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Similarly, Fahy recalls the MD-candidate who asked a Permanente department chief not to talk to her current colleagues because she wanted to keep her job hunt confidential. He respected her wishes. But once hired, this bright woman proved she was also profoundly narcissistic. One call would have revealed that everything was always all about her. “We had to remove this physician from our group,” says Fahy, “and that’s always painful.”

Today Fahy and her colleagues use their application release to “go three-deep”—that is, to ask a candidate for a reference and then ask the reference for someone else who might feel differently about this person. It’s the best way, she says, to get a mix of opinion about both performance and personality. “If we get a sense that somebody has an issue that’s going to make it difficult to either deliver excellent care or raise the bar in the department, we’re not interested in hiring them,” says Fahy.

So what should you ask? Obviously, you’ll be focused on clinical skills and medical philosophy. But you should have other intangibles in your reference-checking discussions, too. The same type of open-ended questions that you asked of your candidate can now be aimed at a former colleague or boss. For instance, “Can you give me an example of a time when Joe was extremely frustrated? How did he deal with it?” Or “If one of Jane’s patients came into the office, threatening a malpractice suit because he thought she had misdiagnosed him, how would she handle it?”

There are many variations on the theme, but if your probing unearths something new about this person’s modus operandi, you’ll at least be forewarned. Consider the department chairman who felt compelled to issue a final wake-up call to a surgical fellow by mentioning the young doctor’s anger issues when he received reference-check calls. After acknowledging his terrific surgical skills, this chief unloaded about the bad temper. Not surprising, the fellow didn’t score with a job until he figured out how to handle his outbursts.

Perhaps you’ve put on the brakes after hearing similar information. Or maybe your official policy is to make your offer contingent on “no surprises.”

But whatever you do, be aware that federal and state discrimination laws prohibit you from hiring (or not hiring) based on race, religion, disability, and age. What’s more, it’s not just overt mistakes that should make you nervous. The subtleties can get you into trouble, too. For instance, if you want to get better acquainted with a candidate, it’s dangerous to ask about organizations he belongs to since racial or religious affiliation may be implied. Instead, just keep it neutral, “How do you spend your spare time?”

A couple of final legal words to the wise. Just because your practice is small, don’t think you can slip under the discrimination radar. The matrix of regulations is so broad that you’re most likely covered by some statute. Also, hiring professionals warn that the legal bottom line is to stay focused on the actual requirements of the job. That means if you’re asking questions that aren’t directed at performance, tread carefully—and with your lawyer’s approval.

That’s ditto for talking to spouses. Yes, a significant other is likely to know this individual better than anyone else, but if you’re looking to a husband or wife for personal insights, just make sure your questions don’t cross the legal line. Dinner with a candidate and significant other is an informal way to see this person interact, but it’s part of the formal process, so be careful what you ask.

Fleming doesn’t remember a time when he didn’t take his practice administrator along when entertaining a candidate. He depends on her, as the hiring guru in the office, to keep the conversation on the straight and narrow. She’s not afraid to say, “We can’t go there,” when the exchange gets too close to personal issues. “I depend on her for that.”

In fact, the biggest challenge in interviewing colleagues is probably straddling that obscure fine line between professional and personal. That may be difficult, especially if, like the Serotas, you’ve been successful in finding people in the past who have gelled with you like friends. In the six MDs and NPs that make up their practice, these partners say they’ve identified a usually stable group of family-oriented, independent workers who also happen to be team players with patient-friendly skills.

To achieve that mix, the two admit they’re driven more by instincts than questions. But, if the candidate is a pediatric nurse practitioner, they rely on other tools. Since Jo Ann Serota teaches in area NP programs, she’s already familiar with the candidates she’d like to bring on board. So when a serious job offer hangs in the balance, she just invites this individual for a working interview. By collaborating before the offer is extended, she knows the candidate’s skills pretty well.

As for finding that right fit in a physician: The best screening system, say the Serotas, may still be working together. “You can get an idea of how people think by talking to them,” says Fredric Serota, “but nothing is as valuable in predicting how they’ll meld with the rest of the team than just bringing them on board.” n

Do you wonder what to ask during an interview? Of course, the best interviews are tailored to your specific situation. But whether you’re hiring a physician or ancillary health professional, whether your practice is single- or multi-specialty, you can use the same open-ended questions to find your right fit. What you’re looking for is a match to your answers, whether you’re talking clinical skills, values, or goals. Here are a few starters:

• “We’ve all had patients who made life easier
or harder for us. Can you give me examples of particularly memorable ones you’ve treated in
each category?”

• “Give me an example of your ability to supervise staff members effectively. How have you made a difference?”

• “Give me an example of how you partner with your patients?”

• “Tell me about your biggest professional or personal setback. What did you learn from it?”

• “Describe the last challenging situation you had with a patient. How did you deal with it?”

• “Describe a difficult conversation or conflict you’ve had with a colleague. How did you resolve it?”

• “How would your former co-workers say you handle stress?”

• “If I were to talk to Dr. Smith, whom you listed as a reference, what would he/she say are areas where you need development?” Later, if Dr. Smith offers some generic endorsement to your initial questions, you’re ready with a response: “Oh, really? Jane/Joe thought you’d describe X, Y, and Z. Can you tell me more

• “It’s been a terrible day in the office. The phones are ringing off the hook, two nurses called in sick and the waiting room is full of angry patients. How would Jane handle that situation?”

• “Mrs. Jones came into the office today and demanded to see Joe’s boss. She accused him of misdiagnosing a disease—of missing an alleged malignancy. How would Joe deal with that?”

• “What areas should we focus on in mentoring Jane/Joe?”

Crossing arms. Uncrossing legs. How much attention should you pay to body language?

Of course, if this candidate hangs his legs over the chair in your office or that one plants her face squarely in yours, you’ll probably wince and think twice.

But it’s tricky business, say experts, to read too much into other physical gesticulations, given that we all possess a wide repertoire of emotions and they’re often conveyed in many subtle and contradictory ways. Someone who fails to make eye contact, for instance, could be signaling that he’s dishonest, defensive, or even bored. Then again, he might just be scared.

In fact, the most common indicators or “symptoms” that we associate with a myriad of other states-of-mind are often just nervousness at work. So a word to the wise: Unless you’re a serious student of the subtleties, don’t overanalyze your candidate’s strange or annoying movements. Besides, anything you think you’ll learn from them, you probably can get from a well-structured and executed interview.

As jury consultant Jo Ellan Dimitrius, PhD, suggests in her book, Reading People (Random House, 1998): “Physical characteristics and body language are what you’ll often notice first, but file those observations away for a while. You need much more information to make a sound judgment.” n

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