Finding your new associate in the age of Monster

You’ll still need old-fashioned due diligence even with today’s online tools.

By René Luthe, Senior Editor

Today, you may have more ways than ever to post your “Help Wanted” sign for a new associate, but that does not mean finding a good match is any easier. According to practices that have recently gone through the process, you should forget about shortcuts — a new MD or OD is simply too important a position to fudge on — and instead follow these timeless tips.

THE SEARCH

Online resources

For practices on the hunt for a new associate, job posting sites like Monster and LinkedIn, and portals specifically for health professionals have made things much easier than in days of yore. Medical societies, including the American Academy of Ophthalmology, offer online resources for both employers and job seekers. These sites offer the benefits of large number of CVs for candidates throughout the country that practices can access any time. The Academy’s website, (www.aao.org/ophthalmologyjobcenter/), for instance, features more than 100,000 resumes in its system, with each job having an average of 540 views.

Job seekers can access a database with a savable search, set up alerts for jobs in specialties and browse for jobs visually on a map as well as by specialty or name. Thanks to technology, you can expand your search as never before.

Old ways are best?

Many, however, recommend good old-fashioned networking as the best way to find the kind of associate you have in mind. Robert E Wiggins, MD, MHA, in practice in Asheville, N.C., and the Academy’s senior secretary for Ophthalmic Practice, calls residency programs where his practice’s doctors have trained to see if they have ophthalmologists coming up. In addition to serving as an inside track on new physicians, this approach gives the practice the opportunity to talk about potential candidates with those candidates “we know and respect,” Dr. Wiggins says.

These are the candidates who have trained and worked with the residents, he points out, so they know the residents’ diagnostic and surgical skills. In Dr. Wiggins’ experience, conversations with these colleagues are a far more reliable indicator of a candidate’s abilities than watching their surgical videos. “We find that is probably the most important factor in deciding whether to go further with a candidate,” he says.

Richard Hoffman, MD, in practice in Eugene, Ore., also favors going to the people who know the candidates firsthand. “We were attendings at the university, so we would staff residents at the VA hospital; that’s a nice way to see how a resident is interacting with other staff and what their surgical skills are,” he explains.

His practice’s most recent partner was a surgeon who had been operating in the area for a few years, so the physicians were already familiar with her skills. “It was kind of a no-brainer,” he says.

However you find your candidate, it is crucial that you do not shortcut the research stage. Practices sometimes make the mistake of focusing too much on the resume, Dr. Wiggins says. “I think you have to dig deeper than that in terms of vetting the candidate very carefully with as many people as you can who know the candidate well, and the personal interview,” he says.

Using a business psychologist

When it comes time for that key hire, Daniel Durrie, MD’s, practice, in Overland Park, Kan., follows its own process for finding the right person for the job. It’s a one they use for every position in the practice. And while it may seem exacting to some, Dr. Durrie maintains it has made a difference to his practice in employee retention and team building.

For starters, the practice has a business psychologist on staff who helps create a profile of the type of person who would be best suited to a given position. “And we get the psychologist involved in the hiring process to make sure we don’t just rely on resumes and interviews,” Dr. Durrie explains. Not many practices may have a business psychologist on staff, but, he says, for an important hire such as an MD or OD, consulting one is worthwhile.

Measuring personality and intelligence

In addition, the practice uses other professional sources for finding and managing employee strengths. A favorite is the Kolbe Index (www.kolbe.com). An alternative to personality and intelligence tests, it features three parts:

• Kolbe A measures the subject’s instinctive way of doing things to determine her or his modus operandi.

• Kolbe B, Dr. Durrie explains, allows a co-worker to take a test on what he thinks the job is like. “That gives you the profile and strengths to look for.”

• Kolbe C allows the supervisor to give the candidate a view of the job.

“Then you have a lot of information,” Dr. Durrie says. “When we are doing our interviews, while we certainly look at resumes, before we do a second interview, we will do their Kolbe A and make sure we have a match. It’s certainly not the only thing we look at, but it’s one of the key things that I think has added to our success.”

NOW FOR THE OFFER

Arriving at the number

Say you’ve found the candidate you want, and it’s time to make an offer. A variety of sources, including the Academy and the Bureau of Labor Statistics (www.bls.gov), offer salary data. You can go the time-honored route of consulting your colleagues both in your area and around the country to get a feel for appropriate compensation.

According to a recent survey from the Medical Group Management Association, though, you may have to increase your figure. The MGMA Physician Placement Starting Salary Survey: 2014 Report, based on 2013 data, showed that primary care physicians reported $186,475 in median first-year guaranteed compensation, and specialists brought in $260,000. Practices have also increased benefit offerings, according to the survey — 60% of physicians placed in a new practice said they received signing bonuses, and 72% received paid relocation packages as part of their employment offers.

MGMA senior analyst Laura Palmer attributes the more competitive compensation to the uncertainty surrounding the effect the Affordable Care Act insurance exchanges would have on health-care organizations, in addition to the anticipated physician shortage. Though none of the practices contacted reported encountering a shortage yet, it may already be affecting the job market.

Employee or partner material?

Some practices have noted recently that newly minted physicians more frequently express a preference to work as an employee rather than eventually buy in and take on the responsibilities of ownership. For many other young physicians, though, buying into a practice remains an attractive proposition.

Practices that plan on offering a position that will eventually lead to partnership must deal with the issue of creating a fair and competitive agreement. Dr. Hoffman recommends employing a practice management consulting firm for the task. While many operating agreements are boilerplate, he points out that a consultant is an objective voice not only on issues such as what a corneal specialist is worth in your area, but also on the more delicate question of what your practice is worth.

“It’s like when you’re selling a house and you think it’s worth more than it is,” Dr. Hoffman says.

A consultant can also offer different options for structuring the buy-in. “We used Bruce Maller of BSM Consulting, and he gave us two or three different ways for our new associate to buy in, in terms of structuring good will and the value,” Dr. Hoffman says.

“And by having an independent person do it, I don’t have to feel like I’m selling the practice for more than it’s worth, and the other person doesn’t have to worry that I’m gouging. The consultant is an objective person who tell you how much the practice is worth based on your collections and your assets.”

Another advantage of using consultants, Dr. Hoffman says, is they cost less than attorneys.

The employee route

What if your new associate is one of those who want to be an employee rather than an owner? Although that could be a problem for a hiring physician moving closer to retirement and thus looking for an exit strategy, it may be advantageous for other physicians.

“Just having an employee usually is more profitable for the senior physician, because if they have an overhead of 35%, they might be paying that employee 30% or 25% of their collections, let’s say, so they are making 5% or 10% profit off that individual,” Dr. Hoffman explains.

In addition to being more profitable for the senior physicians at the practice, an employed physician may indeed be in the new doctor’s best interest. “Buying in is expensive, because you are buying a revenue stream,” says Dr. Durrie. “And if that’s not where you want to put your money, don’t do it.”

Parting advice

As eager as a practice may be to get another doctor and spread the patient load, Dr. Wiggins warns against the temptation to rush the decision on a new associate. “I think taking care and taking time in making the decision is probably most important,” he says. “If the candidate doesn’t seem like to be a good fit, it’s probably better to wait until somebody else comes along.”

Dr. Durrie agrees. “A bad hire costs you an awful lot of money, so we want to make sure we are not short-circuiting the hiring process.”

Once you’ve made your choice and the contract is signed, you have one more thing to do to make the relationship succeed, according to Dr. Hoffman.

“You need to look at the associate as a partner and not as an employee. When they first come, they are an employee, but you should still treat them as a future partner. You may lose money on them the first year or two, you may make money the first year or two, but I think if they feel like they are a partner or a future partner as soon as they come, it’s a much more collegial relationship, and they are more likely to buy in.” OM