|
Here's how one physician assesses job applicants' skills, common sense, and other qualities.
Hiring competent support staff is a protracted and difficult undertaking. The right worker can make you; the wrong one can cost you dearly in productivity, office morale, and patient satisfaction—and can even be a malpractice risk.
I use a three-step interview process to check applicants' suitability; only qualified candidates go on from one phase to the next. Candidates' proficiency in job-related tasks is rated on a scale from 1 to 5, with 1 being poor, 3 average, and 5 excellent. I hold on to the evaluations for several years in the event that a rejected candidate claims that he or she was unfairly denied employment and takes legal action.
Steps 1 and 2—Resume and phone interview
First I review all resumes for spelling, neatness, and presentation. If the person doesn't have the pride or intelligence to make a good first impression when she's trying to get something she wants, then I know she won't take that extra step in representing the office. Although I usually don't disqualify a candidate who doesn't have experience in the job I'm interviewing for, I consider it heavily.
Stability is another important criteria, since replacing employees is expensive and time-consuming. It counts for patient satisfaction, too. Patients like to know the person at the front desk and the medical assistant who asks them personal questions. I hold frequent job changes against an applicant, unless an explanation relieves me of the thought that history will repeat itself.
Rating a resume takes 30 seconds.
Those with acceptable resumes get a two to five minute phone interview. During the conversation, I rate the candidate on professionalism, pleasantness, enthusiasm, courtesy, and believability. This may be the first voice that a new patient hears. What sort of impression would the patient have?
I explain the work schedule and ask, "Are these the hours you'd be interested in working? Sometimes we get busy and run an hour or more late. Are you able to stay overtime?" The phone interview continues only if there's no difficulty with the schedule. If we do continue, I ask what type of work the person is interested in doing to see if she has realistic expectations.
Step 3—A face-to-face interview
If I don't think the match is right, I tell the person so, but I also indicate that I'll keep the application in case my needs change. If the phone conversation has gone well, I schedule an in-person interview. Even the scheduling process is part of the test: If I'm very interested, I tell the candidate that I haven't finished with my phone interviews, but to call me the next day at a specific time to set up a time to meet in person.
If I'm less impressed, I ask the applicant to call in a few days or a week, again at a specific time, to schedule an interview. My intention is to test the candidate's resolve and ability to follow through, since this person's duties might be to contact a patient or a physician, track lab data, collect bills, or do other tasks that require persistence. The order of the scheduled follow-up calls allows me to interview the best-qualified applicants first.
The face-to-face interview can take up to 15 minutes. I ask applicants to tell me about themselves. Candidates are ranked on appearance, personality, and presentation. If there's an obvious problem (i.e., wearing dirty, cut-off jeans), the process stops immediately and I jot a comment as to why the person wouldn't fit in.
During the interview, I give the candidate two scenarios to test medical judgment.
• "A man comes in with his 4-year-old son. The boy has a 1-inch gash on the top of his scalp and it's bleeding all over. The waiting room is packed. I'm busy doing a Pap test on a very nervous lady. The dad is shouting, 'Get the doctor! Get the doctor!' What do you do?"
I expect the candidate to say that she'd bring the father and son into an exam room, try to calm them, and perhaps offer a compress. If the applicant says she'd interrupt the gynecologic exam, I gently explain that a gash on the scalp can bleed a lot and look bad, but if I fix it now or two hours from now, the outcome wouldn't be much different, so there's no need to interrupt the nervous lady's Pap. I purposely make this point because of the next scenario.
• "The waiting room is packed. I'm doing another Pap exam on another nervous lady. A 70-year-old man comes in clutching his chest, saying, 'I started having indigestion an hour ago. I see you're very busy now. Can you get me an appointment for next week?' The guy's breaking out in a cold sweat, he's gray in color, and doesn't look good. What do you do?"
Of all the questions I ask a candidate, this is the most crucial. I can't teach common sense and good judgment. I would never hire someone who says she'd give the man an appointment and let him leave the office. The reply that she wouldn't know what to do but she'd get me is acceptable (rated a 3, average). Because of the first scene, many applicants say they'd try to handle the situation on their own, not wanting to disturb me. I ask them to specify how long they'd wait for me. If the answer is 10 minutes or more, they get a score of 2.
The applicant who says she'll take the man immediately back to a room, notify me that there's an urgent situation occurring, begin to take vitals, and come to get me if I'm not out in a couple of minutes, gets a 5.
The next step: having the candidate type a short dictated letter. This tests typing, rudimentary computer skills, spelling, and performance under pressure. I try to the put the candidate at ease when I tell her, "I'll purposely use words you might be unfamiliar with. Give your best guess."
Dear Dr. Johnson:
Jane Doe is a 38-year-old female with shortness of breath on exertion. Her CBC and chest X-ray are normal. Please consult on the dyspnea.
I don't time the typing since a crude judgment of speed suffices. Once the candidate finishes, I ask her to print the page, circle errors, and write a few guesses as to the correct spelling (to see if she'd be capable of looking the word up in a dictionary).
Finally, I hand the applicant an anonymous explanation of benefits and ask her how much the insurance company paid the office and how much the patient owes.
While a candidate's in the office, I have other staff members talk to her individually and then tell me whether they'd be comfortable working with her.
At the end of the interview I let the candidate know if she performed well. I ask the ones I'm most interested in to call me the next day for my decision on whether they got the job. Others are told to call at a later date.
My interviewing process works well in comparing candidates, but it's also been enlightening in unexpected ways. I've had applicants ask if they really had to type since they just got their nails done, break down and cry with frustration at the dictation, or not be able to type a single word without an error despite turtle speed (the resume claimed the candidate typed 100 words per minute). One nurse abrasively argued she could take care of the potential heart attack victim herself—even after I told her how I wanted the situation handled.
Cynthia Troiano, DO
2004 Doctors' Writing Contest--Best Practice Solution award
Medical Economics
|
While the benefits of advanced clinical software such as electronic health records (EHRs) are well-documented, the up-front costs and resources needed to implement and support these systems can be prohibitive for some physician practices. 
The authors conclude that with the emergence of reliable broadband technology, the ASP model is an increasingly viable choice for many small to medium-size practices. Particularly for those with limited capital and IT resources, it may offer the only practical strategy for migrating to EHRs.
As information technology in the health care industry evolves from an administrative tool for billing and bookkeeping to a clinical tool for improving the quality and efficiency of health care, the scope of information sharing is expanding beyond the walls of individual institutions. Achieving this level of integration will require that software models overcome a host of technical obstacles, and that they are accessible, affordable, and widely supported.
While not heralding the end of commercial software vendors, the report concludes that conditions are ripe for open source solutions to take root in health care, and that it will likely become the standard for capturing, sharing, and managing patient information to support quality care. It also notes that health care businesses have the opportunity to take the lead and drive the shift to this new model.
From USB flash drives to MP3 players, many pocket-sized electronic devices can be used to download and store large amounts of data, including protected health information.