Business of Oncology

Perspective

Rules for Recruiting By David H. Johnson, MD

Over the past three decades, I have recruited a number of individuals to faculty positions in two academic medical centers. This experience has led me to develop a few so-called rules for recruiting that I have found to be useful, which I would now like to share with a nonsolicitous public. As a preamble, I should note that although it is my firm belief the rules are largely my own creation, I freely admit that some are variations of rules openly plagiarized from people I greatly admire and to whom I will give due credit. It is also possible that I may have stolen (unknowingly, of course) a few of these rules, because I have a penchant for jotting down witticisms I find humorous, interesting, or instructive … and later turning them into my own. Being from the South, this is considered perfectly permissible and frankly expected. Lastly, the list continues to grow; it is truly a work in progress.

Rule #1: Recruit Normal People One might think this one is pretty self-evident … but apparently it is not. According to the Oxford English Dictionary (OED), normal means “conforming to the standard or the common type; usual; not abnormal; regular; natural” or “serving to establish a standard.” In psychology, however, normal means “approximately average in any psychological trait, as intelligence, personality, or emotional adjustment,” but it can also mean “free from any mental disorder; sane.” When it comes to recruiting, the latter definition is paramount.

Rule #2: Recruit Happy People I like happy people. They are a joy to be around, plus they make me happy. Happy people also tend to be highly productive.1 However, recognizing happiness is apparently not a common skill among recruiters … nor does it seem to be instinctive. I say this because I have encountered a lot of unhappy people in my profession … and clearly someone hired them! The OED defines happy as “characterized by or indicative of pleasure, contentment, or joy.” I think this must be wrong (and therefore misleading), because some people I know seem to take great pleasure, contentment, AND joy in their despair. So let me provide some not-so-subtle signs of happiness, in case the reader is in recruitment mode. Unlike sad, sullen, despondent, angry, or mad people, happy people tend to be positive. One rarely if ever hears a truly happy person engaged in a negative conversation. By contrast, an unhappy person can move from a positive to negative conversation with awesome alacrity. This may come in the form of open criticisms directed at the recruit’s home institution and/or current boss … during a recruitment visit. I Copyright © 2014 by American Society of Clinical Oncology

consider this a bad sign. Happy people tend to be those individuals who will never leave ____ (fill in the blank) institution. I like to recruit individuals who will never leave, because that usually means they are happy. It is not a failsafe marker of happiness … but it works pretty well, in my experience. Stick to happy … avoid unhappy.

Rule #3: Never Recruit a Body This is one of the most commonly violated rules in recruiting … and one of the most difficult situations from which to recover. The scenario is exceedingly familiar. The team is working hard; everyone is productive, knocking out the relative value units, and suddenly … a colleague leaves! Yikes— or in the patois of the Gen Xers, OMG. And of course, now is not a good time to be recruiting (see Rule #7). Panic sets in. In the nanosecond that follows the formal announcement, your nondeparting colleagues initiate a litany of questions. Who will pick up the departing colleague’s patients (all eyes turn toward you)? Who will take the departing colleague’s inpatient and consult service months for the remainder of the year (those eyes again)? Why did YOU backload all of his service months at the end of the academic year (typically, the most vocal critics are the same faculty members who demanded no service time during spring break)? The potential recipients of these new “opportunities” camp out on your doorstep demanding immediate reinforcements (being a relatively new Texan, I am now steeped in the history of the Alamo; FYI, reinforcements never came). To be sure, your faculty want to help … so they offer up numerous recruitment suggestions, such as that former resident who left the program under mysterious circumstances, currently practicing in Alaska, but a really good guy and now seeking to return to the lower 48 —more importantly, he is immediately available. So you bite and hire the first warm body to cross your threshold. Never mind that his name is Hannibal Lecter. Not surprisingly, Hannibal turns out to be the wrong person for the wrong job at the wrong time. Hannibal needs to go … but Hannibal has the human resources office on his side … Hannibal is staying. There go the resources needed to hire the right person for the right job at the right time. Never hire a body.

Rule #4: The Best Athlete Isn’t Always the Best Fit for the Job This one I blatantly stole from my friend Joe Simone. Joe said it better than I can: Recruiting the best athlete, or in this case the best scientist, is a “stupid oversimplification.”2 Indeed, team players are greatly undervalued! Think Terrell Owens,

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University of Texas Southwestern School of Medicine, Dallas, TX

David H. Johnson

Rule #5: Recruit Visionaries Like the word normal, the word visionary has several meanings. A visionary can be characterized as “one who is given to impractical or speculative ideas; a dreamer, existing in imagination only” or someone “tending to envision things in perfect but unrealistic form.” A Japanese proverb more or less sums up this kind of visionary: “Vision without action is a daydream. Action without vision is a nightmare.” Visionaries also can be characterized as narcissistic,5 but they do not have to be … and one should avoid the narcissist at all costs. The preferred visionary is characterized by foresight, someone who is “thinking about or planning the future with imagination or wisdom.” Adjectives often heard when describing such an individual include inspired, imaginative, creative, inventive, ingenious, enterprising, and innovative. Whenever possible, recruit a visionary who possesses these traits.

Rule #6: There Is No Perfect Candidate This one should be self-explanatory, although like Rule #3, it too is frequently violated. In my experience, interviewing just one more person to find the perfect candidate may result in the loss of the perfect candidate. As one might imagine, violation of this rule is more common if a search committee is involved. However, department chairs and division chiefs can violate this rule as well, a fact to which I can personally attest. Recruitment is not like engineering with its strictness and precision. Instead, recruitment it is more like biology; there may be some imperfections, but these sometimes yield beautiful and unexpected results. In recruiting, avoid letting perfect be the enemy of the (very) good. 116

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Rule #7: Recruiting Is a Full-Time Job I am surprised how often this concept is lost on good program leaders, division chiefs, and even the occasional chairman. I once had a division chief tell me he would start his recruitment efforts in the fall when “recruitment season” began anew. I was flabbergasted. Because I am from the South, I am familiar with hunting and fishing seasons … but I was completely unaware that there is a recruiting season. The best recruiters I know are seemingly always on their game, even if there is not a perceived need (see Rule #3). Annual society meetings are fertile ground for recruitment, and as a new division chief, I quickly learned to attend as many abstract sessions as possible at the these gatherings. I was especially interested in attending the oral and poster presentations of fellows and junior faculty, whom I viewed as potential future faculty. What better way to get to know people than to chat with them alongside their posters? But scientific meetings clearly are not the only venue for recruitment. The best recruiters seek every opportunity to recruit. Let me share a short recruiting vignette. Several years ago, a close friend of mine and I shared a taxi to Reagan Airport in Washington. We had just left a meeting at the American Society of Clinical Oncology headquarters in Alexandria, Virginia. We got through security and were headed to the Admiral’s Club when he abruptly bid me adieu and headed off to a nearby gate. Odd, I thought … that is, until I saw him sit down next to a young colleague to whom we had been introduced earlier that day. Neither of us had known her, but she had made a particularly impressive presentation related to work she had done as a fellow. In fact, we had chatted about her during the cab ride to the airport. I suddenly realized my friend had gone into recruitment mode, and sure enough, a year later, the woman joined his division where she is now a budding superstar. Lesson learned. Recruitment is a full-time job … it is not seasonal!

Rule #8: Recruiting Is Hard Work It is often assumed that recruitment is akin to a Broadway play: The actual recruitment process (ie, the performance) remains more or less the same, whereas the recruit (ie, the audience) changes frequently. Not so. Every recruitment visit needs to be carefully choreographed down to the last detail … and the performance is never exactly the same. I know of one important recruit who was left standing at the airport for over an hour as his host hastily arranged last minute limousine service from a major metropolitan airport … that detail had been overlooked. The recruit had taken a red-eye flight from the West to the East Coast. Needless to say, the visit went poorly. Seemingly minor niceties also matter. I am also aware of a terrific recruit who was lost to a well-known institution largely because those involved in his recruitment failed to recognize his displeasure over the repeated use of a nickname he had assiduously avoided since childhood. After several attempts to bring an end to this faux pas, he quit trying … and joined the faculty of another prestigious institution. Finally, although I am no expert on the topic, it seems pretty clear that Boomers, Gen Xers, and Gen Yers have different communication styles.6 It behooves us to know and use those styles in the course of recruiting. Successful recruit-

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Randy Moss, or Alex Rodriguez … all great athletes … but not necessarily great teammates. As productive as he was, Owens was equally controversial, creating firestorms with almost every team he played for as a professional.3 The academic counterpart is the (thankfully) rare faculty colleague who seemingly has the ability to sap energy from everyone around him or her. A telltale sign of the so-called good athlete–poor teammate is the individual who spends a few years at one site before moving on—not always based on that individual’s volition. Some good athletes– poor teammates I have met have spent time at as many as four or five different academic centers. This is a clue! On paper, they continue to look good; their stats may be all star, but their behavior … not so much. By contrast, we all know faculty who are great teammates, always willing to pitch in and make the rest of us better. Think Shane Battier, the former Duke basketball star and current NBA player. Battier has been called “the ultimate glue guy” for playing “sound, fundamental, team-oriented basketball, making his teammates more effective without flash or padding his own stats, and for making the most of his skills with discipline and hustle rather than raw athleticism.”4 I prefer a Shane to a Terrell … and not simply because I prefer basketball to football.

Rules for Recruiting

ment requires an awareness of these and other generational differences as well as attention to details and little niceties.

Rule #9: It Takes a Village

Rule #10: Recruit the Spouse Recruit the spouse! This one should be obvious, but here again, mistakes are made all too often. I am not talking about dual professional recruitment, although these are increasingly common and complex and certainly cannot be ignored. I am speaking to the recruitment of the nonmedical spouse, who needs to know he or she, too, is vitally important to the recruitment effort. It is essential to demonstrate concern for the spouse’s needs even if one cannot address them fully. A genuine interest in the spouse’s needs is crucial. Over the course of the last 40 years, I have twice accepted positions at new institutions and twice turned down generous offers. In each case, my spouse (of 44 years) was a major determining factor, if not the major factor. I cannot imagine that I am all that different from any other individual being recruited to a faculty position. I repeat, recruit the spouse!

Rule #12: The Offer Letter Should Be Short This is another rule I borrowed from Dr Simone, who has so artfully opined that “the longer and more detailed the written offer to a new faculty recruit, the more likely both sides will end up unhappy.”2 Shockingly, or so it seems to some recruits, not every career contingency can be anticipated, nor is it possible to solve every problem before it occurs … and certainly not within an offer letter. My name is not Cassandra. (For the non–Greek mythology aficionado, Cassandra had the power of prophecy and the curse of never being believed. For chairmen, the former power is clearly not correct … and the latter is inescapable.) Regretfully, I have engaged in the occasional recruitment where the offer letter became an exercise in solipsism, an assignment reductio ad absurdum. Offer letters are not like the Bible— truth does not lie within! And unlike the Ten Commandments, they are not written in stone. They are at best promissory notes, Table 1. Summary of Rules for Recruiting

Rule #11: Your Best Recruiter Is Your Last Recruit At first glance, this rule may seem exceedingly cynical, but it is not intended to be. True, the most recent recruit is highly unlikely to have something negative to say about his or her new home … after all, he or she just arrived and did so presumably for positive reasons. Moreover, he or she may not yet have discovered the various underlying problems every institution tends to experience. In any case, the newest recruit is not likely to admit he or she has made a mistake … at least, not initially. Although the foregoing perhaps represents the cynic’s viewpoint, I would like to proffer another possibility. In reality, the Copyright © 2014 by American Society of Clinical Oncology

M A R C H 2014

Rule

Brief Explanation

Recruit normal people

Self-explanatory

Recruit happy people

Think he or she will never leave

Never recruit a body

Only if you’re seeking everlasting pain

The best athlete isn’t always the best fit for the job

Think Shane Battier

Recruit visionaries

Visionaries aren’t simply dreamers

There is no perfect candidate

Except the one you lose seeking perfection

Recruiting is a full-time job

Recruiting season is year round

Recruiting is hard work

Start early, stay late

It takes a village

Recruiting is a team sport

Recruit the spouse

I repeat, recruit the spouse!

Your best recruiter is your last recruit

Think first class, second class

The offer letter should be short

The Gettysburg Address was 272 words!



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With all due credit to former Secretary Hillary Clinton, it really does take a village to recruit successfully. Everyone needs to be involved in the process. . . the faculty, personal assistants, administrative office staff, nurses, clinic staff, the realtor, and even the person picking up the recruit at the airport. The process can break down anywhere along the way. Some of the best recruiters I know have been my personal assistants. Not to infer purposeful deceitfulness, but they can put lipstick on a pig with the best of them. They also serve as a splendid source of information … in a bidirectional manner, I might add, but almost always to the recruiter’s advantage. On more than one occasion, I have obtained valuable information gleaned from a hallway conversation between the recruit and my assistant as she escorted the individual to an on-campus interview. A number of recruits have told me that my personal assistant played a key role in their decision to accept a position within the division or department. In my own case, I can say with certainty that the assistant of the search committee chair was incredibly helpful and made me feel most welcome and valued. Likewise, conversations with the limo driver en route to the airport or with the realtor have proved exceedingly useful in addressing previously unspoken concerns of the recruit. In short, recruiting is a team sport.

last recruit was hired almost certainly because of shared values and goals with the recruiter (ie, you). As such, the recent faculty recruit should be eager to help enlist likeminded individuals (even if he or she is not consciously aware of this desire). As Dr Simone has taught us, “first-class people recruit first-class people; second-class people recruit third-class people.”2 In my experience, this statement holds true at all levels of leadership … even among the most junior of faculty. Great young faculty members like being surrounded by great colleagues. So if you did your job correctly, these so-called first-class people will help you recruit additional first-class people. Not so paradoxically, these young leaders are more likely to oppose the recruitment of a “body,” even if their personal workload temporarily increases (see Rule #3). Finally, as a corollary to this rule, the worst recruiter is the perpetually unhappy faculty member who can make recruitment 100 times harder. I believe in honesty, but to my knowledge, there is nothing in the recruitment rulebook that says one is obliged to showcase the unhappy faculty member. Accordingly, I do not recommend it.

David H. Johnson

backed by the full faith and credit of the department, not the US Government. If that trust goes sour, and the institution fails … guess what? Did I mention I am from the South? I still have some of those full faith and credit bills issued by the Confederate States of America.

Summary

Author’s Disclosures of Potential Conflicts of Interest The author indicated no potential conflicts of interest. Corresponding author: David H. Johnson, MD, Donald W. Seldin Distinguished Chair in Internal Medicine, Professor and Chairman, Department of Internal Medicine, UT Southwestern School of Medicine, 5323 Harry Hines Blvd, Rm G5.206, Dallas, TX 75390; e-mail: david.johnson@ utsouthwestern.edu.

DOI: 10.1200/JOP.2013.001352; published online ahead of print at jop.ascopubs.org on February 4, 2014.

References 1. Oswald AJ, Wu S: Objective confirmation of subjective measures of human well-being: Evidence from the U.S.A. Science 327:576-579, 2010 2. Simone JV: Understanding academic medical centers: Simone’s Maxims. Clin Cancer Res 5:2281-2285, 1999 3. Terrell Owens. http://en.wikipedia.org/wiki/Terrell_Owens

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4. Shane Battier. http://en.wikipedia.org/wiki/Shane_Battier 5. Maccoby M: Narcissistic Leaders: Who Succeeds and Who Fails. Boston, MA, Harvard Business School Press, 2007 6. Hewlett SA, Sherbin L, Sumberg K: How Gen Y and Boomers will reshape your agenda. Harv Bus Rev 87:71-76, 2009

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Although these recruiting rules were developed largely with academic institutions in mind, I suspect they apply equally well to the private sector. During the course of my career, I have broken each of these rules with predictable and regrettable results. However, like placing one’s hand on a hot stove, experience can be a great teacher. Developing a formal rules list is my attempt to avoid repeat transgressions. I suppose some readers may wish to use the list as well, and to that end, I briefly summarize the rules in table format (Table 1). The astute reader can simply clip the summary from this journal, fold it in two, and place it in his or her coat pocket for ready reference before,

during, and even after a recruitment effort. Finally, because this effort is a work in progress, I sincerely hope readers will share their experiences (via e-mail or snail mail) so that they might be added to the list. If the suggestion resonates with me, I will definitely add it to the list … and, of course, turn it into my own. Did I mention I am from the South?

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