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Dear DG,
While a job interview where you did your residency may be nothing more than a tour and a formality, most interviews are critical. Although I’ll check references and review CVs, I have never had any applicant provide me with a list of references where the references weren’t pretty glowing. Therefore, most directors are forced to make decisions based on the interview.

I’m looking for someone who will fit into our group and has the personality necessary to work with our patients and meet the hospital’s (and my) expectations for our department. I’ve interviewed physicians who didn’t get excited when they were telling me about their first cricothyroitomy which they performed a week ago. If you can’t get excited about that and show a little personality, I have to wonder what kind of personality you’ll show to our patients when you’re tired or stressed. I’ve interviewed other physicians who were so much fun to talk to, I looked at the clock and was shocked to see that two hours had passed. Not a surprise, when I’ve hired them, the nurses and patients have loved them as well.

As for preparation, you should certainly know a little about the hospital, patient population, and specialty care (trauma or burn center, cardiac surgery, etc…). The interview is also your opportunity to learn about the hospital, the medical director, and the physician and nursing group. Hopefully, you have spent some time considering what practice environment is best for you. The interview can help you align your expectations for a work environment with the reality of a job. Be sure to spend time talking to the other doctors and the nurses on staff. Ask questions about things that you’re interested in and be sure to see the facility.

In summary, know a little about the job you’re interviewing for, when you go to your interview, be energetic, engaging, and enthusiastic, and remember that the interview is a two way conversation.
 
See next page for another Ask the Boss with Michael Silverman, MD
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My director wants higher patient sat scores

Dear Director,
My medical director said I need to improve my patient satisfaction. I think it’s all baloney anyway and I know I’m providing good medical care. Does it matter and if so, can you help me?
-LG, St. Augustine, FL
 
Dear LG,
You may think that patient satisfaction scoring isn’t important, but it’s here to stay. Think about who really runs, and sets the agenda, in the hospital. It’s the board of directors, comprised of businessmen and women, who set the course and goals for the hospital president to follow. These people are used to having measurable metrics and they realize that their businesses depend on the customer.
Consider this--if the ED is the front door to the hospital, do you think if patients have a good ED experience that they are more or less likely to return if they (or family) require emergency care? What about if they require outpatient surgery and their surgeon offers them a choice of two hospitals?

Obviously, the business managers see some benefit to having happy patients as a positive impact for future bottom line dollars. For doctors, we just need to focus on the questions from which we are rated. They cover attributes like compassion, being informative, listening, etc… Aren’t these things that you would want from your physician? I honestly think that these qualities go hand in hand with wearing a white coat.

Now, knowing that you’ll take the time to sit down with your patient, listen to them, keep them informed, and show compassion, the next key I’ve found is that there is a very strong correlation with length of stay. The shorter the visit, the happier the patient. Get patients from triage to the doctor quickly. Initiate orders and get results. For patients with long waits, apologize for the wait and then move on to care for them. Obviously, some patients will have prolonged work-ups in the ED, and the key to success with these patients is to keep them informed as to where they are in the process and what kind of time frame they should expect.
 
For example, when I order a po contrast abdomen and pelvis CT, I warn the patients that it’s a two hour drinking process and then realistically an hour from study completed until results. This leaves me a little room if the CT tech or radiologist is behind. Business types describe this concept by saying, “underpromise and overperform.”
Patient satisfaction surveys are here to stay, at least for the foreseeable future. Accepting that fact and learning how to operate well within the system is part of the business of medicine.
 
Michael Silverman, MD, is the Chairman of Emergency Medicine at Harbor Hospital in Baltimore and is Co-Director, Johns Hopkins/TeamHealth Administrative Fellowship
 

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