Three Principles for Systematically Hiring the Right People

So one of the most important parts of being able to get to great outcomes that we don’t emphasize enough in medicine is how to hire. The way we hire and build people in medicine is we train them, work with them for years, and then pick the ones who, you know, we already know are the right ones to bring on to our teams. We don’t all get that luxury. There are a few things that I have learned are critical, and I’ve been a devotee of a book called “Who,” by Geoff Smart and and Randy Street. One of the things that is emphasized as important is having a systematic approach to how you get to great hiring results. It took me a lot of time to incorporate the basics.

Number one, the biggest reason that you fail to achieve a successful fit in hiring someone into your organization is you didn’t know what you were actually looking for. The goal is to be crisp and clear enough that there are those expectations. Spending enough time on the job description to become clear is vital to your hiring the right person and for them to know, “This is what I’m actually expected to do.” “What am I going to ask this person to deliver on at the end of a year or two years?” And actually naming that as part of the job description. “I expect you to fundraise X amount of dollars.” “I expect you to take care of X number of patients by the end of two years.”

Second is then to look for your criteria to actually be relevant to that set of goals. It’s amazing how often on job descriptions we say, “Well, I need to see 10 years of specialized experience in X, Y, or Z.” But you’re not asking, “How important is that to getting the best possible person?” In our department, we went through and scrubbed out all of the requirements that you need a bachelor’s degree for key jobs in our organizations. There’s nothing about being a manager that says you can’t be a good manager if you don’t have a bachelor’s degree. We have gotten great people and a much wider pool, more diverse pool of people coming in by removing requirements that are unnecessary. But then putting in the requirements that you actually believe can be necessary, you want to have that in the job description. Overall, though, it leads you to pare back and be open to a wider range of people coming in to do many jobs. I’ve been the annoying one who’s even said, “Why do we have to have a surgeon lead the surgery department? We’re a 100 million dollar plus operation. Perhaps this could be led by someone who doesn’t have to be a surgeon to understand it.”

Finally, you have to have an approach to how you run interviews. Answers in an interview do not tell you whether this person is going to be an 80 percent likelihood of success. Instead, what you want is the evidence of how they have done before in the work that they have had. I can’t recommend more highly having a system in place that can give you a structured understanding of how to evaluate people. I’ve really focused on asking people to walk me through every job that they’ve had, every transition that they’ve had, what went well in that job, what didn’t go well in that job, what feedback they’d received, positive and negative. Those are vital ways that you begin to gather information and then really using the references to understand and plumb what comes back. People chronically underinvest time in hiring carefully and then spend inordinate amounts of time dealing with a poor hire. It sets you back months and months. So it’s worth taking the extra weeks and time to invest in getting it right.