Notes from the other side of the interview desk

Ever wonder what’s happening on the employer’s side? An in-house physician recruiter shares notes.

By Therese Karsten | Feature Articles | Summer 2018

 

Over my three decades of working in health care and countless physician interviews, I’ve learned that the job-search process looks a little different from my side of the interviewer’s desk. I wanted to roll back the curtain to show physician candidates what happens on the recruiter’s side, so I polled others in the field for their take. Their answers can help you land and plan your interviews.

We will probably Google you

A recruiter’s Google search of Brent Herron, M.D., illuminated the “why” behind his request for an atypical schedule: charity work that made him a great candidate. · Photo by Jamie Rubeis

A recruiter’s Google search of Brent Herron, M.D., illuminated the “why” behind his request for an atypical schedule: charity work that made him a great candidate. · Photo by Jamie Rubeis

After reviewing your CV to confirm that you meet the basic criteria, there’s a good chance a recruiter, administrator or physician will turn to Google before inviting you to interview. This isn’t an attempt to dig up dirt; employers simply want to connect the dots. We’re looking to confirm that you’re a promising candidate, and we’re crossing our fingers that we don’t to see any red flags.

At some organizations, an online search is a routine part of the vetting process; at others, they’re conducted unofficially. For example, a curious senior partner might look while reviewing CVs on her home laptop.

Checking out social media profiles is still a hotly debated practice. Some hospital systems prohibit recruiters from searching anything other than official databases.

“Google searches incur the risk that the recruiter will turn up photos or indications of age, gender or country of origin that could be used as grounds for discrimination,” explains Christy Bray Ricks, MHA, FASPR, senior director of physician recruitment for LifePoint Health. One of Ricks’ former employers prohibited online searches not only to prevent inadvertent exposure to information associated with an equal opportunity protected class, but also because information on social media can present a skewed picture.

“There simply isn’t a way to forget information about extramarital affairs on a blog. No way to un-see the small town newspaper’s lurid and detailed account of a patient death,” Ricks says. “That information may not be accurate or relevant to the employment decision, so better to avoid it entirely.”

Not all organizations play by those rules. Many contend that anything that pops up in a search engine is fair game for review. Whether you agree with the practice or not, the smart thing to do is to prepare to be Googled. Open a browser window in incognito mode, Google yourself and see what pops up. Do a search for every name and nickname that might be associated with you, and don’t stop at the first page of entries. Then ask a tech-savvy friend or family member to do the same and see what they can find.

Look at your public footprints through the eyes of the senior partners at your previous employers. If you’d be proud to show a photo to those physicians, then it’s fine to keep public. Pictures of you with your dog, out with friends, even holding a glass of wine are all great. But no photos, posts or memes about alcohol impairment or recreational drug use should be publicly visible.

With the legalization of marijuana in several states, many younger physicians assume it’s no big deal to post memes and photos implying recreational use. Not so. Health care employers in Colorado, Oregon and California are worried about adverse selection—individuals who want to move to their states for unlimited legal access to their drug of choice.

Candidates should also delete photos that are distinctly unflattering, disturbing or sexually suggestive. Ask friends and family not to tag you in any posts that they would not show a prospective boss. I recently saw a female resident whose teenage cousin had tagged her in a string of selfies with zombie and witch filters. The photos weren’t scandalous, but they showed tongues out, strange hand gestures and cleavage—the kind of thing a 17-year-old’s friends would love. Thankfully, the resident removed the photos within a few days, but even that brief posting could have cost her an interview invitation if a physician interviewer had picked that week to Google her.

Bruce Guyant, Director of Provider Growth and Integration for Novant Health in North Carolina, also warns physicians to think twice before posting about their political or social activism. “With my previous hospital system, we had to back away from a candidate who blogged and posted extensively about a particular hot-button issue,” he recalls.

It was a tough decision. “At the end of the day, though, the CEO could not shake the concern that this physician’s weekend and evening activities would attract attention and impair her ability to build a practice in a conservative community,” Guyant says. “They worried that her activism could result in isolation for her—and evening news footage of protestors in front of the hospital.” He acknowledged that she would fit beautifully in more politically diverse markets, but her public expression of her views could make her and the facility a target.

Google results aren’t always a deterrent for employers. Sometimes a search reveals unique stories that help a candidate be successful. For example, I’m working with Brent Herron, M.D., a family medicine resident. Herron wants an atypical schedule: working late some days and taking some Fridays off to train for triathlons and manage endurance sports events. Typically, that kind of flexibility is earned over time, and practice administrators worry about priorities when a candidate asks for Fridays off even before interviewing. Several practices passed on Herron without reading anything other than his schedule criteria.

So I asked a hospital-employed practice to take a second look at Herron and sent along a link about his community involvement. Before going to medical school, Herron started a nonprofit that helps endurance athletes raise money for the nonprofit of their choice. He explains, “The inspiration came from my father being diagnosed with multiple sclerosis and my realization that everyone has a ‘multiple sclerosis’ in their life that motivates them.”

The practice considering Herron cares for a large, urban, younger adult demographic—exactly the kind of working adults who would value weeknight appointments. Once his prospective employers understood why Herron made the request, they began to see how his schedule could work well for their practice.

Another kind of Google hit that makes our day? An engagement announcement or wedding website. It’s wonderful to see pictures of a happy, glowing couple, and the narrative about what you enjoy doing together in your spare time usually confirms what we have already heard about why you’re a good fit for our community.

Google searches can also fill in the blanks for employers. I once had a terrific practicing candidate with a three-month gap on his CV. Gaps like this can be a red flag because they are often associated with substance abuse rehab. He had quit his job and listed his availability date as three months in the future. After a Google search, everything made sense. He remains unnamed here because he prefers that no one on planet Earth remember he was (excruciatingly briefly) a contestant on reality TV show “The Bachelorette,” which required him to stop practicing for three months.

We’ll talk to more than just your references

“There is an extended, diverse pool of people involved in vetting a candidate,” explains Brian Pate, M.D., chair of pediatrics at KU School of Medicine-Wichita. “You can’t predict who they might know at your training facility.”

Pate says it’s common for other department physicians, staff or facility administrators with ties to your training institution to have feedback about a candidate’s reputation. “The important thing to know is that, unlike formal references from your program director and faculty, the informal opinions afford 360-degree exposure,” he says. “If a physician is accountable and professional only to those above him or her…we often learn about it.”

Once during a hospital tour, Pate says a faculty member recognized a candidate as a former peer. “We unexpectedly received detailed feedback of how this individual was perceived as difficult to work with by peers, learners and hospital staff,” Pate says. “This information contributed to the overall impression of the applicant.” He encourages physicians in training to remember that preparing for a successful interview begins with a daily commitment to professionalism and best practices in their current positions.

Ricks agrees. “It surprises me that candidates don’t realize how much networking goes on in physician recruiting,” she says. “Most health systems are on a shared candidate management system. …If a candidate interviewed at a sister hospital in another state and didn’t get the job, I can call my colleague and find out how that interview went and get details that might not have made it into the database.”

It works the other way, too. “Networking can be a real plus for candidates who have made a good impression,” Ricks says. And a referral from a trusted colleague grabs a recruiter’s attention.

Shared databases can also reveal discrepancies between a candidate’s account of competing offers—and the truth. For example, physician recruiter Christopher Link recalls a candidate who was considering one offer from a group in the Midwest and another from Link’s employer in a different state—both HCA facilities.

“Maybe [the candidate] simply didn’t believe us when we told her that we stay in close touch as soon as we see that a candidate is engaged with another HCA hospital. It simply doesn’t make business sense for two hospitals in the same system to get into a bidding war,” Link recalls. “[The candidate] repeatedly tried to leverage our offers against each other using partial truths and omissions about the other offer in an attempt to secure better terms.”

We’re evaluating you on your presentation

Personal, handwritten thank-you notes to his interviewing team helped Sultan Mahmood, M.D., stand out—and get the job. · Photo by Danielle Shearon

Personal, handwritten thank-you notes to his interviewing team helped Sultan Mahmood, M.D., stand out—and get the job. · Photo by Danielle Shearon

When recruiters and administrators talk about “presentation,” they don’t mean beauty, style or media-perfect diction. But how you choose to present yourself when you make a first impression matters—because your judgment is what’s really on display.

According to Mary Wine, administrator at Advanced Orthopaedic Associates in Wichita, Kansas, overly casual attire sends the wrong message. “I haven’t had anyone show up in scrubs yet, but I have seen candidates show up for a formal interview in khakis and an open collared shirt,” she says.

Unless you have explicit instructions to the contrary, you should interview in a suit and tie or the female equivalent. “First impressions are lasting,” Wine says. “Effort shows that you are serious about wanting to join my group. Formal business attire demonstrates that you will know how to dress on the day I need to take you to meet hospital administrators with whom we have important contracts.”

Interpersonal skills are also important. Guyant says that if an applicant mumbles in a phone message, there will be no call back. “I am assuming that you are putting your best foot forward when contacting a prospective employer for the first time,” Guyant explains. “Accents are not an issue, but clear and comprehensible verbal communication is a job requirement.”

“The first opportunity a candidate has to demonstrate that is on a phone message to the recruiter,” he says. “If you mumble, whisper or speak so fast I can’t understand you, it’s likely that my patients and medical staff would end up confused and frustrated with you. I will put my time to more productive use, and I instruct my recruiters to do the same.”

Another element of professional presentation is the post-interview thank-you note. Since most communication today takes place by email, an interview panel takes notice of handwritten notes.

“Dr. Sultan Mahmood, a gastroenterologist I recently signed, sent thank-you notes to everyone on his itinerary, including me,” recalls Marci Jackson, FASPR, physician recruitment manager with Marshfield Clinic Health System in Wisconsin. “The front of the note was a family picture: the physician, his physician wife and his two children. With each note, he thanked that person for something specific.”

Mahmood says taking notes throughout the interview day was the key to personalizing these notes. Otherwise, minor details about each interviewer fade quickly from memory. “Having been on the receiving/interviewing side as a fellowship interview,” he says, “I knew that a personalized note can make a difference.”

Jackson agrees. “During an interview, it’s difficult to get the full measure of someone’s personality,” she says. “The courtesy and warmth demonstrated by Mahmood’s special thank-you note lent depth to our final impression of him. …I think it was important in the department’s decision to offer.”

We get wary when you say you’re open to any location

Andrew Walker, CMSR, FASPR, director of physician recruitment and contracting for CarePoint Healthcare, says recruiters get skeptical when physicians say they’re interested in 10 or more states. “I just know what I will hear when I screen this physician. He’ll say he is open geographically and is really focused on finding the right job,” Walker says.

There are other reasons physicians may give. One might say that since he doesn’t have family in the country, he’s able to settle wherever he finds the best job. Another might say she’s spent her whole life on the East Coast and is ready to experience something new.

However, we recruiters interpret these explanations in the context of our own experience. We speak to hundreds of candidates—month after month, year after year. And we’ve learned it’s easier to attract a candidate who is interested in a specific region. “If I’m recruiting for my site in Utah, I know that the candidate likely to accept if offered and put down roots in my community is the one who has a good reason to want to live here,” explains Walker.

That reason does not necessarily have to be family, but there had better be a well-articulated explanation if decision-makers are going to take the candidacy seriously.

“Recruiters know from experience that physician candidates underestimate the pressure they will get from family about living a 10-hour travel day away,” Walker says. If your extended family lives near each other—but five states away from your job—the pressure to move home and raise your kids near family will only intensify over time. Your remote job will probably last a few years, at most.

Recruiters can tell when a candidate is all-in for the long-term—hell-bent on becoming partner and gunning for a department head job in five years. Great cultures are built by these passionate physicians. “If my group has two candidates with roughly equal credentials … the one who is fired up about building a life here and genuinely excited about our practice is going to have an edge,” says Walker.

Candidates can jump to the top of employers’ hot lists by adding details in their cover letter to explain their interest in the area. For example, a candidate might write: “I’m interested in this job because my older brother and his family live in [suburb name], and my best friend from college lives downtown. Our wives are also friends, and we visit or vacation together almost every year.”

Or perhaps: “I have no ties to [city name], but I visited twice for medical conferences, and my husband and I simply fell in love with your city. Everywhere we looked, everyone we met reinforced the feeling that this was our ideal home. We are also looking at [other city] and [other city], but your city is our No. 1 choice, and we are excited about starting to explore.”

We can’t tell you everything

Most employers won’t tell you why you didn’t get the interview or the job. Typically, hiring managers and recruiters can only say they are moving forward with another candidate. This zipped-lip protocol developed as so many rules do: through lawsuits.

Any further discussion runs the risk of an EEOC complaint or, at the very least, unpleasant discussions with legal counsel, internal ethics committees and HR executives about a candidate’s complaint. Even at small practices that aren’t subject to EEOC regulations, the rationale for hiring decisions isn’t shared with the candidates.

Another thing employers and recruiters won’t tell you? Any troubling details about the practice itself or the local economy. Ricks wishes more candidates would do their due diligence on the job market instead of blindly trusting a prospective employer’s projections.

“Operational leaders call it ‘optimization’ when they eliminate unsustainable practices,” says Ricks, adding that this euphemism often means that “the physician is out of a job or has to move to another community.” To avoid getting “optimized” out of a job, Ricks recommends asking your interviewers: “Have you laid off or decided not to renew any physician contracts in the past five years?”

Before accepting a job, you should be sure that the employer is financially sound and that the area can support another physician in your specialty. Google the hospital system to find out what other news outlets, patients and employees are saying about an employer. You can also ask neutral third parties, such as the local chamber of commerce, to verify demographic trends.

We want you to find a good fit

Even though we can’t tell you everything while you’re interviewing, physician recruiters and employers want you to find a good fit. We’re always working to make the application and interview process easier to navigate. Once you understand what the process looks like from our side of the interviewer’s desk, you can put your best foot forward—and help us help you land the right job.

Therese Karsten, MBA, CMSR, FASPR is the director of physician recruitment for HCA Physician Services Group.

 

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