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Published 9/1/2011

Hiring the right people

Recruiting and hiring administrative and clinical employees for a medical practice is not easy; there are never any guarantees that a person hired for a job will work out in the long term. All too frequently, though, employees in orthopaedic offices who are responsible for hiring staff fail to follow a protocol. Following a protocol reduces the likelihood of a bad hire and improves the likelihood of a good one.

Everyone involved in hiring staff must recognize from the outset that, to recruit staff successfully, the practice must first develop a mission statement and formulate both short-term and long-term strategic plans. Such is the case regardless of the size of the office. Without a mission statement and strategic plans, it is difficult for any business to determine either the positions that need to be filled or specify the qualifications that candidates must have.

On average, the time involved in recruiting, hiring, and training a new staff person is three to four months. This will vary, however, depending on the practice’s location, the position, the salary and benefits, and the economic climate.

A practice may choose to use a search firm to recruit for upper-level staff rather than undertake the search internally. Doing so will save time and effort on the part of physicians. The fees recruiting firms charge to undertake searches, however, may be high: a percent of the selected person’s first year’s salary plus expenses incurred in connection with the search.

A hiring protocol
Step 1: Develop/update the position description.
Examples of position descriptions are available on the on-line AAOS Practice Management Center at

Step 2: Identify potential candidates from inside and outside the practice. Internal candidates possess an inherent advantage in that they already know a lot about the office. External candidates may possess education, knowledge, and skills that internal candidates lack. As a general rule, hiring a physician’s spouse or other relative to work in the office is not a good idea. All persons interested in applying for a position in the practice should submit a cover letter, a resume, and a list of references.

Step 3: Conduct an initial phone screening of candidates. The person in the office who is overseeing the search for the new person should sort resumes received into three categories: definite interest, possible interest, and not qualified.

Persons in categories 1 and possibly 2 should be contacted and interviewed via the phone. Ideally one person should conduct all these interviews and should plan on spending 15 to 30 minutes per candidate. The interviewer should have a series of questions to ask all candidates (so they can be compared relative to one another) and should take detailed notes of candidates’ responses. The interviewer should be familiar with federal, state, and local human resource-related laws, including anti-discrimination regulations. The interviewer should also provide detailed information to candidates regarding the nature of the position, including duties and the working environment.

Step 4: Interview candidates in person. In-person interviews should be conducted in a manner similar to phone interviews and will typically take at least an hour per person. Questions should build on the queries posed via the phone. Depending on the level of the position, interviews may be conducted by more than one person.

Step 5: Narrow the field to two or three people and conduct follow up in-person interviews. The follow-up interviews should not focus on whether the person can perform the job, but should focus on issues such as candidate’s ability to work well under pressure, to deal with difficult persons, and to solve problems.

Step 6: Check references, do background checks and (if appropriate) conduct drug tests. Checking references from employers is often difficult due to legal concerns. Background checks and drug testing are important, particularly if the person is going to be handling money or will have access to pharmaceutical products. Drug testing should only be undertaken within the context of an organization-wide policy that has been reviewed by legal counsel.

Step 7: Extend a written offer to the best candidate, one that sets forth in detail the conditions of employment. The offer letter should specify salary, start date, and payroll information, and provide general information concerning employee benefits such as health, life, and disability insurance. The letter should explicitly state that there will be an initial assessment period. The practice’s attorney should review standard provisions of offer letters to ensure compliance with government regulations.

Step 8: Orient and train the new employee. Orientation and training are critical activities even if the person is promoted from inside or comes from another orthopaedic office.

Editor’s note: This article is excerpted from the AAOS Practice Management Primer on Human Resources Management, which can be downloaded for free at www.aaos.org/pracman