The judgment factor

“Hard NO,” said the practice manager after a virtual interview that was supposed to be followed by a site visit and offer to the family physician candidate. “He was spinning the chair around and seemed distracted. What was he thinking? Did he misunderstand that this was an interview? Or worse—is slouching and fidgeting just his normal demeanor, and he would present this way with patients and hospital executives?”

The feedback stunned me, the presenting recruiter. The candidate had impeccable credentials, experience, local ties, and his references positively sparkled. A phone screen with the practice manager had gone well. But the candidate’s virtual interview behavior made the practice question his judgment. This candidacy was in ashes… a door irrevocably closed.

Your board scores, the caliber of your education and training and your discussions with interviewing physicians measure your clinical fit with the job. Equally important is the judgment factor: your EQ (emotional intelligence), social awareness, common sense, and the team’s perception of how quickly you can read the room.

The team is trying to assess your ability to make good choices in your interactions with patients, families, staff and peers. Even a superb clinician can lose a job offer based on what the hiring team perceives about the candidate’s common sense and judgment based on their interview behavior.

As a physician recruiter with more than 25 years in the field, I want to share how seemingly minor choices on what to say, write or do carry an inordinate weight. That’s because they are clues to decision-makers about how you would function as a member of the team. 

Everyone in the physician recruitment process is listening, watching and sharing their observations because good interview behavior/good judgment correlates well with successful hires who are happy and productive. Short, rocky employments are costly for the employer’s bottom line, and a physician who exhibits poor judgment is likely to distract a team with drama. Throughout your candidacy, people are interpreting the choices you make in the job search dance.

First impressions: Your CV and screening interviews

Cherisa Sandrow, D.O., is a family medicine physician who coaches, teaches and speaks to physicians about making career transitions.

She was one of the early adopters of telehealth in 2015 and now advises other physicians about how to present themselves for highly competitive positions, particularly on the newest frontiers of health care delivery.

“We are taught in med school to create a CV, which is a timeline of our patient care jobs and our training,” Sandrow says. “Yet unfortunately, it does not leave us memorable. This is your first opportunity to shine…and demonstrate that you understand how much our work as physicians is evolving.”

If the organization is looking for a physician to help innovate, develop and take their telehealth program to new levels across many channels, then the candidate needs to look like that physician digitally. Sandrow says it’s best to include a strong résumé with an objective statement and details about projects, committees and initiatives. Use a template like those available on Canva.com, and carefully curate your online profiles.

Sometimes, how a candidate presents on a telephone screen or virtual interview speaks louder than what the candidate says.

Remember the spinning chair/fidgeting virtual interview performance that cost a physician a site visit invitation? I later learned that the physician was coming off an 8-hour shift that ended at 13 hours. Too much caffeine, too many patients, too much adrenaline from a frantic volume left him passionate about getting a new job (but too wired for the virtual interview). 

He took the call on his cell phone, and the self-view box was so small that he didn’t register how he might be coming across. Upon reflection, he realized his exhaustion impaired his ability to read his audience. Rescheduling for when he was able to be fully engaged and present might have resulted in an offer. Fortunately, he did well on interviews with other practices and had multiple offers.

Physicians who schedule interviews for drive time raise a red flag with recruiters. Collin McKahin, recruitment administrator for Marvin, a mental health provider for clinicians, advises candidates to reschedule rather than keep an appointment that you’d have to take on the road.

He recalls a video interview appointment with a candidate who was merging into highway traffic when he logged into the interview. “What was he thinking?” McKahin mused. “It was high speed, maybe 80 mph, and heavy traffic. I got off quickly but couldn’t help wondering what kind of chances he would take with patients if he would put himself and others around him at risk on the highway.”

E. Thomas Bernhoffer, M.D., is an interim medical director with Walmart Health Virtual Care. He says that video interviewers are watching and listening for the traits that distinguish excellence from competence in rapport-building. “Smile when you say hello!” says Bernhoffer. “I want to see warmth, approachability, eye contact. Show the interviewer that you know how to establish rapport quickly. We don’t have time to wait for physicians to ‘warm up’ in telehealth.”

When video interviewing, position the interviewer’s image just beneath the laptop or monitor-mounted camera on your screen to get as close to an eye-to-eye lineup as possible. Feel free to sip water or coffee (we would offer it to you if you were in person with us). Make sure you are not putting the mug your friend gave you on camera—that one with the unprintable joke or political slogan.

Site visit planning

Travel logistics for a site visit are inconsequential—unless you throw a red flag. Your requests and choices regarding flights, hotel and rental vehicles are an opportunity to demonstrate good stewardship of the company’s resources and respect for the recruitment team’s needs. 

The team wants to craft an interview that gives both them and you a robust picture of the opportunity and allows everyone to learn enough to reach a well-grounded decision. If you exhibit disregard for their priorities and needs, they understandably expect that things will be no different if they bring you on board.

One physician sounded like a great fit for a busy private practice until we were booking travel for he and his wife to fly in for a visit. The candidate initially agreed with our two-night, 1.5-day site visit format, but later insisted that he wanted to fly in late Sunday evening and leave on a 2 p.m. flight on Monday…alone. The candidate claimed his wife’s presence was not necessary because she would go wherever he chose a job.

This candidate did not show behavior consistent with a good fit, so the hospital withdrew the invitation to interview.

James Stepien, vice president of business development for Wesley Medical Center, says, “We haven’t had great retention experience with physicians who claim their spouse is not a part of the location decision.”

McKahin recalls a red flag moment when a physician candidate canceled the community tour during an interview visit. “Candidates should understand that we are looking for physicians who will become part of our community and not just mark time until the end of the income guarantee obligation to practice in the community,” he says. “Anything that a candidate does or says that is not consistent with really getting to know us is a huge warning sign that the real intention is to just do what is necessary to get the income guarantee.”

Practice administrator Carol Ann Tolbert advises candidates to be especially careful with incurring interview expenses that will attract attention. She recalls interviewing one candidate who rented a GMC Hummer as her interview rental vehicle at nearly three times the cost of the standard category. Because of the size, weight and high clearance, Hummers were making national news.

“That choice just carried so much baggage,” Tolbert says. “It made us wonder how astute she was at reading situations if she thought this was an appropriate choice on an employer’s tab.”

Site visit meetings

When advising candidates who are preparing for roles that include telehealth, Sandrow suggests being ready to talk about how you envision advancing patient engagement and improving outcomes for the employer’s immediate community and beyond.

“In this space, health care executives are scrambling to keep up with the rapidly evolving knowledge,” she says. “You need to demonstrate how you can help move them forward and keep them competitive. Discuss how your work will align the employer within their health care system, state, national and global strategies.”

“Your goal,” Sandrow explains, “is to have interviewers leave the discussion believing that you will advance their ability to pivot and lead in a changing digital landscape.”

Lee Rosacci, D.O., says that a candidate’s choice of topics can accelerate or stall the trajectory of their candidacy. Rosacci interviewed extensively in Denver as she sought to return to primary care after several years in urgent care. The practice COO raved to me about Rosacci’s interview when she advised me of their intent to offer.

I asked Rosacci why she thought her interview performance resonated so strongly.

“I talked about something I was passionate about,” she explains. She knew they were an entrepreneurial private practice where physicians and APPs pursued projects and niche interests. When asked what she would bring to the practice besides good patient care, she proposed a project with a local osteopathic school. It had the potential to be a contribution to the local community, a hook for positive PR, and potentially open a pipeline to recruiting those medical students back to the practice after their residencies. “I was talking about something that connects me with the core of why I went into medicine and that’s what shaped their perceptions of me as a prospective member of the practice,” Rosacci says.

She advises residents to think about what that is for them. “Find what tickles you in medicine and talk about it when asked an open question,” she says. “Talking about your passion reveals a tangential energy that changes your tone of voice and lights up your eyes. …To show decision-makers who you are and get them advocating for you, you have to peel back some layers so that your light shines.”

Contract negotiation

Winning the offer is a huge milestone, but poor judgment in the final stages can still derail a promising opportunity.

McKahin recalls a spectacularly bad choice a physician made when interviewing for a position. The letter of intent was prepared, and the candidate had flown in. The hospital was feeling optimistic…until a VP learned that the candidate had already signed a contract with a competing group. The candidate was anticipating using McKahin’s offer as leverage. Upon confirming, McKahin’s group withdrew immediately.

“The real surprise came a few days later when we learned that the other practice had rescinded their signed contract,” McKahin says.

Onboarding

The contract is signed, the moving van is scheduled, so the book is closed, right? No.

Between the time a physician signs the contract and the first day of practice, there is still discussion about what the administrative team is seeing during onboarding. If the newly signed physician is responsive and helpful in moving credentialing forward, his or her name does not come up in a negative light. Questioning and suggestions for alternative options are fine if communications are respectful.

Think in terms of patterns: the organization is watching for patterns of good judgment, good interactions with staff, good intentions and actions reflective of good stewardship of the organization’s resources. Candidates whose choices wave a red flag with the credentialing/onboarding team soon learn that those choices can have delayed consequences.

For example, one specialist requested reimbursement for a $1,500 tip (not a misprint) for a cousin who helped move the physician’s household. Reimbursement for the tip was denied, and the physician’s rude emails defending his submission and condemning the group’s denial of reimbursement were kept permanently on file. 

If his communication with his facility and operations staff over the next year had been satisfactory, the attempt at enriching his cousin might have faded into history. But he continued to resort to sarcastic and derogatory responses any time he did not receive a “yes.” The entire history came under review as his contract renewal discussions commenced…and ended.

Conversely, the physician who is pleasant and responsive to the onboarding team is earning goodwill points that could tip the balance their way in the future.

Most physicians have heard that looking for a job is like dating a new romantic partner. The metaphor has stood the test of time because each party’s words and deeds in a new relationship are clues to how they are likely to behave in a committed partnership.

As a physician candidate, put yourself in the employer’s shoes. What do your words and actions as a candidate say about what kind of partner you will be to this team and organization? Do you display good common sense, a strong ethical grounding, and a high degree of emotional intelligence? What do the employer’s words and deeds say about how they will show up as an employer? May the best match win! •

Therese Karsten, MBA, CPRP is senior talent acquisition partner for behavioral health provider recruitment at Walmart Health Virtual Care.