It’s not surprising that medical students, physician residents, and fellows develop tunnel vision while advancing their professional careers. There’s just no time or space to plan for what happens at the end of the academic rainbow. This may lead to deferral of important employment related plans and unanswered questions, both large and small. Recruiters who are not privy to the motivating factors behind a physician candidate’s job search may miss underlying, and often important, factors. Recruiters may be left guessing which candidates to advance for opportunities based on incomplete profiles. At best, a partial picture of the candidate’s motivations is revealed through traditional health profession interviewing practices.
Motivational interviewing (MI) is an effective behavioral health tool that’s been adapted for many uses. Patients with complex primary care conditions gain tools for better self-care through MI-guided interviewing. Those experiencing substance misuse learn to identify and remove obstacles that stand in the way of recovery through MI. Using the framework of MI, recruiters can take the guess work out of interviewing and develop more meaningful assessments of candidates to better align them with opportunities, practice culture, and communities.
Engaging – Engaging within MI involves developing a therapeutic relationship between client and counselor. In the physician recruitment world, this translates to rapport building with your top candidates. MI uses the OARS model of Q&A, which involves Open-ended questions, Affirmation, Reflective listening and Summarizing. One open-ended question might be, “What challenges you as a physician?” Or, to get at what skills the physician especially enjoys or excels in, ask “From a clinical perspective, what did you enjoy most during (residency, fellowship, your last position/role, et al.)?” Once the physician candidate is more relaxed in the interview, you might ask “What sparked your interest in medicine?” You’d be surprised how diverse and telling the responses to this question are. Many answers will reveal some aspect of the candidate’s motivation that’s been left unsaid.
Focusing – Focus allows the recruiter to help guide the candidate to identify the most important elements of her or his search. Are excellent school systems the top priority? Where does overall lifestyle options and amenities land on the list? Similarly, recruiters can help declutter those low priority factors of the candidate’s search; aka, watch your back, Marie Kondo! This saves the candidate from getting stuck on factors that won’t have a big impact on her or his life and job. (Remember: physicians live in a world that hinges on details; encourage them to step back to look at the big picture.) Guided focus may include Affirming the candidate’s journey to complete his/her academic path through saying something like, “That’s a lot to do in that amount of time.” Summarizing – another OARS skill – allows you to restate what you’ve heard from the candidate thus far. If your summary of the candidates’ wants and needs doesn’t match theirs, begin asking more pointed questions.
Evoking – In physician recruitment, change talk typically occurs once a candidate begins to feel comfortable enough with the recruiter to develop a real rapport. Physician candidates are now ready for the prompt, “Imagine doing exactly what you want to do and where you want to do it…no limits…what is your dream job?” These big-ticket items are evoked to reveal motivation as well as gauge if aspects of the dream job are possible within your organization. Maybe a candidate wants to use prior management experience to help lead and grow one of your specialty practices. Or maybe a candidate has always wanted to help develop and staff a mobile unit. Or possibly your candidate’s first love is telehealth. Through Reflective Listening, say to the candidate, “It sounds like your dream job has you leading both the clinical and management side of a practice. Is that right?” Not only is it important to listen to the detailed vision, but through this you’ve gained an understanding of what his/her ideal role entails.
Planning – The most valuable aspect of planning in MI is that your candidate’s priority list of wants and needs has been fully revealed and expressed. The candidate’s sense of ownership of those plans is vital to her or his long-term success and growth in your community. It’s time for you to reframe what the candidate has expressed against the backdrop of your position expectations and requirements. After this reframing, ask for feedback from the candidate about all that’s been discussed. By now you should both have some strong indication about whether or not the candidate is a good fit for your practice or hospital and community. If these are incongruent, the recruiter should ask more clarifying questions to determine where the disconnect lies.
At its core, MI seeks to reveal those things unspoken, things candidates may avoid voicing for many different reasons. Creating a feeling that someone has listened to you, versus simply “heard what you said,” is the foundation of MI. Knowing your candidates’ true motivations goes a long way in matching them to your hospital or practice for long and successful careers in your community.