A foundational component of any strong business is the ability to recruit and keep good people. Ophthalmology practices, regardless of size or location, are no different. Unfortunately, like any matchmaking process, recruiting the right person can often be fraught with pitfalls on both sides.

Physician hiring is as challenging as it is critical, as the position has unique aspects that differ from nearly any other industry — a long training time, relative scarcity of qualified applicants, the prevalence of restrictive covenants, significant time for licensure, etc. Most positions can take a year to fill, from the initial job posting to the start date of the new hire. But, with the right planning and approach, the recruiting process can be done in a smooth, timely and ultimately successful manner.

As part of a large practice that remains committed to growth through hiring, here are some of the tips we’ve learned along the way about how to hire the right associate.

TAKE A CLOSE LOOK AT YOUR NEED

Practices have multiple reasons to consider hiring a new physician: to replace a departing doctor, succession planning, growth in an existing office, opening a new location, expanding a service line, etc. It is essential for the practice not to just evaluate why a new position is needed, but also what factors are present to make the position successful.

If the position is a new one, what is the growth potential in that particular office location? What is the demand for a given subspecialty in that area? What about the demographics and competition in the area will help to make the position successful?

If the position is a replacement, how strong is the existing patient base? Can it be maintained or increased? What is the need for subspecialty coverage?

Having a clear idea of the practice’s needs and how a new associate will meet those needs is necessary to have a clear idea of the position you are offering.

IDENTIFY YOUR IDEAL CANDIDATE

Different candidates have different skill sets, and different jobs have different needs. Identify what will make your new hire successful within your organization. To do so, ask yourself the following questions:

• Do you need the recruit to see a high volume of patients or do a high volume of surgery?
• Does the recruit need to do complex, reconstructive cases?
• How important is a research background?
• Will the recruit need to function well independently in a satellite or get along with others in a large main office?
• Is it preferable to hire someone right out of training or with years of experience?
• Does the recruit need to have local ties to the area?

Fleshing out these desired attributes prior to beginning the recruitment process allows the employer to vet candidates much more quickly and identify those most appropriate. A candidate may come along who has excellent credentials but is a poor fit for the open position. We always advocate hiring for the position, not the candidate.

CLARIFY THE POSITION

Just as the candidate is selling him- or herself, the employer must sell the position to the candidate. Details such as office locations, surgery center locations, scope of practice, expected clinical and surgical volume, call burden and growth potential must be clearly hashed out prior to beginning the recruitment process.

Will the new hire be traveling to different offices? How will that clinic be staffed? Where in that clinic will the new hire operate? What part of town should the recruit expect to live in?

A well-thought-out position shows the candidate that the practice is serious about both hiring a new associate and helping the associate to be successful long term. Financial issues should also be anticipated as much as possible:

• What is the starting salary range?
• What is the bonus structure? How quickly can a new associate expect to bonus?
• What will the growth curve be for the first five years?
• How will the practice help support the growth of the new doctor’s profession?
• What marketing efforts will be expected of the new hire?

FIGURE OUT THE PARTNERSHIP TRACK (OR LACK OF ONE)

One of the most important criteria that candidates will evaluate in your practice is the partnership track. While some practices choose not to offer partnership track positions, in general the highest-caliber candidates will look for partnership opportunities. The more information you can give the candidate about the partnership track, the stronger the position will appear to him or her.

Even if you cannot give full details to the candidate, it’s important to provide broad guidelines, such as the expected timeline, method for calculating the buy-in and approximate percentage of ownership. Other partnership opportunities, such as surgery centers, optical shops and real estate, must also be fully considered, so that those can also be clearly presented to the candidate.

This conveys to the candidate that he or she will be valued not only in the short term but also as a long-term member of the organization.

ADVERTISE WELL

Practices have multiple avenues through which to get out the word about their position. The AAO and ASCRS as well as many subspecialty societies run job-posting sites that are either free or low-cost and can connect you to the widest audience of potential recruits. While more expensive, some practices may choose to hire a headhunter to aid in their search. This can be a particularly attractive route for smaller practices that may lack the manpower to properly vet a large number of candidates. Whatever the method, the ad for the position must be clear, concise and effectively sell the positives of both the position and the locale.

CREATE A RECRUITING PROTOCOL

Regardless of the size and makeup of the practice, it is always a unique challenge to create a streamlined, manageable and cost-effective recruiting process that is still comprehensive enough for both sides to fully evaluate the position in question. Creating a recruiting protocol allows for a process that is consistent, reproducible and thorough. It also ensures that each candidate is evaluated in the same way and has the same exposure and experience with the members of the group.

Because of the size of our practice, our protocol spells out how candidate are contacted, how they are evaluated for an interview, what components make up the interview itinerary and how an eventual decision is made. While every protocol doesn’t have to be this granular, an agreed-upon process is smoother and more fruitful for both sides.

MAKE THE INTERVIEW AS HIGH-YIELD AS POSSIBLE

Time is scarce for both employers and candidates. While it may sound like a good idea to plan a cursory interview and then a second one later for the most favored candidate to “seal the deal,” it is far preferable to gather enough information necessary for both sides to make a decision during only one visit. This saves time and money and is far less of a burden in planning.

The trick is to make sure that the interview involves all of the necessary people for the practice to make an informed decision: members of the involved office location and/or subspecialty, senior partners or group leaders, members of administration, practice managers, physician significant others, etc. This allows the practice to fully evaluate the candidate from all viewpoints, as well as giving the candidate exposure to all relevant aspects of the practice. If an interview is done properly, no further information should be necessary for either party to decide to move forward with a contract.

It’s also critical to involve the candidate’s significant other and family. At least one event during the interview should give the significant other an opportunity to meet and spend time with members of the practice and their significant others. If the city is not well-known to the candidate, it’s often helpful to plan time for a realtor to take the candidate and spouse on a tour of the city, with particular attention to possible neighborhoods close to the offices where the candidate would work. This allows the entire family to begin envisioning whether the area feels like home.

BE HONEST — IT SAVES EVERYONE’S TIME

While it’s important to put your best foot forward throughout the process, it’s far more important to be honest about what the position can and cannot offer. Sugarcoating the weaknesses in either the position or the practice may aid recruiting in the short term but will lead to short-lived tenures if the issues are significant. If certain relevant areas, such as LASIK, offer less opportunity, this should be disclosed to the candidate; the same is true for financial issues such as significant outstanding practice debt, discussions with private equity, etc. If a candidate accepts a job then leaves shortly after because his or her expectations did not align with the practice’s in some way, it creates a huge loss of time and money for both sides, and this could potentially hurt future recruiting.

It is far better to acknowledge a bad fit and to wait longer for the right person than to enter into a bad relationship. Candidates can sense when employers are authentic and will naturally gravitate towards the positions that best fit them.

DON’T RUSH, BUT DON’T DRAG OUT THE PROCESS

Most candidates are under some sort of time constraint to hear a decision back and may be entertaining multiple offers. Taking the time to choose the correct candidate is paramount, but once the practice has decided, an answer should be given as quickly as possible to the candidate. An expedited response shows confidence in the match and an eagerness to move forward, which can be appealing if a candidate has other options.

Likewise, appropriate time should be given for contract review and negotiations. But, if the candidate and the practice cannot come to terms in a reasonable amount of time, it is likely a poor fit.

BE BALANCED WHEN NEGOTIATING

Often, an otherwise successful recruitment will fall apart during contract negotiation. This most commonly occurs when one side overvalues its contribution and negotiating position. It’s important for both sides to have a sober view of what each brings to the table and what each finds important. For instance, a candidate may more greatly value the financial security of a higher salary, while the practice may value more highly the security of a stronger restrictive covenant. Each side also needs to understand which issues are deal-breakers and which are not.

Having a good-faith attitude of working toward an eventual agreement is essential. Driving too hard a bargain can cause the other side to question how healthy the eventual working relationship would be and sour the positive feelings created during the entire preceding process.

REALLY, THIS CAN RUN SMOOTHLY

Hiring effectively is an essential skill for any practice, whether the need is growth or replacement. Being intentional in evaluating the needs and goals of the new position before the process starts and planning out a comprehensive strategy for recruitment can result in a smoother, more positive recruitment process and a successful, long-term fit for a new associate. OM

About the Author

Vipul C. Shah, MD, is a cataract and corneal surgeon at Charlotte Eye Ear Nose & Throat Associates in North Carolina. As chair of the practice’s Recruiting Committee, Dr. Shah has overseen the hiring of more than 15 new physicians over the last three-and-a-half years. Contact him at: vip.shah@yahoo.com.