Selecting a physician executive - Recruitment

Selecting a Physician Executive

Selecting a physician executive can be a complex task. The process is complicated by the explosive demand for qualified physician executives. Although the number of physician managers has grown since 1979, the demand still outstrips the supply of physicians with track records. Also, many organizations have never had a full-time person serving in the capacity of Medical Director or Vice President of Medical Affairs, so the process of recruiting this person is new to them.

How a physician executive is chosen by an organization depends on the specific job functions involved. As a first step, it is important that the CEO, or the body to whom the vice president for medical affairs will report, develop an outline of responsibilities, determine reporting relationships, and draft a mission statement, if it does not already exist. This will ensure that common goals and objectives are identified and clearly communicated within the organization before recruitment begins. The next step is to establish the search committee. The decision to hire should be made by a group of people who represent different organizational interests and perspectives. The search committee should be small and include the CEO, appropriate board members, the elected chief of staff, and one or two representatives from the medical staff (perhaps department heads) who clearly understand the institution's mission statement. They should provide a broad representation of the institution's practicing physicians, as well. The search committee must decide the criteria by which candidates will be judged. These criteria include specific personal and professional attributes, such as commitment to high-quality care, integrity, leadership, decisiveness, a solid reputation, and high moral integrity. Essential attributes are polished interpersonal skills that allow the person to work as an integral part of a team and developmental skills. The best place for the search committee to start looking for candidates is on the existing medical staff. Are there department heads who have displayed an active interest in becoming a part of the management team? Are these physicians currently in situations where they are involved in decisions that affect quality of care, staffing, and policy making? If they have practices, do they run them effectively and efficiently, yet still take time to develop undisputed professional reputations (such as through continuing medical education)? Do they have strong bonds with practicing physicians--particularly referring physicians? (This can often be either a positive or a negative in terms of how they will be perceived once in the role.) By looking at members of the medical staff first, you often can identify someone who would be able to establish rapport and gain the respect of the medical staff quickly. If there are no suitable internal candidates, key members of the medical staff should be approached for suggestions. This move serves as the basis for net-working that will inevitably take place. Networking simply requires appointing one or two members of the search committee to begin contacting referrals, references, or other institutions of similar size of scope to identify potential candidates. The screening process should be consistent for all candidates. Because commitment to the highest possible quality of health care has been identified as the most desirable characteristic of hospital executives,(*) the first screening question should ask for specific, demonstrated accomplishments in this area. Candidates should be able to point to examples of their personal responsibility for enhancement of services or their involvement in risk management and quality assurance programs. The questioning process also should identify the candidate's reputation and integrity, not only within a specialty, but also within the medical community at large. The screening process also needs to address leadership abilities. How influential has the candidate been in bringing projects to fulfillment? How does he or the plan to deal with disciplinary actions? How does the candidate influence people's thinking and opinions? The strength of the candidate's interpersonal skills needs to be determined. Is the candidate candid in both written and oral communications, and tactful when implementing decisions? Some questions are better asked of a member of the management team with whom the candidate has worked. These include the candidate's ability to hire and retain the best possible management team, as well as his or her outlook on and adherence to management philosophy. (*) Halstead, F. "Boards Want Leadership and Decisiveness." Physician Executive 15(4):12-14, July-Aug. 1989. To determine personality characteristics that would match those of the existing management team, ask candidates specific questions about things that stress or motivate them, the types of individuals with whom they most enjoy working, and specific areas of strengths and weakness. It is helpful to ask for both personal and biographical data so that a picture of the candidate can be painted. Ask why the candidate entered administrative medicine or chose his or her specialty. If the candidate is coming from a different type of position, find out why he or she considers him-or herself qualified as a director. Candidates also should be asked to describe their practice and management styles. (For example, are they conservative or aggressive?) The last questions during the screening process are similar to those asked of candidates for any position within an institution. These include their health status, their extracurricular activities, their concerns about the position, why they are interested in the opportunity, and why they are considering relocation. Particularly for a Vice President or a Medical Director position, it is suggested that the candidate have been involved in the clinical practice of medicine at some point for credibility as a liaison with practicing physicians. Check references before interviewing any candidates! Do not rely on written letters of reference. A member of the management team should personally check a minimum of three personal references and three professional references from the institution with which the physician is currently associated. If an in-depth screening process is carried out, the interview process itself should flow smoothly. As in all physician interviews, the spouse should be included even in the first interview and his/her needs addressed as well. Some time should be set aside to allow the candidate and spouse to join in activities of the community, such as dinners, luncheons, and PTA meetings. In this way, the search committee can assess how the individual conducts himself/herself in a social setting. Candidates should be interviewed by all members of the search committee. In addition, it is a good idea to include as many department heads as possible (particularly if the job description calls for managing some of them) so that candidates can get a feel for the medical staff's positions and opinions. The objective is to paint a picture of what day-to-day life and activity within the hospital is like so that the candidate has a clear picture of what he is judging. Make sure that the CEO, or immediate supervisor, addresses any concerns or questions that the physician may have developed during the interview, such as new projects to be developed and budgeting issues. One member of the search committee should be made responsible for follow-up with the candidate within three to five working days after the interview. A letter of intent often is used for physician management positions and is sent out only to the strongest candidate immediately after the visit. The letter is a nonbinding document, designed to outline the conditions under which the physician would be employed, and represents a psychological commitment. The document includes a job description and addresses specific job concerns, with a section describing the compensation/benefit package. Both the CEO and the physician should sign the letter of intent. The keys to selecting a physician manager include careful selection of the search committee, preparation of a specific position description and mission statement, and a carefully orchestrated recruitment process that explores several search or networking avenues. Unearthing potential candidates in today's supply side environment by selectively widening candidate specifications is the heart of a successful search.

Robin L. Walker is Senior Vice President, Tyler and Company, Atlanta, Ga.

COPYRIGHT 1989 American College of Physician Executives
COPYRIGHT 2004 Gale Group