Hiring the best: Interview essentials

Experts and practices give their advice on how to talk to a job candidate, whether it be a physician or a staff member, to ensure you get the best hire.

By Larry Stevens amednews correspondent — Posted Nov. 21, 2005

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When it comes to filling a position in your practice, whether it's for a physician or a receptionist, looking at a resume is easy; interviewing is hard.

A resume gives you an objective, verifiable look at what the job candidate has done before showing up at your doorstep. The interview is supposed to separate those who look good on paper from those who will do well in action, but it can be difficult to find the right questions to elicit the information you seek. It also can be difficult to tell if someone who appears to interview well actually will be someone who works well within your practice.

Experts and practices who've had success with interviewing say there are many different ways to approach these problems,but the underlying factor for success is being prepared. It helps if your practice has an established routine for handling interviews and enough of an understanding of procedures and personnel to determine which outsiders would fit best.

This matters whether interviewing potential physicians or potential staff.

Interviewing physicians

Medical groups have at least one advantage over many other types of small businesses when hiring associates: State licensing boards and medical society credentialing requirements do a lot of the gumshoe work.

While the interview should ascertain at least to some extent whether the prospective associate has the necessary skills for the job, neurologist Soren Ryberg, MD, points out, "It's virtually impossible during an interview to adequately quiz someone on his or her medical knowledge."

So to evaluate a prospective associate's medical skills, Dr. Ryberg's 25-physician Noran Neurological Clinic in Minneapolis relies on reviewing credentials and talking with physicians in the candidate's previous groups. In addition, often someone at the clinic knows, or at least has heard about, the prospective new associate.

Because the medical skills questions are usually answered long before the doctor is invited for an interview, the primary purpose of the meetings is to determine if the new doctor will fit in with the group in terms of philosophy and personality.

Richard D. Hansen, vice president and managing principal of the MGMA Health Care Consulting Group, which has worked with Dr. Ryberg's group to help evaluate new employees, says groups should try to determine personality issues, such as whether the candidate is a leader or a follower, or whether the doctor is very ambitious or more laid back.

"Such concerns are important, because if a practice already has a strong leader, a second may cause factionalism and dislocation," Hansen says.

Dr. Ryberg, the Noran clinic's president, agrees that sizing up a prospective associate's personality is essential, but he has found that formal questioning is not usually the best way to get to the heart of the matter.

If you ask people if they're well-liked or get along well with others, most would respond in the affirmative. So doctors at Noran Neurological prefer more informal meetings, including at least one dinner meeting during which the job candidate is strategically situated in the center of the group.

"These are times when we can get to know the doctor in an unthreatening setting," Dr. Ryberg says. "We can watch his social skills and the way he interacts with other doctors."

Noran Neurological does hold at least one formal interview during which it describes the group's goals and work habits, Dr. Ryberg said. They talk about things such as how many patients doctors are expected to see each day, how much time off they take and how they are compensated.

Monica Schnitzer, a director with MDI Medical in Atlanta, was responsible for recruiting and interviewing doctors for more than 10 years. She agrees with Dr. Ryberg that candidates have to understand the practice's goals to determine if they fit in with their own.

But before describing its goals, the group might engage in a bit of self-evaluation.

"If you're the kind of group that is willing to sacrifice compensation in order to have more family time, you should be aware that's your work style and put that on the table when interviewing a new doctor," she says.

Besides the formal and informal interviews, Noran Neurological puts applicants through one more series of conversations. The doctors are introduced to as many of the office staff as possible and given an opportunity to interact with them on a personal and informal basis.

"We love our support staff, and it's essential for doctors to get along with them," Dr. Ryberg says. The staff is not actually asked to evaluate candidates. But if a number of them spontaneously voice a negative opinion of the doctor, the group might decide to take another look.

At six-physician West Chester (Pa.) GI Associates, a lot of the background work is accomplished by its administrator, Matthew Davis. He carefully checks credentials, references and other administrative issues, such as disciplinary action.

"I make sure there aren't any surprises or things the doctors should be aware of before the interview," he says.

In the formal interview, the four partners in the group meet with the prospective associate to discuss administrative aspects of the group practice. These include how many patients they see each day, how compensation is distributed and how call schedules are set up.

The group also discusses the benefits of living in the community, real estate prices and the local school systems.

While the content of the interview is important, "at the same time we're observing the doctor, taking his or her measure, seeing how sharp he is," says David Neiblum, MD, a partner in the group.

Interviewing staff

Often, particularly in larger practices, physicians aren't directly involved with hiring staff, leaving that work to an administrator. But experts say physicians still have an important role to play in the staff interviewing process. Whether doctors get directly involved in interviewing staff or not, they should provide some guidance to the administrator who will be doing the questioning, experts say. After all, a rude or disorganized scheduling clerk might turn away patients.

Broadly speaking, when interviewing prospective staff members, you can ask what they actually did in a given situation or what they would do in a hypothetical situation. Most administrators and hiring consultants say the former is by far a better predictor of someone's capabilities.

"If you give someone a hypothetical scenario, they'll describe themselves in the best possible light, which may or may not be accurate," MGMA's Hansen says.

The position being applied for determines the questions, of course. But Hansen might ask a prospective receptionist to describe how he or she handled a patient who was angry because of a long waiting time, or he might ask a prospective scheduling clerk how he or she dealt with a patient who insisted on seeing his doctor that day.

Gail Lorenzen, a consultant with the Sage Group, an employee training company based in Brentwood, Tenn., suggests asking questions that encourage long responses.

"At the end of the interview, you should have the feeling that the applicant did most of the talking," she says. Lorenzen suggests questions such as: "Describe a situation that you feel very good about." Or, "Remember a time when you had a dispute with someone in the office."

West Chester's administrator Davis points out that he isn't always impressed when the applicant comes out smelling like a rose.

"I like it when someone says to me, 'I know I made a mistake in this situation. But this is what I learned from my mistake,' " Davis says. This kind of response shows the applicant is honest, is willing to learn and probably will take suggestions without feeling offended.

Davis also tries to determine not only how the applicants responded in a given situation but how they felt as they were responding.

"If someone describes a situation in which their reaction was picture perfect but inside they were seething, there's a problem," he says. Attitude is important, he believes. You can try to keep a stiff upper lip, but if you don't honestly want to resolve the problem, your true feelings will usually emerge.

Of course, you can't ask applicants who have never worked in a medical office how they handled specific situations. Davis says when he has to resort to hypothetical "how would you handle" questions, he tries to ferret out canned responses.

He says, "You can usually get a sense of whether someone rehearsed an answer ahead of time. They're too fast to respond, and the answer is just too pat." Davis would rather see someone struggle with a question and answer sincerely.

Only very large groups can afford human resources professionals to handle interviews. So most doctors have to depend on seat-of-the pants evaluations. But a set of well-thought-out questions and careful observation greatly can increase the group's chances of hiring the best available people.

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What not to ask

Employment law varies from state to state. But according to Rosen and other experts, there are topics interviewers should avoid:

Do not ask any questions that would reveal the ethnicity or country of origin of the applicant or the applicant's spouse or parents. These include questions about birthplace or nationality.

Do not ask questions related to disability. You can, however, ask in a general way (without referring specifically to any disability) whether the applicant can fulfill the responsibilities of the job as you've defined them.

Do not ask questions related to religion. This includes whether the applicant will want to take days off for religious observations.

Do not ask about marital status, pregnancy, whether the applicant has children or if he or she needs child care.

Do not ask questions related to health or health history.

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What to ask

Lester S. Rosen, a Novato, Calif., attorney and president of Employment Screening Resources, suggests asking all applicants:

"We do a background check on all applicants. Is there anything in your background you'd like to explain?"

"We also do a criminal background check. Are there any issues regarding that we should discuss?"

"We contact all references. Would you like to explain any possible negative responses from any of your previous employers or associates?"

Rosen says these queries offer two advantages. First, the applicant might reveal something that won't show up in a background check. Second, the applicant's explanation could save the group from rejecting a capable applicant because of a previous mistake or misunderstanding.

"Just because someone has an arrest in her background shouldn't necessarily disqualify her for a job. And the fact that someone didn't get along with an office manager might even be a positive sign," Rosen says.

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