In such a highly specialized space, finding the right spine professional can be difficult — and retaining experienced spine professionals even more so.
"You need to treat the hiring process as a key business practice — have a plan, make a timeline and reach your goal," Nicola Hawkinson, DNP, RN, CEO and founder of SpineSearch, said in a presentation at Becker's Healthcare's 13th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference in Chicago.
Dr. Hawkinson founded the New York City-based recruitment, education and consulting company after witnessing the amount of turnover in the spine sector due to a lack of recruitment strategies and knowledge. Here are six steps and strategies from Dr. Hawkinson's experience that ASCs, physician practices and hospitals can use to hire and retain top orthopedic spine surgeons, neurosurgeons, pain management physicians and other spine professionals.
1. Identify the vacancy and need before beginning the search. Before the process begins, employers need to identify the reason for hiring, whether it is due to expansion, increased patient volume or replacement for an existing position.
"Employers must have an understanding of why an individual is leaving as well as an understanding of practice and retention metrics, so if there is anything they need to change, they can do so before the next individual is brought on board," Dr. Hawkinson said.
After identifying the need, employers should establish the specifics of the position they are filling, down to the title, supervisor, job description, compensation package, scope of practice, responsibilities and hours.
It is important to spend time writing a good job description as this will be used in the advertising process. According to Dr. Hawkinson, hiring without a thorough job description communicates to candidates that the organization is unorganized or unserious about hiring. Employers should use clear language and careful wording to avoid discrimination against any possible candidates. Dr. Hawkinson recommends comparing the job description to existing ones for similar positions to ensure it is as thorough as possible. She also cautions employers against relying entirely on recruitment firms to write the job description.
"[Recruitment firms and employers] can write one together, but [firms] won't write it for you," she said. "They don't know what you want the position to be."
Next, employers should determine the compensation and benefits package before beginning the hiring process.
"Employees today are not just motivated by money," Dr. Hawkinson said. Many employees also look for benefits like healthcare, 401k or flex hours. Market rates, skill level, years of experience and supply and demand should factor into constructing the compensation portion, but it must reflect what the practice or center can actually afford, Dr. Hawkinson said.
Lastly, employers need to think about what kind of person they would like to fill the position. This discussion should include details such as personality type, interests, geographical barriers and key attributes.
"If you are in the situation where you are replacing a former employee, take some time to think about pros and cons of the last person who sat in that seat. Use this analysis as a learning model to have a higher retention rate with next person," Dr. Hawkinson said.
2. Create a search strategy. The next step is to define a strategy and make a timeline. Some positions, such as physicians, require more time to recruit, whereas medical secretaries or scribes can be selected more quickly, according to Dr. Hawkinson.
"If you are going to put out a search, you have to set aside a time to interview those people," Dr. Hawkinson said.
The strategy should include search methods, a quota of candidates to interview before making a selection, a defined screening and interview process, criteria for selection and the selection team. Time should also be allotted to look at internal candidates in case there is an opportunity for intercompany advancement.
For external advertising, Dr. Hawkinson recommends attending live events or job fairs, posting on job boards, websites and social media outlets based on the type of recruit you are looking for and the cost and time you have available. Think about where this type of person would seek a new job. If it's a new graduate, go to university job boards and post ads there, for example, and only repeat old advertisements or strategies if they worked.
3. Interview slowly. Dr. Hawkinson recommends building a steady stream of applicants and interviewing them in groups of three to five per day for back-to-back comparison. Employers should set aside two to three hours for interviewing, with approximately 30 minutes per interview and a couple minutes to score candidates between sessions.
"If you have multiple people chiming in on the hiring decision, creating a scoring selection model is important so you can easily make your selection as opposed to everyone taking notes and comparing," she said.
Before candidates come for in-person interviews, Dr. Hawkinson recommends providing information on the date, time and location of interviews, in addition to the number of people that will be interviewing candidates, and if any special testing will be involved. This information can be relayed via email or over the phone.
This first point of contact, she said, whether it's over the phone, via email or on Skype, is when the interview begins. Candidates should speak and write professionally. However, it is important not to make assumptions too early in the process. Dr. Hawkinson warns against assuming who is right or wrong for the job too early; go through due diligence, she said, because candidates can surprise you.
During the interview, Dr. Hawkinson recommends abiding by the “80/20 rule,” meaning candidates should talk for about 80 percent of the time, and the other 20 percent should be devoted to employers answering any questions candidates may have about the vacancy.
She also stressed the importance of asking the right questions. Employers need to make sure a candidate's vision and goals align with those of the practice. "Don't overlook small things," Dr. Hawkinson said. "They could turn into bigger issues. If their job experience does not match what you are looking for, don't ignore it."
4. Keep candidates engaged throughout the selection process. Qualified candidates should be promptly acknowledged, according to Dr. Hawkinson.
"Time kills all deals," she said. Good candidates are likely considering multiple opportunities, so you do not want to lose them at any point during the process through a lack of communication.
After the interview, even if employers are not ready to make a selection, qualified candidates should be promptly contacted with next steps or updates on when more information about next steps will be available. Candidates who are highly interested will likely reach out within 24 hours about opportunity, so employers should have next steps ready.
5. Don't ignore red flags. While the interview process is underway, practices should simultaneously perform reference checks, contacting three to five references with a detailed questionnaire tailored specifically to the business or practice.
"The real importance of references is that they help you spot the very small number of job applicants who give misleading information about their past or are giving false information," Dr. Hawkinson said.
In addition to investigating a candidate's skill set and work ethic, a full background check should also be done — U.S. work eligibility, previous employment, criminal background, health screening and other qualifications, such as academic degrees, must all be checked.
"You want to make sure you are bringing the right individual into your practice," Dr. Hawkinson said.
When practices feel they have found the right person, they should make a contingency offer. That way, employers still have the opportunity to revoke the job offer based on the results of background checks. Dr. Hawkinson stressed the importance of keeping candidates engaged throughout this process as well.
6. Design a detailed on-boarding process to improve retention. Once a candidate has been selected and the offer has been accepted, employers are still recruiting this person, Dr. Hawkinson said. On Day 1, it is critical to show the candidate thought was put into the on-boarding process.
Employers should let candidates know when and where to arrive. They should establish before the candidates arrive where they will sit, who they will shadow and what the day's agenda will look like. The first week should be entirely planned, hour-by-hour.
"A great idea for someone, if possible, is to identify a mentor or buddy in the group who can support, advise, motivate and encourage this person in regards to the employee handbook, what time to take lunch, etc.," Dr. Hawkinson said.
Within the first day or week, employers should set a date for the new employee's 90-day review and provide information on what they will be evaluated on. This strategy sets the tone and creates a structured work environment. Plus, it lets candidates know there is a plan for them that includes upward mobility, according to Dr. Hawkinson.
"Staff retention will only happen when you have all your management policies right."