People Matters: Hiring, Retaining, and Developing Clinicians

Define Ventures Head of People Karsten Vagner sat down with Dr. Okiki Louis, President at Oscar Medical Group, Oscar Health to discuss a topic that is increasingly on the minds of digital health leaders: successfully building clinical teams at startups.

Among the many unique people challenges that digital health companies contend with, building a clinical team within a startup is among the most complex. At a time when frontline healthcare provider burnout is real and telehealth solutions are in demand more than ever, it seems like a natural solution for providers to shift their careers and join startups. But any career shift comes with complications: a startup is not a hospital, nor a health system. The work of seeing patients and providing care may be the same, but the environment is entirely different.

Karsten Vagner saw these adjustments firsthand during his three year tenure leading People at Maven Clinic. He invited Dr. Louis to join him in a conversation about this topic because of her deep experience leading clinical teams — in practices that have been around for decades, and at startups. As someone who made the adjustment from a traditional healthcare environment to startups herself, Dr. Louis shared her experience as a clinician and as a manager of clinicians. Her insights are sure to be helpful to digital health leaders looking to successfully build clinical teams.

“We set very clear expectations during the interview process,” Dr. Louis shared. This is an important — and often overlooked — step in building clinical teams. Given the competitive market and high demand in digital health for clinicians, it is easy to default to hiring quickly and hoping it all works out. But the interview process is the best time for a digital health company to make sure the candidate is right for them, and the company is right for the candidate. Setting clear expectations — this is what your day will look like, this is how we will measure your performance, this is how we communicate, this is how we compensate — is a tried and true way for a company to bring in the right people.

“Onboarding is so important because this is their first interface with what their future is going to look like.” Dr. Louis explained how at Oscar, clinician onboarding is virtual and also asynchronous to make sure the program is as robust as possible. A key part of onboarding clinicians that is different from onboarding non-clinical employees is that often, this is the clinicians’ first time working in a business. Through clinician onboarding, it is critical to educate and set context around company and team goals, modes of communication and meetings, and how (and when) performance is measured. Companies may also want to include guidance and training on their tech stack: Google Docs/Microsoft Office, Slack, intranet, and any other tool that a clinician may never have worked with before.

While most HR teams at startups are used to onboarding new hires, most of those new hires have come from startups, or other businesses. Onboarding clinicians — who are coming directly from hospitals or clinics — takes an extra level of thoughtfulness. The tools, vocabulary, and style of working can be a big adjustment all at once. Making sure clinicians understand the tech ecosystem — What is a board? What is equity? What is a fundraise? What is hypergrowth? — will only help them succeed faster and more easily.

“Clinicians don’t go into medicine thinking that they’re going to have a boss.” Dr. Louis gave her thoughts on how to manage clinicians well, sharing that first and foremost in a manager, she looks for clinical excellence. In addition, “you need someone who is an excellent communicator, is able to share the vision, and connect clinicians to the vision.” She went on to say that while it’s important to have managers of clinicians who can connect well with people, it is just as important to have managers who are unafraid of conflict and can hold people accountable. She reminded the audience that clinicians are used to having evidence and data, so any manager of clinicians should set very clear standards and expectations of success that are rooted in data.

Dr. Louis shared that at Oscar, clinicians are given scorecards quarterly. Beginning in onboarding, she and her team are transparent with clinicians about the evidence-based metrics they will be held accountable to. “We’ve been able to improve our outcomes quarter over quarter using these evidence-based metrics. Those scorecards are critical to performance management.”

In addition to discussing the interview process, onboarding, and finding the right managers for clinicians, Dr. Louis stressed the importance of documentation. In measuring success, managing performance, and in helping clinicians develop, documentation is key. “I write out my performance discussion before I meet the provider so it’s very clear to me what my coaching is going to be, and so I can email the provider immediately after the discussion is done.” Many managers default to feedback verbally in person or over video. The problem with that model is that memories aren’t perfect and sometimes, both parties end up leaving the conversation remembering only what they want to hear. Documenting feedback is critical in managing, coaching, and helping develop clinicians. And anyone else.