5 keys to courting a colleague: Have a recruitment strategy, then follow it

For many physician groups, hiring a new doctor is a straightforward process. There's a salary, specialty, level of expertise and experience in mind. A recruiter does the screening legwork and suggests a short list. The group interviews a few candidates and makes the hire.

But this system can hide some serious deficiencies. The new doctor might not be the practice's first choice, might not stay long, or might not fit in with the group's culture and goals or "click" with patients. Sometimes a hire just goes wrong.

Some physicians and experts say this risk can be minimized by establishing a standard strategy for adding new physicians.

This boils down to five steps: be realistic about who you attract; talk compensation; show off the sites; keep the spouse or partner in mind; and have a big send-off. By that fifth step, experts say, both the practice and the candidate should know if the partnership is a good, long-term fit.

David A. Josephson, MD, a neurologist and CEO of Josephson-Wallack-Munshower Neurology, says his group's hiring process allows current members and a prospective doctor to consider each other in a realistic light.

"The more we know about someone we might hire, and the more they know about us and also our community, the more successful the decision on both sides," Dr. Josephson says. In the last 10 years, his Indianapolis-based group has grown from eight to 22 neurologists.

Step 1: Be realistic about who you attract

The killer, up-front issue in hiring, and one that can cause a lot of problems later on, often is not money, clinical philosophy or personalities. It's location.

The first recruiting step at JWM is interviewing the prospective hire with the goal of determining whether the geographic fit is right.

"I basically want to know why they think they'd be happy in Indianapolis," says Gary Kaufman, the group's chief operating officer and executive director. "Do they have a connection to the Midwest -- a family member or a partner's family member, for example -- or have they lived here for a few years?"

Kaufman won't automatically disqualify candidates who were born, bred and educated in, say, San Francisco or New York and who might never have seen the Midwest at ground level. But in the initial interview, he tries to make sure candidates with no Midwest connections understand that at the very least, they would have to overcome some culture shock. If they're not prepared to do that, moving to the next phase of the hiring process would be a waste of the group's and the candidates' time.

Barry Haberman, a consultant with Medical Specialties Managers, agrees with Kaufman's approach. He emphasizes that you want to paint a realistic picture of the geographic area, not sell the locale. "There's a tendency for people to extol the area they live in. But you don't want to get a candidate so excited they'll start to try to sell themselves, and then you're both engaged in marketing rather than in a candid meeting of the minds," Haberman says.

After the interview, if there is interest on both sides, Kaufman says, the next step is a doctor-to-doctor telephone interview. If the candidate has a subspecialty, the most senior physician in the group with that subspecialty could conduct the second interview.

"This is the time when we discuss our clinical philosophies. It's also a time when we try to determine how much the candidate knows about the field," Dr. Josephson says.

If location and clinical philosophy jibe, then it's time to talk money.

Step 2: Talk compensation

Compensation issues often are handled by the recruiting company, if the group uses one. But if the group wants to handle that issue itself, it shouldn't wait too long, advises Kathy Murray, senior director for key accounts at St. Louis-based medical recruitment company Cejka Search.

While compensation should not be the thrust of the initial telephone conversation, neither should it be avoided. "Pretty early on, you want to find out if the candidate's expectations match yours," Murray says. While there is usually room for some negotiation, there are times when the two expectations are so far apart that it makes any further consideration worthless.

"Salary is just one form of compensation," Murray says. "There's lots of creative ways to expand that without creating a situation where the new doctor's income matches that of partners." For example, groups can provide signing bonuses or make student loan payments for a number of years.

But whatever creative compensation is drawn up, provisions should ensure that the candidate doesn't bolt as soon as the incentive pay ends. "You want some way to protect that investment, to make sure you can recoup it either through continuing employment or in some other way which can be worked out by your lawyer," Murray says.

Compensation can be a complex issue, says Gary Tuttle, a practice consultant who helped develop the hiring process for Dr. Josephson's practice, so he suggests summarizing any offer in a two-page brief. "This is basically a bulleted version of what eventually becomes a 50-page employment contract," Tuttle says.

The summary, which can be faxed after the initial telephone conversation or handed to the candidate after the first face-to-face meeting, provides an easy reference for the candidate to use when comparing opportunities. It also shows that the group is well-managed, competent in business matters and serious about the offer, Tuttle and other experts say.

Step 3: Show off the sites

Once the initial set of telephone interviews has gone well, the next step is to invite the physician for a daylong tour of the medical facilities and to meet other doctors and some of the staff.

JWM makes all arrangements and pays the costs for the physician and the spouse or partner. This includes plane tickets and transportation from the airport to the hotel and office. Candidates usually fly in on a Thursday evening, so they will be fresh for meetings to be held the next day.

Generally, Kaufman and one of the doctors meet the candidate for breakfast. Then at the office location (JWM has nine locations), each doctor meets individually with the candidate for about 15 minutes. Depending on the specific location, the candidate then might go to lunch with doctors in the office. At the end of the day, Dr. Josephson meets with the candidate for about two hours to discuss in detail each other's thoughts about the position.

The same day, the doctors who have met with the candidate each fill out a three-item checklist that indicates whether they think the candidate will be successful at the group. The results of that vote go a long way toward determining whether the group will make an offer.

While all experts agree that doctors should be given a daylong tour, they have different ideas on how many doctors the candidate should meet, especially in a group situation such as a lunch or a group meeting.

"You don't want to overwhelm the candidate unnecessarily," Murray says. She points out that sometimes more is less. "If you have a group lunch, people will end up talking to their friends, and the new candidate won't get as much attention as in a lunch with only two or three doctors," she says.

Murray notes that some practices don't provide daylong meetings and tours to local candidates. She thinks that is a serious mistake. "Even if the doctor is just coming down the hall, you should give him or her the same respect and attention as one who's coming across country. A daylong tour makes a doctor feel the group is competent and interested, and that can go a long way in encouraging the candidate to accept the offer," she says.

Step 4: Don't forget the spouse or partner

The experts interviewed for this article all emphasize the importance of including the candidate's spouse or partner in the recruitment process.

"In actuality, many of the opportunities that candidates look at are similar. So the group is not recruiting the doctor, but really it's recruiting the spouse," Tuttle says. In fact, Kaufman says, his group has lost at least three candidates because of last-minute defections from the candidate's partner or spouse.

Experts say that when the candidate travels to the group's city for the interview, the spouse or partner should come along when possible. Real estate agents or others can show the spouse or partner around the city while the candidate is touring the medical facilities. In most cases, the spouse can be given the option of getting a general tour of the area, a look at some available houses or both.

If the spouse or partner is a professional, either medical or in another field, the group should try to use its members' connections to set up brief meetings with local professionals. The purpose is not to help the spouse get a job -- although some groups do offer to pass around the spouse's CV -- but to give the spouse an idea of opportunities in the area.

Step 5: Have a big send-off

At the end of the daylong visit, some groups have informal or even formal banquets for the doctor and spouse, in which the rest of the group and occasionally the group members' spouses attend.

As with group lunches, experts vary in their opinion of this strategy's value. Some believe it makes the candidate and spouse feel special. Others worry that candidates or spouses might not be comfortable in large, unfamiliar groups of people, and the dinner could seem more of a burden. So if a group wants to do it, it's best to give the candidate the option and a graceful way to opt out, experts say.

In any case, the next day, if the candidate has stayed overnight and doesn't have an early flight, use the morning hours for an informal meal and discussion with one doctor and possibly the administrator. And after the candidate returns home, send a gift, such as a fruit basket. "You want to leave them with a warm, fuzzy feeling about the group," Tuttle says.

No strategy can ensure that a hired doctor will be ideal for the group or that a candidate will accept the job. But by paying attention to detail, exuding a sense of competence and interest, and ensuring that family members are included in the process, groups can increase their chances of success.