When physicians started and owned their own practices, the idea of being in one practice for their entire life was the norm. Some did move around, but starting up a practice took time, had costs associated with it and physicians who moved were often looked upon suspiciously.
Today, with more than 50 percent of physicians employed by a hospital, medical group, payor organization or some similar entity, physicians see employment much like other professionals see their employment. It’s changeable and transient. That perspective places considerable pressure on their employers to improve selection processes and to develop and implement definable structured mechanisms to retain the best of those recruits. Various statistics exist to quantify the cost of bad physician recruitment decisions, but $250,000 floats around the internet as a conservative cost associated with replacing a primary care physician. And high-fee surgical specialties could cost an organization many times that number, and more yet when facility income is added to practice-specific revenues.
I recruited physicians for 20 years. During that time, it was fly in on Friday, tour and dine on Saturday, and get a contract on Sunday morning. Much of the decision-making was conducted by the staff physicians’ review of the candidate’s CV. The meetings were just confirmation: assure us you’ve been a hard worker and wish to continue to be a hard worker and that you don’t or won’t do silly things. Occasionally, someone seemed so far outside the bounds of comportment as to render a reject opinion, but that was rare.
Aberrant behaviors, however, often didn’t show up immediately. And while I always prided myself on my ability to read people, I occasionally made a mistake. But, consider this, where the real problems occurred were not with the few troubled physicians who made it past our screening, but with those we held in very high regard but who chose to leave us. Those were the costliest mistakes. Really bad actors are quick to assess and quick to remedy, and everyone knows you are better off without them. Really good people who choose to leave can be difficult and costly to replace and their departures often reverberate through both the medical staff and the patient base for an extended period of time. Those are the mistakes you can’t afford to make. They will disgruntle your medical staff, erode your patient goodwill, and kill your career.
Making the right decision when everything about a physician candidate seems 100 percent positive can be the hardest decision you have to make. It doesn’t have to be. Smart companies around the world hire the right people from a host of highly positive candidates every day. They know that an exceptional skill set and an attractive personality don’t guarantee success in their organizations. All organizations have cultures, ways of doing things that aren’t necessarily part of the corporate handbook or employee manual. Corporations have attitudes and styles, behaviors if you will, that are successful and supported, and others, that could be equally positive and successful, bit are not supported. Understanding what your organization wants and what your organization supports are two of the most important pieces of information you can have in successfully selecting the right fit physician from all those talented physicians who apply.
Acquiring this information can be a challenge. Some of it is obvious, but some data you acquire or develop may actually prove contrary to those aforementioned manuals and handbooks. Corporate culture in practice doesn’t always follow the rules. One way around the political landmines you may encounter is to study the best performing physicians to define their characteristics that you, your organization, would like to duplicate through new staff members. That’s an historically validated approach. Another is to further define, subjectively, the best behaviors, best approaches, and best methods as defined by Key Opinion Leaders and Key Thought Leaders in your organization. Those indicators have also been highly tested and proven accurate in selecting best fit candidates. Sophisticated organizations know that combining the two databases to create a base profile comprised of objective data defining both your best actual practitioners as well as those other attributes, for example, organizational leadership or other characteristics defined as preferred qualities, will yield the best overall results.
Consider this, measurable profiles can be created and administered based on standard or personalized data for high producing physicians, physicians who are best at coordinating patient care in the group (ACO) setting, physicians who represent the most preferred leadership characteristics, physicians most respected by fellow physicians, best liked by patients, etc… The list actually is endless. However, the opportunity presented by these lists is to build a high performing, highly coordinated team that yields both immediate tactical results and sets the foundation for longer term strategic success.
If your responsibility is to build and retain a high performing medical staff and you are not using behavioral measures for both recruitment and staff development, you’re leaving a valuable and proven resource on the sidelines.