Good things come to those who wait. That's a lesson family physician Kristen Dillon learned firsthand when she and the rest of the staff at Columbia Gorge Family Medicine in Hood River, Ore., were searching for a new administrator. It took seven months for the four-physician practice to find one that matched its needs; seven months in which the practice operated without one.
"The administrator is just a crucial person," Dillon says. "It was a huge amount of work for us, and it took some good leadership and messaging for the practice to continue to run without someone in that position."
Though the practice received several resumes, Dillon says the staff just didn't feel like the candidates had the right qualifications. And, when they did find a strong candidate to interview, they turned her down, too, because she didn't seem to mesh with their management style.
About three months into the search they thought they'd found their man, but he backed out at the last minute.
"It was very disappointing, and really kind of anxiety provoking," says Dillon.
Still, instead of reconsidering applicants from the original pool they'd previously discarded, the practice re-advertised the position and started its search again from scratch.
Despite the headaches and the delay, Dillon says it was a smart choice not to settle.
Ultimately, they found a great administrator; one who has been working with them for more than five years.
"Even if it means that your operations or some things are a little shaky for a few months, it's absolutely worth taking the time to find the right person and not settling for someone that you have reservations about," says Dillon.
Defining the role
Finding the right administrator who fits your practice and your needs is crucial. A great administrator can strengthen your weaknesses and keep things running smoothly. But how do you find him or her? And how do you do it quickly?
Maureen Waddle, senior consultant at BSM Consulting based in Incline Village, Nev., says identifying the skills and training the administrator needs to possess is the first step. Without clearly defined requirements, you won't be able to write a clear job description and you won't be able to attract the right applicants, she says.
There are key skills and training that all successful administrators in all practices need to have, says Stacy Orrick, co-owner of Orrick Associates, a practice management and staff recruitment consulting firm based in Newton Center, Mass. "You need someone who has strong people skills, a good communicator, accounting skills, management, supervision," she says.
And, she notes, previous experience in healthcare — at least three to five years worth — is essential. That's because some things integral to the administrator position, such as understanding the latest healthcare rules, regulations, and technology, can't be taught in the classroom or learned in other office settings, says Orrick. "The administrator needs to know how to do everyone's job."
Raising the bar
Of course, no two practices are the same, and it's also important to identify the additional skills your practice administrator needs to have.
A good place to start is by soliciting staff feedback, Waddle says. Ask what skills and training key staff members think the administrator needs to have.
This "will help you define the characteristics and personality traits" required, she says.
Judy Bee, a principal at Practice Performance Group, a management consulting firm in La Jolla, Calif., says a good administrator can also help address and improve your practice's weaknesses. For instance, if you are struggling to adapt to EHRs, an administrator with previous experience in an EHR transition would be ideal.
But Bee, who worked in a medical practice for seven years prior to consulting, says practices should be cautious when looking for that "something extra" in applicants. Don't be tempted to hire someone who has great additional skills (like social-media marketing), but lacks more essential practice-management skills (like billing, collections, personnel), she says. "You don't want somebody who's a hot rod with Facebook trying to run a multimillion-dollar medical practice."
New recruitment methods
Once you have your skills and requirements defined, it's time to start the recruitment process. First, ensure that you have a clear and concise job description, Orrick says, because it will catch the attention of the right applicants.
Waddle says the description should include a straightforward job title, a one-to-two sentence overview of the position and its primary responsibilities, and the qualifications and skills required.
Then, it's time to advertise. Take note: The recruiting process has changed drastically in the past few years. "Even five years ago people were placing newspaper ads, which nobody really reads anymore, and they're pretty expensive," Waddle says. Today, she says, think Internet, not print.
Bee says posting jobs on state Medical Group Management Association (MGMA) websites is an ideal tactic because you're sure to reach your target audience. "People who are in the business, who belong to the MGMA, are already self selecting," she says. "Somebody who's more experienced understands the value of a professional organization."
Craigslist, Monster, CareerBuilder, and your practice's Web portal (if you have one) are other great recruitment outlets, Orrick says.
And don't forget about good old-fashioned networking — well, with a spin. Social networking sites like LinkedIn and Facebook are great job posting resources as well and a lot of tech-savvy administrators go there to look for openings, says Waddle.
Narrowing the playing field
When the resumes start pouring in, it's decision-making time. But since you've already defined your required skills and training, it should be simple to make cuts. "Eliminate anyone who doesn't meet the minimum criteria," Waddle says.
Next, conduct phone screenings of the remaining candidates, says Orrick. This brief conversation will help you gauge an applicant's personality, plus his phone and communication skills.
Finally, invite your remaining top applicants into the office for interviews.
This process will vary depending on the amount of time your practice can put into it.
Ideally, Waddle says, once you've narrowed it down to one or two top contenders, they will be invited into the office for an "all-day interview" during which they will observe operations, interact with staff, participate in a formal interview, and enjoy a meal with key staff members.
"[The candidate and the practice] both need to have the right expectations of each other," says Waddle. "There's got to be enough time for both to understand the good, the bad, and the wonderful."
It's also important that all staff members meet your final candidate before you hire her — even if it's just for a brief phone conversation, Orrick says. "Usually, right away staff either likes or does not like the person. Getting respect and getting along with staff is big."
Skills tests
During the interview process, it's important to make sure your final candidates can back up their skills and training, Bee says. She suggests conducting an Excel test and a test for dyslexia (which makes filing difficult).
Practices should also administer a judgment and communication skills test in the form of scenario/challenge questions during the interviews, she says.
For example, Bee might ask an applicant, "You are new on the job and a physician comes to you demanding an employee be fired on the spot. What do you do?"
Practices should form scenario questions around problems their office is currently facing, Bee says. That way your practice can gauge how the applicant's personality and professional skills match up with your practice's needs.
Waddle also recommends a "presentation test." For example, she might provide an applicant with productivity measures related to the number of office visits at a practice per month. Waddle will then ask the candidate to present the measures, detail his concerns, and suggest improvement plans. "You get a good idea of their analytical assessment and their ability to take data and information and turn it into something meaningful," says Waddle.
Finally, before hiring anyone, Waddle says perform criminal background checks, credit checks, and speak to references.
"Really the goal of the administrator is to take the owner's vision and create and implement that action plan that's going to achieve that vision," she says. "You really need to take the time to find the right match."
Aubrey Westgate is an associate editor for Physicians Practice. She can be reached at Aubrey.westgate@ubm.com.
This article originally appeared in the January 2012 issue of Physicians Practice.
