Hiring a spine practice manager can be difficult because the job requires several skills: business management, accounting, marketing and human resources, to name a few. Dr. Kube, several spine surgeons and industry experts discuss 8 steps to hire a spine practice manager.
1. Network with professional organizations to find candidates. There are several ways physician groups can find practice managers — through head hunters, job listing agencies or word-of-mouth — but a sure way to collect a pool of qualified candidates is through professional healthcare management organizations. Contact these organizations and they can send you a list of members who are looking for jobs.
Organizations such as The Ortho Forum and American Association of Orthopaedic Executives could be helpful.
“Those are some good groups from whom to look for office managers,” says Barbara Bergin, MD, an orthopedic surgeon with Texas Orthopedics Sports & Rehabilitation Associates in Austin. “Most office managers stay in their job for four to five years. It’s difficult to have all the skills both administratively and clinically.”
The CEO of Dr. Bergin’s practice has been with them for 25 years, but an outside consultant advised that searching for a new CEO will not be easy, when theirs decides to retire.
2. Ask lots of questions. From the very beginning, ask candidates several questions about themselves and their previous work experience. Send the questions out via email for the first round, if possible, so you can quickly read through each response and narrow down your list from there.
“We email a questionnaire of 30 questions and find applicants’ answers incredibly revealing,” says Dr. Lynne Curry, a management consultant with The Growth Company Inc. which helps spine and medical practices hire professionals and staff. “The questions include: When we call up your past supervisor, how would they describe you? What do you consider if you are choosing between two groups? If the hiring market is tight, we might only send 10 questions because we don’t want that to be a barrier.”
Once you have narrowed down the candidates, bring them in for personal interviews where you can either have two different people interview them in a row or have several people interview them at the same time.
“It’s important to have more than one person doing the interview because the second person might see something the first person didn’t,” says Dr. Curry. “By the time you get to the second interview, the candidate thinks they have a good shot at the job so they begin interviewing you at the same time. They ask questions that they might not in the initial interview.”
3. Find evidence of the ability to work in a team. It’s crucial for the business practice manager to be a team player and reinforce the goals you have at your practice. “Look to acquire a business leader for the corporation who compliments your style and fully subscribes to your goals,” says Richard Kube, MD, spine surgeon and founder of Prairie Spine & Pain Institute in Peoria, Ill. “If the business leader and medical director are on the same page [with] ideas, culture, expectations, they will be implemented more seamlessly. Any new hires must also subscribe to the goals of the corporation. New employees must become you, not the other way around.”
Surgeon owners must be part of the hiring process for all practice leaders so they are aware of what happens in their business and are able to provide support as a clinical for business plans.
“Individuals looking for a career will take the time to understand your goals and be proactive in implementing them because they will tend to share your vision,” says Dr. Kube. “If someone is not meeting these points during the interview, it is typically better to pass than to settle.”
4. Look for emotional intelligence. While clearly a good business sense is important, emotional intelligence draws the line between good and great practice leaders. Even if the candidate has the right schooling and previous experience, you want to make sure they will fit into your culture and work within the practice structure to achieve your goals without putting up any roadblocks.
“Within the person’s work history, look for examples of teamwork and emotional intelligence,” says Dr. Curry. “You can identify emotional intelligence by how flexible and judgmental they are. Someone who tends to judge will find things in any practice they don’t like. Ask them how they would handle different situations and monitor their response.”
Another crucial question to ask, at least by the second interview, is how long they plan to stay with the practice. If the person hesitates, ask them why. If they aren’t sure your practice is the right place, or that they want to live in your community, they may not be a good fit for you.
“You want to make sure they will be able to delegate responsibilities and get along with people, and you can figure that out in the interview,” says Dr. Bergin. “You want to make sure they have an understanding of what it will take to run your business.”
5. Understand their work habits. Leaders have various work habits that can be successful in differing environments. Surgeons are often attracted to leaders who are perfectionists, which may sound like a great quality, but these types of people generally aren’t able to handle the “people” situations in your practice and might take too long to complete a task.
“Depending on how big your practice is, you might need someone who has experience with marketing, contract negotiations and the ability to talk through complex financial situations with practice owners,” says Dr. Curry. “Some folks in the spine profession might think a perfectionist would be great, but they won’t be able to handle these people-oriented situations.”
The business practice manager should be able to deal with several issues at once. “You need a CEO who is going to deal with the day to day issues of the employees and nuances of running the business itself,” says Brian Gill, MD, a spine surgeon with Nebraska Spine Center in Omaha. “You need a financial office and IT office, especially as we move more toward electronic medical records. This is a business, so you have to have someone who is good with the fundamentals.”
Also pay attention to people who would likely be “control and command” administrators and gauge whether this will really work in your setting.
“You can hand all the business functions over to someone who is a ‘control and command’ leader, but what happens when you have a different opinion?” says Dr. Curry. “In this case, the administrator might withhold information from you. You don’t want that type of person; you want someone who will collaborate with the owners.”
6. Check their references — and beyond. Every candidate will give you a list of references who will likely speak positively about them and advocate for them. Look beyond just these references and also contact their former employer or the owners of their previous practice. Here again, spend significant time on the phone with the references and ask lots of questions.
“Keep them on the phone for 45 minutes asking questions,” says Dr. Curry. “Everyone will have co-workers or patients that like them, but the person who writes the check has an interesting perspective. Most people giving references expect to get off the phone after six or seven minutes, but they don’t mind staying longer when we engage them.”
Make sure every candidate waives responsibility for the reference to avoid defamation lawsuits. In many states, laws protect people giving references as long as their statements are based on facts and performance, so assure the references there will be no repercussions for their statement.
7. Consider medical knowledge, but don’t let that deter you. Medical knowledge or a clinical background could provide a clear advantage for practice manager candidates. The business of medicine has unique aspects that aren’t the case for other areas of business.
“It’s hard to bring in a traditional CPA for your business because they don’t have an understanding of how your clinical business works,” says Dr. Bergin. “Medicine is very different from other office situations.”
However, don’t let a lack of medical knowledge or clinical experience necessarily deter you from hiring a strong manager candidate.
“The CEO of our organization had no health experience at all; he came from a purely business standpoint,” says Dr. Gill. “You need to have someone who has good fundamentals in business. Healthcare is ever changing and dynamic but the basics of running a business remain the same. Having some healthcare background knowledge is a bonus, but if a candidate possesses other superior business characteristics, then understanding the nuisances of the healthcare industry will be more easily taught and learned.”
8. Assess whether the candidate can take criticism. Surgeons are bright enough to run their practices by themselves, and some even gain business training to become better practice leaders. However, they don’t have time to perform all the duties of a practice manager while also being a clinical practitioner. Any practice manager must be able to work with surgeon owners toward common goals and accept criticism as a team member.
“Our practice manager has to work with a lot of bright people. Even though our surgeons don’t have time to do the medical management of the office, they are bright people and pay attention,” says Dr. Bergin. “And office manager should accept criticism and be prepared to answer probing questions. Our practice manager is never defensive and is able to take criticism and answer any questions from the surgeons.”
During the interview process, Dr. Kube and his team stress the rigors of the practice leadership positions.
“Everyone needs to understand that they are expendable and if they try to implement goals or care out objectives that are counter productive for the corporation, they simply don’t work for us anymore,” says Dr. Kube. “When hiring, we take time to sort these issues out. We almost try to talk candidates out of working for us. This allows us to determine whether the individual is looking for a job or wants to be a member of something larger and fulfill a role as a member of a team throughout a career. The former may make an okay worker-bee type employee. The latter has a better chance of becoming a superstar and being a trouble shooter.”