Finding Dr. 'Right'

In the market for a new physician? Choosing the right person is a more difficult and subtle task than just getting someone with an MD in the door. The "right physician" is not only someone who can take good care of patients but also someone who fits in with the organization, its people, and goals. It's about your practice's culture.

At Fallon Clinic, we find that comprehensive interviewing and assimilation processes enable us to attract higher caliber physicians who are more likely to stay with us. Everyone has shared expectations and there are no surprises.

We start with a professional recruiter from national physician placement firm, Cejka Search. This person knows the personalities and situation at each of our locations and specialty divisions where we're recruiting, and does the initial review of the candidate's curriculum vitae, a telephone interview, and a reference check.

Physicians who meet our needs in the first pass are interviewed by the senior management team, including the chief human resources officer, chief medical officer, quality medical director, chief operating officer, and president. We each take a role outlining Fallon Clinic's mission, vision, and goals so candidates have a clear understanding of who we are, where we are going, and what we stand for.

The right way to interview

We've trained our physician and administrative leaders in behavioral interviewing, an approach that is invaluable to matching candidates with our corporate culture, people, and strategic plan. This includes not only how to ask the questions, but also how to evaluate the answers and why those answers are so important to long-term success.

We ask physician candidates to describe specific situations from their medical training or practice. For example, I might ask candidates to describe a patient whose course went badly and how they dealt with the patient and his family. Some will say candidates can "fudge it" - of course, everybody will say they were empathetic, sensitive, and caring. But it's generally pretty obvious from the answers whether physicians care and can communicate that caring or whether they have communication issues. The nonverbal response, especially, is generally loud and clear.

Put everything on the table

Every organization has - or should have - an orientation process. There was a time when new recruits to Fallon Clinic got two days of concentrated education in how to log on to the corporate network, where to get their badge, and how to read their pay stub. But we thought about what the purpose of orientation was, and have changed it significantly so that it's more about bringing new physicians onto our team.

We've kept - and enhanced - the two days of personal and administrative orientation, but have also implemented a much more detailed and focused process we call "acculturation," aimed at explicitly stating, discussing, and understanding mutual expectations.

These sessions are designed to put everything on the table with both clinical and administrative leaders. New physicians not only hear about and discuss expectations, they get to know our leadership much better as a result.

Get connected

How would you feel, as a new physician in a large multispecialty group practice, about having to stand up at a staff meeting attended by 150 to 200 colleagues to be introduced? We decided that was not the best approach. So we created a shadowing program in which new physicians spend at least 16 hours one-on-one with some of our best role-model physicians in the three primary-care specialties and physicians in specialties related to the new recruit's area of work.

And the role models love it. Who doesn't relish the chance to show how they deal with their patients, the challenges of practice, the teamwork of the division, and their communication skills - and the chance to teach new colleagues how to deal with all of this themselves?

Families into the fold

Although our physician acculturation program is robust, our retention goals will be a bust if physicians' families don't want to stay around. Since we've chosen physicians based on a well-rounded evaluation, chances are they and their families are right for our geographic area and vice versa.

Still, we have begun a family orientation for spouses, partners, children, and, as appropriate, extended family. Our Physician Well-Being Committee, including new and established physicians, their spouses, and partners, came up with the Fallon Clinic "welcome wagon," offering group outings, from the arts to amusement parks and picnics.

There are two informal evening sessions (cocktail parties with intelligent conversation) to get feedback on physicians' and families' experiences with the other parts of the acculturation program. It's a great way for new physicians, longer-term physicians, and administrative leadership to exchange ideas and get to know each other.

Measuring results

How do we know if our program is successful? It's a bit too soon to tell. We've been developing and implementing all of this over the past year. Year by year, we will gather data specifically on voluntary physician separations from the group, including an exit interview process. We'll be measuring the effects of geography, finances, professional satisfaction, family influence, and sense of belonging on those who leave. This is an ongoing process, and we'll use the results to fine-tune our acculturation program.

Of course, we're optimistic at this point. No recruits who have been through our program to date have left, but we understand that this is not statistically significant just yet. We'll have follow-up, and we'll report the results, good (we hope) or bad (I doubt). Don't touch that dial ...

Marc Greenwald, MD, is chief medical officer at Fallon Clinic, a 250-physician multispecialty group practice based in Worcester, Mass. He can be reached via editor@physicianspractice.com.

This article originally appeared in the October 2005 issue of Physicians Practice.