A Focus on Obesity, Part 2:
••Summer 2003/Vol. 7, No. 3

External Affairs

Physicians as Leaders:
Closing the Recruitment Loop | pdf >>

By Debra Mipos, MPA

"To us, leadership is everyone's business. Leadership is not about a position or a place. It's an attitude and a sense of responsibilityfor making a difference." -- The Leadership Challenge; J Kouzes, B Posner, Jossey-Bass

One of the great things about being a Kaiser Permanente (KP) physician is working with highly talented, committed colleagues. Recruitment and retention of excellent physicians affects all physicians. We want to get the best so we can work with the best and ensure high-quality care for our patients. When you have a great candidate, do you worry you might lose him or her? Are you torn because you know that offering special incentives will set an expensive precedent? There is always the tension between giving away the store and being perceived as cheap. What is your role? When you are the final negotiator, you are responsible for helping the physician candidate make an informed choice. The desired outcome is a good fit for the new physician and the department. In some ways, you need to sell KP to the physicians. But, like a really good salesperson, you do that only if you believe it will be mutually beneficial. Never oversell!

I have interviewed successful recruiters inside and outside KP, and several Permanente Medical Directors and Physicians-in-Chief (PICs) to find out the successful practices in "closing the deal" with a candidate. Here is a synopsis of their advice for you to consider.

1. Listen to the candidate. This practice establishes a climate of respect and elicits information about what is important to the candidate.
2. Money isn't everything. Most people are looking for more than a high salary. Find out what is important to the candidate. Ask questions, check with the recruiter, and get briefed by the chief of service. Factors important to the candidate could be research, stability, geography, housing costs, good schools, predictable income, autonomy of practice, or variety of practice.
3. You are important. Spending time with candidates communicates that you believe they are important and that you are selective about who becomes a Permanente physician. It helps candidates feel they are getting into an exclusive organization. Not everyone is good enough to be a Permanente physician.
4. When discussing money, be straightforward. Find out if candidates are looking at other offers and, if so, what the offers are. Remember the total compensation we offer may be worth more than other offers they have received. Total compensation includes: overtime, benefits, malpractice insurance, excellent retirement, small or no "buy-in" fees, and extra compensation for taking call or working extra sessions.
5. Be aware of all the ways we are a good place to practice. On the business side, for example, most Permanente Medical Groups predict your future earnings base. This is not contingent on how many patients you bring in. Our form of capitation is not going to be a horrible renegotiation process every year as it is in some practices. Another advantage the candidate will have is no need for "tail coverage," ie, malpractice insurance coverage after leaving a practice. Ask yourself what kind of questions candidates ask about compensation, and be sure you can answer them, even if the candidate doesn't quite ask.

Research on selling shows that high sales success correlates with 16 specific practices. Among these 16 practices, the ones that seem most relevant to recruiting negotiations are the following:

• Ask questions about the customer's needs
• Ask about the customer's situation (sales folk would say to ask about the customer's company
• Explain the product's drawbacks (in our case, this means don't lie about KP's downside)
• Be concise
• Maintain eye contact
• Restate accurately what the customer has told you
• Show enthusiasm
• Answer questions

The medical director or PIC makes a huge difference in a candidate's interest in the position and in the decision to join KP. Get to know their needs, and help them to see how we could meet them. If we can't meet their needs, don't promise we will. There is a balance between sweetening the pot and giving away the store. Remember, whatever you negotiate will not only have a long-term impact on you but on all your colleagues as well.

 

Notes from the Forum Corporation's Research on Successful Sales1,2 Hiring a recruit is not the same as selling a product; it is much more complex. However, when you are recruiting, you are "selling." There are things we can learn from successful selling practices. Some key points from The Forum Corporation's research are: I. Focus on the physician you are trying to recruit (s/he is the customer). The more you understand about the physician--what he or she needs, wants, expects, and values--the easier it will be to decide if your position is a good fit and to know how to make that position attractive to the physician. II. Earn the right to advance in the conversation. (You don't want to move on and leave the customer behind.) This usually is accomplished by asking questions, showing you have listened, summarizing, and getting agreement on what has been discussed, and asking permission to move on. For example asking, "Can we discuss ...?" III. Persuade through involvement. (The more the physician talks, thinks, and participates, the more likely s/he is to feel positive.) Using questions, telling stories, getting stories, seeing the interchange as mutual problem-solving will all help set up the kind of dynamic that leads to success.

 

Five Sales Techniques for Recruitment1,2 1. Connecting--establish a personal bond with the physician Eye contact--helps to make both parties feel connected. Adapt--the physician will give you cues through body language, speaking patterns, so adapt your pacing and tone. Build rapport--smile and find common ground; a little small talk is ok, but not too much. 2. Encouraging--keep the physician participating Reinforce--nod, use supportive questions and phrases such as "That sounds interesting. Tell me more," or "Please go on, I would love to know more." Empathize--show that you understand the feelings; for example: "That must have been very frustrating." Accepting--show that you heard what they said; for example: "I can see your point," or "That is interesting." 3. Questioning--discover the physician's needs, issues, problems, and interests Use high-gain questions--questions that stimulate thought, evaluation, or feelings. 4. Confirming--be explicit about what you have heard and what you have to offer Summarize. Check for agreement. 5. Providing--giving information that creates a clear, positive image of you, KP, your facility, and the job Describe benefits--be able to say the many advantages of Permanente Medicine and KP. Emphasize the benefits you have discovered that the candidate cares most about. Be concise. Be enthusiastic--even though you are concise. Tips a, b Summarize their needs, consequences, and payoffs. Tie them to benefits. Be direct. Act as you have during the whole relationship. Be concise. Make each word count. Think of objections as gifts of information. Remember, sometimes people say that money is the problem when there is a deeper or different issue. Close with confidence. Expect that a physician would want to come here. Use that self-fulfilling prophecy to our advantage. Do not fear silence. Remember, people need time to process and digest what you have said. Affirm their decision to join, and thank them. Follow up. Don't forget to generate the required paperwork.

a. Marilyn Rado, Director of Physician Recruitment of SCPMG ­ personal communication spring 2002

b. Patricia Finnegan, Director, National Recruitment Programs ­ personal communication spring 2002

References

1. Forum Corporation. Sales negotiations [workshop], Boston Massachusetts, 1999.
2. Forum Corporation. Face to face selling skills [workshop], Boston Massachusetts, 2000.

Suggested reading

• Fisher R, Ury W. Getting to yes: negotiating agreement without giving in. 2nd ed. New York: Penguin Books; 1991.
• Bonds RG, Pulliam KA. Physician recruitment & retention: practical techniques for exceptional results. Chicago: American Hospital Publishing; 1991.
  

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