Tools of the Trade
As medicine shifts, groups are hiring radiologists who can not only interpret images appropriately but also serve as practice builders.
In many professions, it is not unusual for people to change employers often. In fact, the Bureau of Labor Statistics reports that in 2012, the median number of years that wage and salary workers had been with their current employer was just 4.6.1 That means that people tend to change employers nearly as often as the nation holds a presidential election. But radiology is different.
Many radiologists stay with a practice or academic department for at least 10 to 15 years. With a commitment longer than some marriages, hiring the right radiologists is perhaps the single most important thing an organization can do to achieve its long-term strategic goals.
“Sometimes practices make a proverbial shoot-from-the-hip decision and say, ‘If one person leaves, we need to automatically get another person,’ without doing a critical analysis of what their needs and resources are.”
-Samir B. Patel, MD
Whether a private practice or an academic department, groups must begin by taking a decisive look at their hiring needs. “Sometimes practices make a proverbial shoot-from-the-hip decision and say, ‘If one person leaves, we need to automatically get another person,’ without doing a critical analysis of what their needs and resources are,” says Samir B. Patel, MD, director of the value management program at Radiology, Inc., in central Indiana. “It’s important to take a critical look at the supply-and-demand needs and use that to make the decision about whether hiring or replacing a radiologist is necessary.”
Once an organization decides to proceed with hiring, it must determine exactly what it wants in a new radiologist. Particularly as medicine shifts to a value-based model, groups are looking for radiologists who can not only interpret images appropriately but also increase quality by engaging with referring physicians, patients, and others in the health care system. “Hiring a radiologist who has excellent credentials, so you can put them in a dark room to read images and never talk to anyone — that’s a thing of the past,” says Jonathan Breslau, MD, FACR, chief radiologist at Sutter Imaging, Sutter Medical Group. “You have to bring in people who have excellent training but who are also Imaging 3.0™ practice builders, who can strengthen relationships with all parts of the health care enterprise and show referring physicians how imaging can help them improve patient care.”
When organizations ponder their needs, they may also consider seeking certain types of candidates, such as those with specific skill sets, those just out of training, or those who can add to the diversity within their group. “If we only surround ourselves with people who think exactly the same as us, we’re going to miss things and we’re going to have blind spots,” explains Michael P. Recht, MD, Louis Marx Professor of Radiology and chair of the department of radiology at NYU Langone Medical Center. “Diversity is something we strive for and is crucial if you’re going to be a successful organization.”
Most radiology groups rely on job boards and word of mouth to recruit new radiologists who meet their needs. “We’ll call people in the field who we respect and say, ‘Have you trained anybody or do you know of anybody?’” Recht says. “That’s really crucial because you’re calling people who you know and trust and who have leadership positions, so you know they’re not going to lie to you.” It’s an approach radiologists have long relied on to recruit new members, but Breslau says that method might be used less often as more radiology practices join multi-specialty groups. “With multi-specialty groups, the vast majority of doctors are primary care, and their hiring is done in a much more standard HR-type process,” explains Breslau, whose group recently integrated into a multi-specialty practice. “The tendency will be to deploy the same process for radiology, but I don’t think that will serve them as well as continuing with the more informal referral networks that have functioned within radiology and other specialties.”
"You have to bring in people who have excellent training but who are also Imaging 3.0 practice builders.”
-Jonathan Breslau, MD, FACR
After reviewing a candidate’s resume, hiring managers often call their own contacts in the field who may know the candidate. “We make lots of calls, because if you just call the two or three references that the person gave you, you’re going to get two or three people who love that person,” says Georgeann McGuinness, MD, FACR, professor and senior vice chair of radiology at NYU Langone Medical Center. However, says Hang B. Truong, ACR senior director of human resources, “Caution should be taken when discussing a candidate with other radiologists. You need to make sure you are only asking about a person’s job performance, skills, and other job-related information.” Asking about certain protected personal information, including a person’s age, race, religion, or gender, violates anti-discrimination laws in the U.S. (For more information about topics to avoid, visit www.eeoc.gov/laws/practices.)
Once a candidate checks out with references, groups must decide what additional information they want to gain during the interview. “Sometimes groups don’t put enough emphasis on interviewing somebody well and really getting to know them before making a decision,” says Frank J. Lexa, MD, MBA, vice chair and professor of radiology at Drexel University College of Medicine.
“If we only surround ourselves with people who think exactly the same as us, we’re going to miss things and we’re going to have blind spots.”
-Michael P. Recht, MD
While it can be difficult to actually get to know someone during an interview, Patel says his group tries to determine whether a candidate is a good fit by giving him or her tours of its sites and holding meet and greets with its radiologists. The meetings allow Patel and his team to see how the candidate interacts with the group, while also giving the candidate insight into how the group operates. “If we anticipate radiologists being here for at least 10 years, we want to make sure that they meet many different people to get an understanding of the culture of the group,” Patel says. Engaging multiple people in the interview process is also beneficial to gain different perspectives on the candidate.
Another way some practices get to know candidates is through behavioral interviews — which use specific, but open-ended, questions about problem-solving to ascertain how someone might perform in the future. Breslau says that his group recently began conducting behavioral interviews that include requests like, “Give an example of a challenging situation you encountered in your work and discuss how you handled it.” This structured process provides valuable insight into how a candidate will acclimate to the group’s culture.
To further gauge how a candidate might work within a group, Lexa suggests asking him or her to interpret a few cases. While radiologists are rarely required to demonstrate their core skills during an interview, other industries regularly ask job candidates to perform such tasks to see how they approach their work. “In my career, no one has asked me during an interview to sit down and show them how I read head CTs or MRIs, and yet, those are the kinds of things that we’re going to be asking them to do,” Lexa notes.
Most radiologists will spend decades — if not their entire careers — with one group, so it is imperative that organizations take the time to find a candidate who meets all of their needs before extending a job offer. While the group may have to work harder in the interim, it will be worth it in the end to have a new member who can see the practice into the future. “I always say that you’re hiring someone for life,” Recht says. “The greatest pitfall is not putting in enough due diligence during the hiring process. You really want to make sure you take the time to get it right.”
Note: click on image below to enlarge.
By Jenny Jones, freelance writer for the ACR Bulletin