn inner circle and they don't follow you on Twitter.  Why?  Because they have professional standards to uphold.  A recruit is not going to let you into their inner most space and allow you to rummage through their proverbial under wear drawer.  The wall between us is high and wide but not insurmountable.  If we cannot get into their private world then we are just going to have to invite them to our public world of hospital sites and group Facebook pages.  The information superhighway has new billboard space and it runs of the freeways of the social network.

Next topic:  How can hospitals use social media?............................