The first step in hiring a practice administrator is to define the job — its duties and its responsibilities. A detailed job description, including a chart showing the chain-of-command, will ensure that everyone in the practice has a clear picture of the position.
When formulating the specifics of the job description, ask yourself these questions:
- Will the practice manager have responsibility for hiring and firing non-clinical staff?
- Will duties include strategic planning and business development?
- Will the manager be able to initiate and negotiate contracts with employers, PPOs, and other organizations?
- Who will be responsible on the clinical side for assisting with such issues as quality assurance and profiling?
To what extent is your market penetrated by managed care? You will want to find a practice administrator who has the necessary experience with PPOs, HMOs, and other health alliances to help your practice keep pace with your market.
If you haven’t developed a mission statement for the practice, now’s the time to do it. If you already have a mission statement, it may be time to review and reassess it. Writing or revising such a document will help you think about the practice’s short-term and long-term priorities and focus. Then, use the mission statement when talking to candidates to let them know where the practice is headed.
Finally, select a search committee of no more than four people, with one member (usually a physician) given primary responsibility for recruitment and preliminary screening (e.g., advertising, working with a search firm, conducting initial phone interviews, developing an evaluation form, and checking references). Of course, other members of the practice should be involved in the interviews and final selection, but the first stages are best handled by one person.
Finding Candidates
Finding qualified candidates can be a challenge. However, there are several tried-and-true ways to identify excellent candidates and begin the screening process.
The most obvious way to begin is by placing an ad in the newspapers and professional journals. The ad should include specifics about the position, as well as a description of the practice — its size, focus, and so forth.
Contacting various professional associations is another way to find qualified candidates. The Medical Group Management Association, the American Group Practice Association, and the American College of Physician Executives all offer excellent resources for finding candidates.
Search firms specializing in health care are another resource for identifying candidates. Search firms work in a couple of ways. Contingency searches provide names only and require payments when a position is filled. Retained search firms generally provide full-service assistance and consultation — from initial screening to reference checking and finalizing the offer. Their fees are usually based on a percentage of the candidate’s first-year earnings.
Conducting Initial Interviews
Selecting candidates from a stack of resumes is an art. When screening resumes, look for candidates with experience in primary care and in a group similar to yours in size, scope, and market conditions. You may also find it helpful to request a statement from each candidate about his other qualifications, personal goals, and reasons for seeking a new position.
Once the top five or so candidates have been identified, schedule telephone interviews with each. These should be limited to 15 minutes and can cover a variety of topics — specific experience, reasons for seeking a new position, philosophy, and professional accomplishments.
Be sure to ask each candidate the same questions and stay on track with the interview. As you talk to the candidate, think about how he or she would fit into the practice. Does his or her background complement the experience of the professional staff? Do the candidate’s skills match the goals you and the other physicians have for the practice? Does it sound as though the candidate would be a team builder and a team player?
Of course, chemistry on the phone is important. If you seem to click with some candidates, while others come across as stiff or disinterested, note this information. This is a way to begin narrowing the field.
However, here’s a word of caution. Just because a candidate interviews well over the phone doesn’t mean he or she will be the best person for the position. Don’t rely solely on the telephone interview to determine whom to invite to visit the practice. Consider the phone interview as part of the larger picture — along with a candidate’s qualifications, education, and experience.
Narrowing the Field
After the phone interview, you should narrow the field to three or four candidates. If you are having trouble settling on three or four, make follow-up phone calls. Limit yourself to a couple of “make-or-break” questions. For example, create a scenario of a typical situation in your practice and ask each candidate how he or she would handle it. Don’t be afraid to probe or ask tough questions.
This is also the time to conduct reference checks and verify degrees and credentials. Never rely on written letters of reference: talk with each of the candidate’s references. Be sure to respect the candidate’s privacy with regards to current employers. You may also want to talk with colleagues from previous positions.
Reference checking can be a difficult process. Increasingly, former employers will only verify employment dates and salary. However, you may be able to get more information by asking about a candidate’s responses to a particular situation or the extent of his or her experience with certain types of management demands, such as finance, data analysis, or managed care.
Inviting Candidates to the Practice
Once you’ve decided on the top candidates, it’s time to set up personal interviews. It is generally the responsibility of the practice to make the arrangements and pay for travel expenses for out-of-town candidates. Send them an itinerary, the position description, community and practice packets, and a general compensation overview.
For site visits, develop a schedule for each candidate to ensure that he or she meets the key players in the practice. The initial interview should be conducted by the head of the search committee, followed by one-on-one interviews with the physicians. Schedule uninterrupted time for these interviews and ask everyone to stay on schedule. Ask the office staff to help by limiting interruptions.
Prior to the visit, each physician should receive a summary about the candidate, in addition to a copy of the resume and any other relevant information the candidate provided. It is also wise to brief the physicians about each candidate, detailing any positive attributes or raising concerns that can be broached during the personal visits.
If any physicians are uncomfortable conducting interviews, they should consider drafting a list of questions beforehand. Each interviewer should be encouraged to take notes as well, so that when it comes time to make an offer, he or she will remember each candidate’s specific strengths and weaknesses.
Candidates should be introduced to the support staff and others who will interact with the practice administrator. It may also be appropriate for the key members of the staff to spend time with each candidate. Afterwards, their input should also be considered in the decision-making process.
Evaluating Candidates
If you’ve conducted a thorough screening process, you should have all the information you need to make your decision. Plan a meeting of the search committee to evaluate the candidates, asking each member for input. (An after-hours meeting is usually best; interruptions are minimized and all participants can take their time to make comments.)
If you’re lucky enough to have several strong candidates, you may find at this point that you’re only ready to narrow the field to two or three. If specific questions remain, schedule follow-up phone interviews.
Making the Offer
The decision to make an offer must be arrived at by a majority of the search committee.
From start date and responsibilities to compensation and benefits, all aspects of the offer must be agreed upon before the offer is made.
The offer should be made in writing, with all details spelled out. The obvious components of the offer — salary, bonuses, and benefits — must be specific. It’s a good idea to ask an attorney to look over the offer before it’s extended.
If accepting the offer means that the candidate will have to relocate, your offer should outline your terms for subsidizing related expenses. Will the practice pay for a house-hunting trip for the administrator and his or her spouse before employment begins? What about temporary housing costs?
Don’t neglect to consider all contingencies. For example, how can the contract be canceled? Will the practice be responsible for moving expenses, etc.? What if employment is canceled by either party within the first year? Will the practice administrator have the option of a contract buy-out?
Resources
Contacting various professional associations is one way to find qualified candidates. The following organizations offer excellent resources:
Medical Group Management Association
Englewood, CO
303-799-1111
American Group Practice Association
Alexandria, VA
703-838-0033
American College of Physician Executives
Tampa, FL
813-287-2000
About the Author
Robin W. Singleton, FAAHC, FACHE, serves as Executive Vice President in DHR International’s Healthcare and Life Sciences Practice Group in Atlanta, GA. DHR International is the fifth retained executive search firm with a wide variety of practices ranging from technology, non-profit, sports and entertainment, financial services, and healthcare.
