"However, if you hire smart, it shouldn't be that big a deal because a good administrator will pay for him or herself by either making or saving your ASC money," he says.
In other words, having a good administrator running your center is a wise investment in your business. Here are Mr. Zoch's six top tips for getting ? and keeping ? top-notch managerial talent at your ASC.
1. Understand your facility's needs.
Owners are, of course, looking for administrators to solve their business challenges. But those vary from facility to facility ? some want to seek accreditation, enhance profitability, raise the quality of care, focus on payor contracting or regulatory issues. There are many issues to deal with at every facility, but one or more of those may have greater weight or be of more immediate need.
Ideally, you should bring together two or three key people to evaluate what the center needs. Ask yourselves: Why is this position open? Where are the deficits we're trying to ameliorate, or what are the most important things we want to build upon?
"When I hear a physician or a regional VP or the president of an ASC company say, 'We want somebody with an MBA with at least five years' experience running an ASC,' my first question is, 'Why?'" he says. "Start from position of trying to determine the challenges you're faced with and finding someone to meet those challenges. It's no good to guess that an MBA is going to be the answer; you need to match up skills with challenges, core values with core values, personality with culture."
Mr. Zoch recommends making two lists: got-to-haves and want-to-haves. The got-to list should be very short, covering the two or three crucial qualities or abilities your center needs in an administrator. The want-to list, describing your ideal candidate (with the understanding "ideal" is unlikely to appear), can be as long as you'd like.
"Take the time to really inspect your center and deliberately craft a list of what you would like to accomplish and, based on that, what you need in an administrator," he says. "You will come out of that process with a better understanding of what you need to do going forward, will be better able to evaluate talent from whatever source [you pool from] and make better choices."
2. Interview to understand ? not screen out ? candidates.
Most people have never had training on how to interview, and don't know the right kind of questions to ask or how to evaluate the answers they do receive. Mr. Zoch suggests focusing on these key questions that can help you understand the needs of a candidate:
? What do you have in your current position that you like? What do you like about what you do? "This provides insight into what's important to them, what their core values are," says Mr. Zoch. "If they don't get to do some of the things they like, they're not going to last long even if they do take the job. Finding out it's not a good fit is a good thing. You don't want to find out three months later that person's all wrong for the center and you have to start from scratch."
? What do you have in your current position you don't like? What would you change? "Put your listening cap on and pay attention to these answers, but don't be too quick to judge," says Mr. Zoch. "It doesn't mean they won't tolerate these things or don't understand that they're part of the job ? it's just information. It's not good or bad, it's neutral and helps you evaluate where they are. Anybody who's self-aware understands there are no perfect people and there are no perfect jobs, and those looking for either are going to be terribly disappointed."
? What motivates you? What drives you to get up every day? "These may seem similar to the first [questions], but different ideas usually surface. It's more big-picture and might strike more to the core of who the candidate is," he says. "Everybody understands everyone is in interview mode: best foot forward, smiling faces, no airing of dirty laundry on either side. You don't trust each other enough to really open up, so you have to ask questions in a way that gives you a hint about what's really going on inside, and probing a little differently might help peel layers off a more superficial answer."
? Why are you here? What about our opportunity do you find appealing? What caused you to want to take hours or a day of your life to come explore this opportunity? "If all this sounds like psychology, that's what it is," says Mr. Zoch. He notes that changing jobs (and, possibly, relocating) rank right up there in terms of stress with divorce and the death of a loved one. In other words, it's major, and something must be motivating the pursuit of change.
"There are two categories of motivation: moving away from and moving toward," he says. "In moving away, things are undesirable, there's pain or a situation that is unacceptable. In moving toward, the person is looking for something better: growth, a situation that more closely matches their goals for life and career."
Ideally, a candidate will be more of a "moving toward" than a "moving away."
"If the sole motivation is moving away ? they hate docs, hate the town, whatever ? often the problem is not the situation, it's them. They may require external forces to get them to do something," says Mr. Zoch. "Those who move toward are more internally motivated. They can see themselves as part of a solution and not as a victim. They take charge and look for opportunities to create satisfaction and value rather than waiting for situations to get so bad they're going to blow up."
3. Know what your facility has to offer ? and play it up.
"The single greatest difference between one employer and another is the culture. What are the people like to work with?" he says. "You won't attract a candidate by handing over a list of their duties ? they know all that. They want to know what it's going to be like to work there, what the people are like, what the expectations are, what we like to do, how we celebrate. If you don?t know what your culture is like, it's a good time to do a half-day retreat with the staff and figure it out."
4. Be prepared to meet or beat the market.
Mr. Zoch recommends including the following components in the compensation package.
? The going salary rate. It's got to be competitive for your region, or it's just not going to fly.
? Reimbursement of relocation expenses for executive-level positions. This has gone up considerably since fuel costs have risen, but you should allow about $10,000 to $12,000.
"In some cases, a professional fee for a procedure will exceed the figure for relocation ? is the fee for one case going to stop you from getting the best person possible?" Mr. Zoch says. "Your hire will likely have a house to sell, which could take 90 to 120 days. Trust me: You don't want to wait for them for that time to start. The longer it takes, the more likely that things will happen, most of them bad."
You don't, for example, want to find out 60 days later the person you hired isn't coming because his house hasn't sold yet, or he's concerned about affording a new place to live.
"The savvy employers are offering interim housing assistance, maybe a one-bedroom apartment, for three or four months, while the family stays behind to sell the house," says Mr. Zoch. "What is that, $3,000 or $4,000? How painful is it to leave the position open for that long?"
? Performance bonuses. As mentioned in "Understanding the Market for ASC Administrators" on p. XX, bonuses are increasingly popular.
"Giving a percentage of the base salary can make a real difference in attracting the right person, especially if they're currently getting little to no bonus," he says. "Offering 15 or 20 percent is a nice carrot for the extra effort to really drive the things you want done. Think through what your center needs and wants, and come up with three or four key criteria. It's a real win-win if you do it right."
5. Invest in continuing education.
"Investing in continuing education pays huge dividends," says Mr. Zoch. "Honing skills is just like going to the gym ? you can't just do it once a year and expect an administrator to perform at his or her peak." If you can offer the ability to attend a couple conferences a year" and support opportunities to sharpen clinical and business knowledge, "that's a good way to attract candidates. And it's important to the best candidates," he says.
He also notes that you can offer opportunities for self-improvement ? the needn't be large or expensive ? across the board within the facility.
"If the director of nursing wants to take a vacation, who's going to run the show?" asks Mr. Zoch. "Tap and educate some of the charge nurses, give them a chance to flex their muscles and grow as well. The baby boomer nurses and nurse managers are getting older, and they're going to eventually start retiring, so you should think about succession planning. If you can tell candidates they have opportunities to grow and advance at your center, that's a big draw."
6. Be realistic.
There will always be a very small pool of grade A candidates, a larger pool of B and a huge pool of C, says Mr. Zoch.
"If you add them up in raw numbers, there's still in a shortage situation of people who know how to run ASCs effectively," he says. "The job of an employer is to evaluate: Is this person A, B, C? Is a B+ really what we need? If I'm an employer, I would rather have a B+ in terms of skills who's a fit for my culture and the personalities, than an A who could create disharmony. And don't let perfect get in the way of great ? if you're waiting for the perfect candidate and putting great candidates on hold, stop it. You're risking losing a great candidate."