5 Most Common Hiring Mistakes in Ambulatory Surgery Centers

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Hiring is especially important in an ambulatory surgery center, where a small work force means every employee must pull his or her weight and fit the culture of the center. Here Greg Zoch, managing director and partner with Kaye-Bassman, discusses five common hiring mistakes in ASCs — and how to avoid them.

1. Treating candidates like applicants.
According to Mr. Zoch, many hiring managers believe that their job is to screen applicants, and that the screening process will reveal the best person for the job. He says while 'screening' candidates seems necessary and logical, "treating qualified candidates like they're applicants is actually a turn-off." So how do you know whether you're treating candidates with the respect they deserve? Here are three signs your behavior is causing candidates to look elsewhere.

You ask candidates to fill out an application with little to no personal communication. Mr. Zoch says if you're hiring an ASC administrator, you should make the hiring process more personal and respectful. Highly-qualified administrators are likely getting calls from competing surgery centers, hospitals and recruiters, and may be put-off by legacy HR practices like this. "Instead of saying, 'Send us your resume and we'll get back to you,' you should engage the candidate in an initial dialogue about your center, the opening, its challenges and rewards, and where it might take their career," he says. Treat every candidate with respect, and show interest in them personally. Top candidates know when they are being handled.  

You talk about money in the initial conversation. You should decide whether you want to hire a candidate before you decide how much to pay them, Mr. Zoch says. Sometimes the salary requirement may prohibit you from hiring them. But don't bring up money in the first interview: You may give the impression that you're looking to hire the cheapest option. "It makes the money seem like a primary consideration," he says. "It makes you look like you're hiring them based on what they're making, not based on what they can bring to the organization."  

You ask, "Why do you want to leave your current employer?" Simply put, your candidate may not want to leave their current employer at all.  Many highly-qualified ASC leaders are simply curious about what the marketplace has to offer and want to grow their careers by taking on new challenges. When you assume the candidate wants to leave their current employer, you may put them on the defensive. "Ask in a different, more sophisticated way, such as, 'You clearly have a lot of experience. What drew you to this opportunity?'" Mr. Zoch says. Understanding their motivation is important, but be sure to ask tactfully what they are seeking in their next opportunity.

You tell the applicant that you have several other people to interview. While this may be true, there is no upside to telling a candidate that you're interviewing other people, Mr. Zoch says. "It tells them, 'You're just one person in a line, so take a number and wait,'" he says. Some might think that candidates will be motivated by having to compete for the position, but in all likelihood, they'll hear "don’t call us — we'll call you" and become disinterested. "The best and brightest candidates are free agents that need to be courted," Mr. Zoch says. He recommends treating every candidate as if you want them. Once you complete your interviewing process, you may find that you do, and the behavior will pay off.

2. Penny-wise and pound-foolish. Mr. Zoch says there is a tendency to formulate compensation plans based on what an employer thinks a position should pay — or what it has paid in the past — rather than on what an individual is worth. "It's okay to have an idea of what you want to pay, and even base that on averages and national benchmarking surveys," he says. "But rarely do employers start out thinking, 'You know, I really want to hire an average person.'" Looking at the 'average' salary for a position really means that you're looking for someone in the middle of the pack — not the "A player" that will bring the most success to your ASC. Mr. Zoch says while a high offer may look daunting to surgery centers with a tight budget, a high-quality employee actually costs less over time than a low-quality one. He says: "There's an old saying, 'If you think hiring an expert is expensive, try hiring an amateur.'"

"If the fit isn't right, it doesn't matter what the position pays or what a candidate's financial expectations are," he says. "Paying somebody more or less money doesn't make them right for the job." He says the center should always determine whether they want to hire the person first, before talking about money. Salary should only factor into the decision if the surgery center is choosing between two equally-qualified individuals who would both be a good fit. He also recommends calculating the amount of money it takes to re-interview and re-hire for the position, and taking that into consideration. If you find the right person for the job, "don't take chances," Mr. Zoch says. "It does you no good to pay someone just enough to get them, but not enough to keep them." Someone will eventually find out if you are underpaying a top person and try to recruit them away.

3. Time is of the essence. Since late 2008, the healthcare industry has seen a high degree of risk-aversion regarding important business decisions, Mr. Zoch says. "Some people are scared to make the wrong decision, so they decide that no decision is better than the wrong decision," he says. When it comes to hiring, this means that the interview process can drag on for weeks or months before a surgery center makes a decision about a candidate. He says that interviews should generally fall into two timeline buckets:

Local candidates. According to Mr. Zoch, local candidates should go through two interviews with the surgery center. Once the hiring committee determines they want to interview the candidate, they should set up a time for the candidate to meet with the clinical director and medical director in person. The following day, the lead person should contact the candidate to schedule a follow-up interview, if necessary. The follow-up interview would involve a key physician partner or two and the business office manager. "You should not have more than two interviews for a local candidate," Mr. Zoch says.  You should streamline the process and ask every interviewer to give a thumbs-up or thumbs-down and why within 24 hours of the interview. This debriefing process will help you clarify the qualifications and soft skills you are really seeking.

Out-of-town candidates. For out-of-town candidates, the interview process should begin with a telephone interview, involving the lead hiring person and perhaps the clinical director. On the following day, the candidate should be invited to visit the center within the following week or two, depending on schedules. During that face-to-face interview, the candidate should meet all the people necessary in order to make a decision. The candidate should also be given extra time to go on a VIP tour of the town with his or her spouse or significant other, in order to look at housing and assess the community.

Mr. Zoch says either way, decisions about hiring should be made 24 to 48 hours after the final interview.  If you have two candidates, try and schedule interviews within the same week to minimize the amount of time before making a decision.  

4. The enemy of 'good' is 'perfect.' "It's normal and preferable to define all of the key attributes and skills you would like to have in the perfect candidate," Mr. Zoch says. "Just be prepared that the perfect candidate may not really exist." He says skills and traits should be divided into two separate categories: "must have" and "want to have." The "must have" traits might include your required level of experience — for example, an ASC administrator should probably have at least two years of experience working in a surgery center leadership capacity. The other category, "want to have," might include traits that you would like to see but are not absolutely required. For an ASC administrator position, this might include CASC certification, an RN degree or an advanced degree (MBA, MHA, etc.). Make sure you have clearly separated each item on your list into one of these two categories, and ensure that all the parties agree on what is required versus desired.

"Be prepared to let go of your 'want to have's if all your 'need to have's are met," Mr. Zoch says.  He says while national or state unemployment may be high, the unemployment rate for excellent ASC administrators is very low. "Don't fool yourself by thinking people are going to line-up and wait around if the process drags-on because they're an '8' and you really want a '10'," he says. "In this marketplace, 8 is the new 10." He says that while a surgery center should never hire a leader who isn't qualified for the position, the hiring committee shouldn't defer making a decision and hold out hope that a perfect candidate will magically present themselves. "The ability to recognize a good candidate and move forward is the sign of a confident, mature and astute hiring authority," he says.

5. No news is bad news. Communication is critical to maintaining momentum during the hiring process, Mr. Zoch says. Throughout the process, articulate your progress to candidates to maintain their interest and keep them engaged. "If they don't know the answer to, 'I wonder what's going on,' they'll probably fill in the blank with something inaccurate or negative," he says. If you interview a candidate and wait a week before contacting them, they will probably assume that you're not interested in hiring them. Once they have assumed that you’re not interested, they'll likely start losing interest. "The natural defense-mechanism kicks in, and they think, 'If the center doesn't want me, maybe I don't want them,'" Mr. Zoch says. "It may sound childish and illogical, but it's the nature of human emotions. Put yourself in their position and imagine how you might feel."  

He says the hiring authority should communicate with the candidate within 24 to 48 hours of each interview to notify them of the next step or to let them know that they will not be moving forward. Communication can be as simple as saying, "It was good to meet you. We're interested in moving forward with you, and we're looking at schedules to see when we might be able to get you in here to meet some of our key people." You don't have to make an offer right away; just let them know that you're interested in moving forward. If you're not, let them know instead of making them wonder.

Greg Zoch is a managing director and partner with Kaye-Bassman International, a 31 year old executive search firm. He may be reached at This email address is being protected from spambots. You need JavaScript enabled to view it. or 972-931-5242.

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