OHA June 2014

When a culture fit becomes an issue for hiring physicians

DAVID ANDRICKDIRECTOR PHYSICIAN RECRUITMENT

ADRIAN R. BYRNEP R E S I D E N T

L U N D - B Y R N E A S S O C I A T E S

Some definitions• The beliefs and behaviors that determine how a company's

employees and management interact and handle outside

business transactions. Often, corporate culture is implied,

not expressly defined, and develops organically over time

from the cumulative traits of the people the company hires.

A company's culture will be reflected in its dress code,

business hours, office setup, employee benefits, turnover,

hiring decisions, treatment of clients, client satisfaction and

every other aspect of operations.

• The distinctive ethos of an organization that influences the

level of formality, loyalty, and general behavior of its

employees

A learned quote

An organization’s corporate culture can account

for up to 30% of its performance when

compared to “culturally unremarkable

competitors”.

This according to Dr. James Heskett

UPS Foundation Professor of Business Logistics, Emeritus at the

Graduate School of Business Administration, Harvard University.

What is “culture”

Culture is an expression of:

• What are the driving values of the

organization

• How things get done, how the priorities are

set and how they are reinforced

• How we measure success

• How people interact within the organization

AND

• “the way things are done around here”

How is culture developed

What defines the behaviors for a desired culture• Force of character of an individual

• A focus on unifying goals

• Leading by example

• Building the company lore on getting there

• Articulating the acceptable processes

• Active support of protocols and standards of care

• Communications – who/what/when/how

• Being prepared to intercept and correct “undesirable” actions

Is there more than one culture?

YES there can be:

• Hospital Culture

• Medical Staff Culture

• Employed Physician Culture

• Independent Physician Culture

• Community Culture

• Do they co exist?

Framework for the culture

• Vision: A hospital presents physicians with a clear plan for its

future in which physician participation is a core element. This

must be a compelling plan that resonates with the new realities

around the three basic needs of the physician — respect, clinical

autonomy and income.

• Branding and marketing: Access to patients is important to

physicians. The hospital’s branding strategy and marketing support

will be effective and seen as a differentiator in employing

physicians.

• Physician leadership: Respected physicians with demonstrated

competence as leaders and managers will play a prominent role in

the employment strategy.

Does reality match the vision

How do you know if there is a fit

Assessing the candidate professionally

• Experience

• Age – practice style

• Levels of involvement

• Creativity

• Memberships

• Likeability

How do you know if there is a fit

Interview process

• Do you plan your interview?

• Select people from your facility that represent

the culture

• Observe a candidates level of interest during the

visits (and Spouse)

• How do you leave things after visits

Can you articulate your cultureDefined as Supported by

Rate as important in

your culture (1 to 10)

Physician friendly?

Quality oriented?

Patient focused

Collegial

Profit motivated

Area leader in services

What attracts a physician to your

culture

• Varies by age and previous experience

• Be aware of practice and physician life cycles

• Will vary by specialty also

• Inventory your contractual offerings

• Do your own SWOT analysis of your culture

• What items are important to and meet the needs and

expectations of the differing age groups, sexes and

nationalities

• Physician shortage issues

Physicians

(50 yrs to 60+ yrs)

Profile How Does Your Culture match up

• Experienced

• No desire to change practice

styles

• Top off pension

• Exert some influence /

mentoring

• Relocation can be easier

without young families

• ___________________

• ___________________

• ___________________

• ___________________

• ___________________

Mid Career Physicians

(40yrs to 50yrs)

Profile How does Your Culture match up

• Experienced

• Open to change

• Wants to maximize income

• Leadership opportunities

• May have young family

• Spouse needs work/social

connections

• __________________

• __________________

• __________________

• __________________

• __________________

Early Career Physicians

(30yrs to 40yrs)

Profile How does Your Culture match up

• Some experience and growing

• May look for mentors

• Open to change

• Enthusiastic

• Wants to maximize income

• No interest in meetings

• May have young family

• Spouse will want to make

connections/work

• ___________________

• ___________________

• ___________________

• ___________________

• ___________________

• ___________________

• ___________________

Why do physicians sign on

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0%

Strongly Disagree -1

2

3

4

5

6

7

8

9

Stongly Agree - 10

Expectation of Cultural Fit as Determining Factor for Employment

Cejka Search: Report 2013

Why do physicians leave

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0%

Strongly Disagree -1

2

3

4

5

6

7

8

9

Stongly Agree - 10

Lack of Cultural Fit as Reason for Leaving

Cejka Search: Report 2013

Why is culture so important

When a recruited Physician leaves the

community

• The cost of recruitment is easier to

calculate

• Soft costs harder to estimate• Loss of downstream cases from the practice

• Practice productivity and support staff

• Loss to the hospital of surgical cases

Why is culture so important

It’s also about competition in a tough market for recruitment:• Competitors can match your contracts

• Your business opportunity is not unique

• It is unlikely that your community is very differentfrom other available options

• Your operating systems can be duplicated

NOTE:

• It is hard for competitors to match a successful culture that has evolved over time.

Accountability and Culture

Personal

Accountability

Cultural

Accountability

Hierarchical Accountability

Reproduced with permission: Joe Tye, CEO Values Coach Inc.

How big are the gaps ???

• The Recruit:• First impressions

• Personality

• Is there something that can be coached to make a fit?

• Will the person be able to change

• Your Organization• Feedback

• Likeability

• Ability

• Environmental / community

Culture as a competitive advantage

• Culture can create competitive differentiation

• Set aside any personal likes/dislikes – does your

culture work?

• Are you hiring warm bodies or cultural fits

• A good culture is hard to duplicate

• If there is a fit, the new people will easily

adapt to the culture

• People are loyal to culture, not strategies

Finding the connection

• What tools do you have in your box to recruit

these physicians

• What tools do you need

• How will you leverage your culture in your

recruitment efforts

• What does the culture do to hinder recruitment

• What does the culture do to help

Bottom Line

CULTURE TRUMPS STRATEGY

Joe Tye, M.H.A., M.B.A., is the CEO and Head Coach of

Values Coach Inc.,