October 23, 2019

As the health care industry shifts toward value-based care, it has become increasingly clear that the industry needs to do a better job of "generating outcomes that matter to patients," but current hiring practices can hinder health care organizations from achieving those goals, Elena Butler and Shreya Kangovi write for Harvard Business Review.

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Why current health care hiring practices are wrong

Butler, a medical student at the University of Pennsylvania, and Kangovi, associate professor of medicine at the University of Pennsylvania Perelman School of Medicine, write that medical professionals have implicit biases about race, class, and educational attainment when it comes to the hiring process. Those biases largely stem from the view that health care is delivered by providers who have "elite training" and "whose success depended mostly on content expertise," Butler and Kangovi write.

However, that vision is outdated, Butler and Kangovi write, noting that a multitude of issues—including social, behavioral, and relational factors—affect a patient's health, Butler and Kangovi write. "Thus, the new health care workforce needs more than biomedical knowledge; it needs empathetic team players at all levels who can support patients holistically."

4 changes that need to be made

But to hire a more holistic team, Butler and Kangovi write that health care organizations need to shed their biases and change their hiring processes. Based on a research review and interviews with hiring experts in health care and other industries, Butler and Kangovi offer a four-part approach for health care organizations to find, hire, and retain "the diverse array of people needed to deliver the outcomes patients and provider organizations now expect."

1. Match your hiring goals to your desired outcomes

The first step is to figure out what outcomes your organization aims to achieve with a new hire, Butler and Kangovi write. For instance, an organization looking to improve and maintain patient health might ask, "What helps people become and stay healthy—especially those who are at the greatest risk for poor health outcomes?"

Butler and Kangovi recommend health care organizations take some time to explore and answer those key questions, and then use that knowledge to identify the qualities a candidate would need to help meet the organization's goal.

2. Know where to look for candidates

Most health care organizations advertise their job opportunities on their own employment websites or other job marketing sites, but this system can "perpetuate systematic class-based biases by creating barriers to entry for people with limited digital access or savvy," Butler and Kangovi write. Instead, organizations should target their recruitment efforts based on the traits they're seeking.

For example, they note that car rental company Enterprise turned to newly graduated student athletes when the company realized it "needed to hire team players," Butler and Kangovi write.

3. Use the right tools to assess your candidates

Generally speaking, candidates' qualifications are currently judged based on their diplomas, resumes, and training certificates, Butler and Kangovi write, but these do little to assess the candidate's personality.

Butler and Kangovi recommend incorporating multimodal tests into your interview processes to assess personality traits or aptitudes to predict job performance. For example, they note that when hiring clinic receptionists, Iora Health assesses potential candidates on their attitudes and instinctive helpfulness, which Butler and Kangovi write "is not reflected on a resume and often is challenging to impart through training."

4. Human resources should be considered a leadership function

Butler and Kangovi write that they believe "the most effective hiring happens when leaders are deeply involved with all aspects of the process because they have a unique sense of the organization's needs and the culture they aspire to."

For example, Butler and Kangovi write that their organization's COO sits in on most community health worker job interviews. They acknowledge this approach could be resource-intensive, but they write that they've found it's the best way to find the team members needed to achieve the goals they want.

"As health care shifts from clinician-dominated, medical-competency work to a team-based practice, addressing the needs of whole patients and communities, hiring strategies need to shift as well," Butler and Kangovi write. They add, "Disrupting hiring practices and human resource policies is difficult work, but it will yield home runs for health care organizations and patients" (Butler/Kangovi, Harvard Business Review, 10/21).

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