To weed out potential bad hires, employees long have used personality tests. Such tests also help job candidates clarify what matters most to them professionally. The SHM’s Career Satisfaction Task Force has developed a framework for hospitalists to do that. The self-test rests on four pillars of job satisfaction: reward/recognition, workload/schedule, autonomy/control, and community/environment (to view, go to www.hospitalmedicine.org and click “Career Satisfaction White Paper”).
Sylvia McKean, MD, medical director, the Brigham & Women’s Hospital/Faulkner Hospitalist Program in Boston and the task force’s co-chair, urges hospitalists to complete the self-test to maximize a potential job fit.
“All jobs have unpleasant side effects,” says Dr. McKean. “People get sick at bad times. There is high stress and sometimes high error rates. It’s important for a hospitalist to analyze what your needs are and to find an environment that best suits them.”
Dr. McKean also offers wisdom from the other side of desk, having interviewed candidates for coveted spots at Brigham & Women’s hospitalist program. “I’ve interviewed doctors who aren’t interested in hospitalist medicine but view our program as a stepping stone to the job they really want here,’’ she says. “We hired and fired someone who wanted her own way all the time. She left for another prestigious hospital. Then there are others who don’t want to teach, but choose a teaching hospital.”
Dr. McKean hopes SHM’s self-assessment tools will help job candidates focus on what they want from a hospital medicine group and avoid the “pebbles” that erode job satisfaction.
IPC, which employs 600 physicians in 100 practices in 24 markets, tried personality testing then discarded it. IPC hired a psychometric firm to devise a psychological profile of “best” and “worst” performing hospitalists. The testers created a test measuring seven key characteristics relating to temperament, intelligence, and clinical skills.
IPC’s CEO Adam Singer, MD, says: “We tested all candidates but found the test ineffective because nearly everyone, including me, got five or better.” He dropped the test, relying instead on extensive interviews. Dr. Singer reviews 2,500 to 3,000 physician resumes annually and spends significant resources on avoiding bad hires. All that hard work doesn’t avoid the occasional mistake.
“I’ve seen everything—the brilliant doctor who can’t function on a team, aloofness, temper tantrums, rudeness, and always pushing responsibility on someone else,” says Dr. Singer. “When something’s wrong, 90% of the time we terminate them ASAP. The other 10% we salvage by finding what’s stressing them, relieving the pressure, and mentoring them into proper behavior.”
Cynthia Stamer, a Dallas-based attorney at Glast, Phillips & Murray, P.C., works extensively with physicians and hospitals and sees young physicians straight from residency joining hospitalist programs “just looking for a job and not focused on whether or not there’s a good personality fit.” She urges job candidates and hirers to better probe the fit.
Stamer finds good hospitalists to be stress jockeys who thrive on the intensity of hospital work. “I think they’re born and not bred,” she says. “They tend to be bored or disruptive in office practices, and to enjoy a pattern of work hard, play hard. The ability to throw the ‘on’ switch and be intense for block scheduling, then be ‘off’ for a block suits them,” she says.
Not That Bad
In a field where an extra pair of hands can make the difference between taking night call or the freedom to take several days off for emergencies, a mediocre team member might seem better than none. Some hospitalist groups would rather pull a bigger load temporarily than tolerate a laggard; others stomach imperfection.