1. Previous ASC experience is essential. ASCs pride themselves on providing an environment for efficient, high-quality healthcare with special attention to customer service and patient care. For this reason, Mr. Zoch says when hiring an administrator, always look for a candidate with ASC experience. “I don’t recommend hiring someone outside the ASC environment. While it might seem logical to consider someone from a hospital outpatient department, the efficiencies are different, reimbursement is different and generally the cultures are different,” he says.
The need for a specialist in a leadership role is paramount, according to Mr. Zoch. He compares this need to a patient that requires heart surgery. “While there may be some general surgeons that could do heart surgeries well, I’d want a cardiovascular surgeon. The outcome would likely be better given their significantly greater core training and experience level. We all want specialists when the outcome is mission-critical.” he says.
Mr. Zoch notes that everyone needs to start from somewhere, but in the current economic and regulatory environment, he says now is not a time to take a risk on a candidate that has no previous ASC experience. “You will almost always see a better return on investment and performance in a candidate that has ASC experience,” he says.
2. Advanced degrees are not always superior to proven experience. Although an MBA or other advanced degree can be a bonus for an ASC administrator, Mr. Zoch says ASCs should not throw the proverbial baby out with the bathwater. “Past performance in the ASC setting is the best indicator for future performance,” he says.
Fantastic administrators are those who have received their “advanced education” through experience. Mr. Zoch says, “Good candidates can include people who have worked their way up through the ranks to gain the experience that book-learning cannot provide. Staff members appreciate working with someone who knows which end is up, and they will respect and follow their lead.”
Mr. Zoch does agree that advanced degrees are important, all other things being equal, but exceptional performers should also be those who are lifelong learners and who are looking for ways to gain more education, both formally and informally.
3. Don’t feel obligated to promote from within. Promoting from within your ASC can be beneficial, as that person will already know the ASC’s players and culture; however, Mr. Zoch says that ASCs should never hire an internal candidate just because they want to give someone a “shot” at administration. “If they are the best person for the job, by all means, hire them,” he says. “But ASCs should be prepared to train them, as there can be a steep learning curve for someone stepping up into a larger role.”
If you are considering promoting someone to an administrator role within your ASC, you might first consider the risks associated with such a move. Mr. Zoch says that the ASC and the person being promoted should understand if it doesn’t work out, that person may end up leaving the organization altogether. “Often when someone is promoted, another person is hired to take their old job,” he says. “If the person can’t grasp the responsibilities of the new position or doesn’t perform at the level the ASC needs, he or she may have to leave the facility since their old job is no longer open. Too often it’s ‘up then out.'”
Mr. Zoch notes that an internal candidate will frequently be asked to take on both the administrative responsibilities and their old responsibilities. This can be a dangerous option. “The new administrator will have their focus split, and the result is often that he or she can’t really do either job well,” he says.
Another common thought process is that a nurse manager who is a “10” will be an outstanding administrator. According to Mr. Zoch, “It’s normal for physicians to suggest who should be promoted, but it is important to ask two questions: 1) Is this what the person really wants? and 2) Can he or she be successful in the new role?”
ASCs should be aware that internal promotions generally won’t immediately be a high performer because they will have a learning curve to climb. Centers should consider if they have the time and expertise needed to train or if they would be better served to hire an outstanding experienced performer off the bat.
4. Don’t expect job boards to produce A-list candidates. Job fairs and online job boards can occasionally bring in potential good candidates for ASC leadership, but Mr. Zoch says it is important to remember that these are low-percentage tools. Likewise, job fairs can limit the candidate pool to the immediate area when the perfect candidate may live 50 or 100 miles away.
Mr. Zoch also says that online job boards can be frustrating for human resources or others tasked with a search. “Some of the responses you will receive from job boards can be laughable,” he says. “People may see a job that says ‘administrator,’ and you’ll get resumes that leave you wondering if the respondents even read your ad. That’s just the nature of the Web. And while occasionally you can get lucky and find a good candidate, it can be a drain on an ASC’s time and resources to have calls coming in and e-mail clogged with candidates that simply don’t fit.”
Another point to consider is that most people who apply for positions via job boards are either under-employed or unemployed, according to Mr. Zoch. “The top talent doesn’t usually spend time looking at online ads, so your message will not likely be reaching the ‘A’ players,” he says. He also notes that candidates found through job boards will likely be interviewing with other companies and can easily be lost to other markets or companies.
Mr. Zoch suggests that rather than relying upon online recruitment methods, ASCs should regard them as one tool among many. “Most top administrator (and other) candidates are not actively looking for jobs, meaning they are not overly motivated to leave their current position. As such, they tend to be highly selective. But if they are interested in exploring your opportunity, they are more than likely not going to be interviewing in other markets,” he says.
5. Hiring a new administrator is like getting married. Mr. Zoch equates finding the right ASC administrator to finding the right spouse: “You could just marry anyone you like, but you wouldn’t because what’s the point if it’s not going to last?” he says.
For ASCs, this means waiting for a person who fits well with the culture of your ASC; someone compatible. Some centers have a more social culture, while others are strictly “all business,” according to Mr. Zoch. ASCs should, therefore, first understand what their culture is, then attract a good candidate who is looking for a center with a similar culture.
ASCs should use their culture as a selling point to the candidate. “The greatest thing an ASC has to offer, from a candidate’s perspective, is their culture,” Mr. Zoch says. “Candidates leave jobs because of the people and are attracted to jobs because of the people. Other aspects of the job factor into a decision to leave or stay, but it’s the people that make or break it.”
When interviewing candidates, ASCs should highlight the atmosphere, the attitude of physicians and staff, their patient outcomes and how the ASC celebrates, including awards and opportunities to socialize within and outside the ASC setting. This can help both the ASC and the candidate determine if there is a good cultural fit before an offer is made.
6. Decide what fair compensation is for the right candidate. Mr. Zoch says ASCs should not depend on surveys to determine what an administrator should be paid; rather, this will be determined by the marketplace. Using the salary of a previous administrator is a good starting point. He points out, “However, ultimately, it is irrelevant if it’s not enough to land the one you want.”
ASCs may encounter a situation where the perfect candidate is making more than the ASC is looking to offer. “It is important to consider what the difference in salary really means to the ASC,” Mr. Zoch says. “If you want to offer $110,000 and the person asks for $120,000, you need ask if $10,000 is reasonable for the right person. Is this candidate worth letting get away? In most cases, the difference is a drop in the bucket, if this truly is the right person. A great administrator will pay the ASC back many times more than the amount invested in great leadership.”
If the difference is more significant, Mr. Zoch suggests that the ASC ask the candidate why they are asking for the salary range. “If a candidate is coming into a new market, they may be coming from an area where housing costs are much lower and feel they need more to buy a home. They may have real-world needs, such as trying to sell a house in a tough market in order to relocate for the position, which may mean making double mortgage payments for an indefinite period,” he says.
In this situation, Mr. Zoch says some negotiation may be necessary to find an agreement that works for both parties. Creativity in this instance will be necessary if the candidate is the right person for the job.
“At the end of the day, it does you no good to pay someone just enough to get them, but not enough to keep them,” Mr. Zoch says.
Greg Zoch is a partner with Kaye/Bassman International, an executive search and recruiting firm. He may be reached by email at gregz@kbic.com. Learn more about Kaye/Bassman.
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