Don't Let One Bad Apple Spoil the Bunch

Can one or two bad apples spoil the bunch? In a word: Yes. According to Paul Levesque, hiring employees for cultural alignment (ie, making sure that your new hire fits in with your clinic’s culture) is just as important as his/her medical skills and experience. Even though Jane Doe’s experience as an associate at a top practice might look dynamite on paper, if she has a brusque attitude or gives clues during her interview that she won’t “gel” with your current staff—keep looking. Hiring someone who will weaken your clinic’s culture amounts to what Levesque calls the “ultimate hiring blunder.” Culture fit isn’t “nice to have” but rather, a “need to have.” Hiring people with all of the right experience and all of the wrong personality can have a devastating effect on your practice's cultural alignment.

It’s important to realize that new employees bring new energy, ideas, and ethics into your hospital. If this person’s personality and energy mirrors that of the other staff members, then both your clinic culture & your staff’s performance are strengthened. However, if the new employee’s personality isn’t a good fit, you are not only deteriorating the culture in your clinic, but are also decreasing staff morale, efficiency, and in the long-term, profit.Think realistically about how this person will get along not only with staff, but also with clients.

Make the mistake of hiring multiple employees based on skill-only, folks who don’t believe in what the clinic stands for, and the original culture could be lost altogether. Levesque likens this to erosion along a riverbank—it’s so slow and gradual that you don’t realize it's happened until one day your house is swept into the river and you’re left wondering, “what the heck just happened?” In other words, skill and prior job experience are important factors when hiring, but not the only factors you should take into consideration.

Here are some of Paul Levesque's favorite, practical interview questions to ask interviewees that will help you deduce whether or not they’re a good cultural fit for your hospital.

1. What do you do for enjoyment away from work?

Wrong answer: "Oh, mostly watch TV, I guess," or "I like hanging out with friends at [name of local bar]." Answers like these suggest our applicant may be at risk of being taunted to "get a life." Our question is designed to reveal personal levels of enthusiasm—the kind of energy that can reinforce cultural alignment, rather than sap it.

Better answer: "I belong to a [car club, community organization, sports team, etc.]," or "I enjoy [photography, traveling, stamp collecting, woodworking, etc.]" This is an individual with hobbies or interests, a person who derives pleasure from feeling that he or she is accomplishing something.

Best answer: "I love [any of the above, or equivalent]." The greater the enthusiasm in the response, the better. Applicants who are highly motivated from the outset have an easier time becoming highly motivated about their new job.

2. Describe your most satisfying job experience ever.

Wrong answer: "One time I got a huge raise." Our object with this question is to gauge the applicant's inherent focus on the interests of others, as opposed to self-interest. Answers that describe satisfaction in purely selfish terms could be danger signs.

Better answer: "One time I [or my work team] achieved a really challenging objective." At least here the organization’s interests took precedence over purely personal ones.

Best answer: "One time I got this amazing feedback from a client I helped." This is the kind of answer that reveals a powerful external focus— of customer focus that can greatly enhance and reinforce cultural alignment.

3. What are the qualities you think an ideal boss would have?

Wrong answer: "I like a boss who's willing to admit [he or she] can be wrong sometimes." The goal here is to fathom the applicant's general attitude toward management. This kind of answer may reveal a predisposition toward an adversarial—rather than collaborative—relationship.

Better answer: "I like a boss who invites my creative ideas and gets me involved in problem-solving." This indicates a willingness to work with management to achieve key objectives.

Best answer: "I like a boss who inspires me to accomplish more than I thought I could." This is an individual eager to achieve outstanding results—and who recognizes that doing so is impossible without management's guidance and participation.

How to Make Sure Your Practice is “Culture Conscious”

1. Recognize that part of your hospital’s success is due to cultural alignment
2. Celebrate your hospital’s culture
3. Look for ways to strengthen & reinforce this culture
4. Take pains to protect your culture
5. Hire for both a "skills fit" and a "cultural fit," and watch your cultural alignment get stronger right before your eyes.