Building Your Team

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By Lawrence Smith, MHA, RT(R)

December 2010–The more experience I gain in my role as a radiology administrator, the more I value and focus on the hiring process, as it is the vital element in ensuring continued strength in your department across all modalities. The key is to select the right candidate, provide outstanding training, and place the person in a position to succeed. I did not come to this realization easily. But my negative experiences have invariably helped me become a more effective radiology administrator because it forced me to develop a strategic plan for hiring quality personnel.

All radiology administrators need to use forbearance in the selection process and realize it is not an exact science. The potential candidate can say all the right things, seem assiduous in his or her approach to work, possess documented experience and training, and appear as a perfect fit for the department.  Even the worst candidates can mislead the most savvy radiology administrator.

Never rush and hire a candidate simply to fill a position of critical need, despite heavy pressure from physicians, staff, or administration. I would rather work short handed with quality technologists than hastily hire the wrong candidate because of enormous pressure to fill the open position. This action can jeopardize the morale of your outstanding technologists and decrease the quality of the imaging services you provide. It also takes great vision on behalf of the radiology administrator to recognize the true potential in a candidate. It is truly satisfying when you can tangibly witness the results of implementing a structured plan for the hiring process that helps identify the right candidates who can assimilate seamlessly into the radiology department.  Below are strategic steps which have proven a successful model over time for hiring quality personnel:

1. Develop structured interview questions and document the responses from the candidate, both positive and negative. This can be a very handy reference, especially when you interview multiple applicants for an open position.

2. Implement a democratic hiring process. Include radiologists, managers, supervisors, and staff technologists in the hiring process. The more feedback and input from staff, the better. Your team will feel empowered by the process and will provide outstanding perspective regarding the hiring decision.

3. Always verify at least two references for all candidates. Ensure the references have had managerial responsibility over the candidate. If you call a reference and the individual is unwilling to provide a reference or refers you to human resources for this information, move on to the next candidate. This is a huge red flag and a candidate you need to avoid hiring, because, more often than not, this candidate is not worthy of hire.  Most radiology administrators will provide a positive reference for those candidates who were good performers at their facility. First of all, they want to help the candidate seeking employment and secondly, they want to assist a colleague in making a good hiring decision by informing them they are getting a great candidate.

4. Never hire a candidate unless you have had the opportunity to interview them in person, face to face. A tremendous amount of information can be learned by meeting the candidate. I once gave the authorization to hire a candidate while I was on vacation, but I did not participate in the interview process. This ended up as one of the worst decisions of my career.

5. Evaluate the candidates’ “soft skills” (ie, personality, social skills). These are inherent skills that you will not be able to coach after hire. You need to evaluate this vital trait on the front end during the interview process. This is the most important skill I look for in every candidate.

6. Never interview a candidate alone. Always have a hospital employee in the room that can corroborate everything that was said during the interview process. This technique also protects the radiology administrator and facility from a legal standpoint.

7. Set clear expectations for the candidate from the start of the interview. Explain that you are only hiring “top performers” who are highly motivated and will provide outstanding imaging services and compassionate care on behalf of the patients.

8. Consider interviewing the candidate several times before making your final decision. This is especially helpful when you are interviewing for critical positions (ie, supervisor). If you have narrowed down the candidates to two or three and they appear equal on paper, the additional interviews will clearly separate them.

9. Always set the tone for the interview. Make a statement such as, “Today we are interviewing for X position and this is not a job offer. We are evaluating you for this open position and you will be notified within two weeks of our decision.”

10. Silence is golden. I am purposely quiet during the early part of the interview. This awkward silence creates an uncomfortable atmosphere in the room, but it stimulates the candidate to communicate. Sometimes you can learn information about the candidate that is both good and bad. I once used this tactic during an interview for an open radiologic technologist weekend position and the candidate referred to a patient in a previous job as a “vegetable.” This candidate was instantly ruled out.

11. Follow your gut instincts about the potential candidate. Every radiology administrator needs to listen to the internal quality conscience. Following this will usually lead to a good hiring decision.

Implementing a strategic plan for the hiring process can be invaluable to every radiology administrator. As an example, I once assumed administrative responsibility for a mammography department that was totally dysfunctional. The mammography technologists who had been previously hired were disruptive, insubordinate towards management, rude to patients and staff, did not complete work as assigned, were not team players, accrued multiple patient complaints, and were disrespectful to the radiologists. This poor performance and unprofessional behavior also had a negative impact on employee morale and patient satisfaction.

My immediate plan was to hold the mammography technologists accountable for their behavior and ultimately improve the quality of the mammography services. Over a period of several months, three job openings became available for mammography technologists, which provided the opportunity to hire the right candidates and rebuild the mammography services. I implemented the strategic hiring strategies outlined above and hired three quality mammography technologists. It is important to note that all three candidates were radiologic technologists without any experience in mammography. I ended up cross training all of them because they met all established criteria and were the right fit for the position.

The transformation was instantaneous. The first sign of improvement came when the morale of the staff and radiologists increased immediately. After a few months, patient compliment letters came pouring in, outpatient satisfaction improved to 100%, radiology management noticed the increase in quality, efficiency, and volume, and radiologist preference for the mammography rotation changed from worst to best. Life in the mammography department was finally good!

This success story would not have been possible without a solid plan in place to screen all candidates effectively and identify those who possessed both the technical ability and soft skills that would translate into top performance for the radiology department.  I wish all of you the best of luck with building your teams, as this provides the opportunity for achieving long term success for every radiology administrator.

Lawrence Smith, MHA, RT(R) is director of radiology at Flagler Hospital in St. Augustine, FL and can be contacted at

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