Recruiting and interviewing employees is never easy—but it can be made less time-consuming and aggravating by following some specific steps.

As salaries and benefits represent the biggest expense—typically between 18% and 24% for a practice without an ambulatory surgical center—you need to make sound hiring decisions. Mistakes are expensive. Some experts put the cost of mishire at roughly $6,000 to $10,000 per employee.

Human Capital Metrics Consortium estimates $140 per $1,000 compensation as an easy way to calculate the cost of turnover. Another reliable source, Saratoga Institute, estimates the cost of turnover at 25% of annual salary plus 25% of benefits.

Most physicians want to avoid paying recruitment fees, so it is beneficial to use a proven process. Therefore, when you are hiring in a hurry, slow down and use the following method to lessen your chances of making a mistake.

Step 1) Double-check the position description. Has it changed since you last hired someone? More important, should you change it now? For instance, if your practice has adopted a new software system—say, an EMR—the candidate filling the job may require a specific or new skill set that the previous employee never really acquired; or maybe they developed it on the job. More than likely, you’d like the new hire to have strong skills in Word, PowerPoint, and Quick Books—as a job prerequisite.

Many job descriptions are weak in terms of quantification. For example, “checks-in clients or patients” is what I typically see. How many clients per day matters—is it eight or 28? “Enters new patient data” is another vague statement. If all eight patients are new, strong keying speed will matter. Put some meat on the bones of your job descriptions.

Step 2) Struggle with the ad copy. Because of the economy, poorly written ads will attract hundreds of resumes—unless your ad is very descriptive and specific. The online services—such as—can edit resumes for you that don’t comply with requirements. This is a feature many job posters fail to use, and it can save hours.

Step 3) Call and prescreen top candidates. Unless you are literally hiring a cover girl, your first step is to determine if the person sounds as good as they looked on paper. Calls save time. Ideally, you should have five to seven top candidates. Your calls will narrow the list to a manageable two or three for face-to-face interviews.

Next, you might want to check listings on MySpace and Facebook. Fortunately, you can learn a lot—maybe even more than you wanted to know—by checking this out.

We’ve learned that Ms Marbles-in-her-Mouth may not be the best person to serve as first phone in your office. I’ve actually had gum snappers during phone interviews—candidates lacking common sense are easy to weed out. On the other hand, I’ve called candidates who are moms whose children are beautifully trained and have wonderful phone manners—I resisted offering one 11-year-old the job. They learned the technique from their parents—a good sign in many ways.

Use the techniques in the sidebar for more phone prescreening techniques.


Review the resumes closely, looking for and noting problems and potential weak points—as well as strengths. Ask yourself why Ms. Job Jumpers with no more than 1 year to 15 months at any previous position will be any different when she’s working for you. One exception: If Ms. Job Jumper can explain her circumstances, you might reconsider.

Many of the questions you ask a candidate during the interview will either be directly based on or modified by specifics from the resume. A few general questions have consistently drawn interesting and useful responses.

Imagine this scenario: You are the only staff member at the moment in the front office. A client walks in, obviously very upset about something, and walks up to the front desk. What steps would you take? If they say, “I’d tell him to calm down,” then you know that the candidate flunked Psychology 101. “Calm down” is a phrase that puts fuel on the fire. Pass; or ask another question and see if they do any better.

Depending on your specialty, you should create several common scenarios to which a candidate can respond. Candidates cannot prepare for well-done situational questions. They will have to draw on their actual experience and common sense to answer appropriately.


  • We’ve all been in situations where we haven’t gotten along with an employer, supervisor, or co-worker. When that happened to you, how did you resolve or handle the situation?

    Pointer: If the candidate says, “Why, that’s never happened to me; I get along with everyone,” then they have obviously not been living on the same planet as the rest of us. Or you better check them for angel wings.

  • “What have you read lately?” has proven to be a very revealing question. One candidate interviewing at my office stated on her resume that she read poetry. The manager, who also reads poetry, asked the candidate what contemporary poets she particularly enjoyed. Happily, the young woman looked back, smiled, and said, “Ed Hirsch.” Hirsch, an American poet and academic who wrote a best seller about reading poetry, also received the National Book Critics Circle Award for his book, Wild Gratitude.

    It’s not unusual to find things listed on resumes that sound good but aren’t true. Evidently, some people discovered this packaging worked on college applications and are continuing to use this technique in their job search. The difference, of course, was that in college the candidate’s parents paid their way. Now it is up to you, their employer, to pay—the stakes have changed.

  • “Would your previous employer consider you very or moderately detail oriented?” If they say yes, you will make sure to verify this assumption if you later call for references. In another example, if I called a friend of yours and asked, “Is Katie balanced in terms of work and play?” then what would they say?
  • Strike the right balance between question asking and question answering. Good interviewers know that when they are talking, they aren’t learning anything. Whereas it is important for candidates to have time to ask you questions, be mindful of the time ratio. We recommend that you do 70% of the listening and 30% of the talking.

    We all have interview pet peeves. Mine concerns questions about “How I found my passion.” I have no idea who instilled in a generation that one is to feel spiritually elevated about their work on a daily basis, but it is a misguided feeling. Let’s face it: People have good days and bad days. I’m not sure that Katie Couric or the women on Wall Street feel “passionate” about their work on a daily basis, and I am quite certain that their passion wasn’t revealed to them at their first position. I feel much better when an applicant asks about what I think he or she will learn on the job. This shows some long-term focus.

  • Ask follow-ups. One of an interviewer’s best tools is the line, “Tell me more about that.” Watch any good television host and you’ll see that the follow-up to a guest’s answer is the “velvet crowbar” that produces the interesting answer.

Reduce the Chances of
Making Mistakes in Hiring

Double-check the position description. Has it changed since you last hired someone?

  • Write and rewrite you ad copy.
  • Call and prescreen top candidates. Do they sound as good as they “looked” on paper?
  • Check candidates’ listings on MySpace and Facebook. You can learn a lot from this.


Handshake—is it like a warm, limp ball of dough or a demonstration that weight training pays off … or somewhere in between? A person’s handshake tells you something about them.

Eye contact—does the candidate look you directly in the eye or does his glance wander? Looking away from you or down at the floor can indicate a lack of self-esteem, confidence, or honesty.

Body language—does the candidate sit still or fidget? Does she appear relaxed or nervous? Would this candidate’s posture and presence represent your business well?

End the interview by declaring the next steps in the recruitment process. Second interviews are strongly recommended. Energized by having made the “cut,” some candidates will feel more comfortable revealing more of their “true selves.” You’ll discover more questions about compensation, that vacation that they forgot to tell you about the first time around, or a boldness that may be pleasing or off-putting.

See also “Taking the Guesswork Out of Hiring a Practice Manager” by Cheryl Whitman in the September 2008 issue of PSP.

The second interview allows the candidate to spend time with the staff. Listening to your staff’s impressions of the candidate is valuable. Again, some candidates may let down their guard with those they see as peers or co-workers.

Using tools that assess behavior is something that many small business owners don’t do and most big businesses wouldn’t think of omitting. These tools, all Equal Employment Opportunity Commission approved, are all useful in assessing likely on-the-job behavior.

For example, Proception 2 is an online profiling system that can help you understand a candidate’s behavioral style in a work environment, as well as identify personal strengths and areas in need of development. The Proception 2 questionnaire process takes less than 1 hour and generates a personalized report.

Another tool, Select, is an efficient, cost-effective screening tool that provides you with insights into a candidate that you may not see during the interview session. This product can provide you with an objective comparison between candidates.

Visit my Web site at to learn more about Proception at $95 per report and Select at $25 per report.

Karen Zupko is a consultant to plastic surgeons and aesthetic dermatologists, with more than 25 years of experience in the business side of managing a practice. She can be reached at (312) 642-5616.

Goals for the Prescreening Interview

Time is valuable in the interview process—you do not want poor candidates to waste yours. Be prepared and plot the course of the phone interview. Get the information you need to collect. A checklist for your phone call should include the following:

  • Check and clarify information from the candidate’s resume. You’d be surprised how often people forget the fictional they have created on their resumes. Does the phone story match the resume? In one case, the candidate asked me, “Which one did I send you?”
  • Determine whether or not the candidate’s availability meets your needs. Can you wait 6 weeks for them to start? That’s how much notice one candidate felt her present employer would need to find and train a replacement. On the one hand, it’s a good sign that shows respect for the other employer; on the other hand, if you are very short staffed you may not have the luxury to wait.
  • Does their expected compensation fall within a range you’re comfortable paying—that is, competitive but not more than you can afford? Why wait until you’ve spent an hour interviewing him or her to figure out that you are on Saturn and they are on Pluto in terms of money? Also important: Does the candidate value the fringe benefits that you’re offering? An appreciation for the value of retirement savings plans, health insurance, transit passes, and other benefits you provide is worth assessing. If you start with a gap the size of the Grand Canyon, trust me—it will always be an issue.
  • Expand on the resume’s more technical information by asking specifics. For example, “How many newsletter articles have you written?” or “Describe what you did running the front desk at the Special Spa.”

    On one occasion, a candidate listed the Act! software we use in our office as one of her technical competencies. Without mentioning that, I asked about a particular functionality, whereupon she assured me the software did not do that. Wrong answer. I asked another question, and this time she stammered, “I don’t know about that.”

    Onto the use of Outlook, another one of her supposed competencies. I asked what she did when she left the office for a few days—any special features that she relied on? No, she replied. Well, if you list yourself as an experienced or expert Outlook user, you would know that the “Out of Office Assistant” feature sends replies to incoming e-mail in your absence, indicating that you will be delayed in responding. Other simple questions tripped her up. Beyond the Send and Reply keys, I’m not sure she knew what Outlook could do. Her padded resume showed intentional dishonesty.

    The message to job seekers who may be reading this story: don’t lie; the message to managers is trust but verify.

  • Use the resume to frame questions about the candidate’s interactions with supervisors, co-workers, and clients. I always ask, “How would your co-worker describe you?” and “Who did you help get ahead?”