The Rx for Business Success: Systematic Hiring

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The number of medical schools offering joint MD-MBA training has increased fivefold in the last two decades (Vanderbilt Medicine Magazine, 2014).

Dr. Arvind Movva, the founder of divvyDOSE and the former CEO of several successful medical services companies, found the prescription for a successful transition from patient care to CEO: systematic hiring. An outlier among the fewer than 10 percent of physicians nationwide who choose nonmedical careers (Vanderbilt Medicine Magazine, 2014), Movva’s advice can serve as inspiration for technical experts seeking to build organizations that deliver positive impact at scale.

Early Intersections of Medicine and Business

At an early age, Movva knew he wanted to work in medicine. “I grew up around a lot of physicians,” he said. “My parents’ community were first generation to this country, so I saw them working very hard but loving what they did professionally…Medicine appealed to me for so many reasons—helping others, earning a stable living, and working in a respected field.”

To his surprise, upon joining a medical practice as a young doctor, Movva quickly gravitated toward the business side, managing existing medical practices.

"We made a lot of mistakes," he says. "For example, we were once hiring for a key role, the nurse manager. This candidate looked good on paper but had been in large, bureaucratic hospital settings. We were a small boutique practice where things were fluid—we were constantly changing things and making the patient care and experience better. The candidate was very kind, which I liked, but it turned out to be a very bad match. It was the wrong fit. She didn’t have the influencing skills to bring others along, so she became the ‘bad captain’ who constantly said, ‘At the big hospital, we did it this way.’ Things got lost in translation. She lacked the skill that mattered most—change management—but because we didn’t have a scorecard, I didn’t know to look for that.”

Starting a Company on His Own

After several years practicing medicine and managing clinical businesses, Movva wanted to elevate his impact on the healthcare industry: “I had a feeling that I could affect more patients—I was not fulfilling my calling.” So, with the money he had saved, Movva founded a full-service pharmacy called divvyDOSE, with the initial goal of reducing negative patient outcomes and helping people with chronic illnesses. “Early in my career, I didn’t understand the importance of talent. I did it all myself, and that only went so far. I focused on the wrong things—our website, our logo—instead of on talent. We got to about 20 people and $5 million in revenue, and it felt like heavy lifting to go any farther. It felt like I was doing everything myself; every question was directed to me.”

Discovering the Secret Medicine: Systematic Hiring

So, what is Movva’s prescription for success as a doctor-turned-entrepreneur? How did Movva grow his company to a $300 million valuation in just five years, culminating in its sale to UnitedHealthcare? Movva shared the actionable recommendations below, illustrating how his commitment to hiring transformed business outcomes.

1. Create a scorecard to identify what matters most. For Movva and his team, “scorecards” were critical to optimizing both hiring and business outcomes. He explained, “Sitting down to really think deeply about the scorecard is at least 50 percent of the challenge of hiring. That’s because any job has very specific, important actions or results that matter most. You need to identify what those key things are and make them the central criteria for hiring someone. The scorecard helped me express what we were looking for.”

2. Interview for who not to hire, not just who to hire. Movva learned that deciding who not to hire was just as important as who to hire. He explained the in-depth interview method: “Working chronologically through someone’s career with them really gets to the truth. It scrambles the story they were going to tell you. I had candidates who loved the interview. It’s really important to understand where they genuinely want to go in their careers to understand if the role is going to excite them.” By implementing data-driven interviews, he was able to see past likability and credentials to ascertain who was most likely to excel in and enjoy the role.

He shared an example of identifying who not to hire as his company reached $20 million in revenue: “I was interviewing a VP of operations. He had all these great credentials—Stanford, Harvard Business School—and had worked at Amazon in logistics. Previously, I would have simply hired him. But, through the Interview, I realized from the data that he was fantastic but was not a match with the level of ambiguity and creativity the role required. I was honest with this candidate: He couldn’t believe I was not going to hire him. A week later, though, he called me and said, ‘You know what? I see the disconnect and you were right.’”

3. Hold yourself accountable to hiring mistakes. Making hiring mistakes inevitably happens even with the best methods—an outcome Movva acknowledged. He revealed his transparent, action-oriented approach to letting go of people who were considered mis-hires: “There is no perfect hiring batting average. We can be wrong occasionally, but we can’t be wrong long. I practice compassionate firing. I believe you need to let them start on their next path, so I’m very upfront and quick. I say, ‘We’re firing you. I understand this is a massive event. I understand a lot is going on in your head at this moment. I’m happy to walk you through all the reasons why, or you can just tell me you want to go home today and digest this news and call me later.'”

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An outlier among the few doctors who have succeeded as entrepreneurs—amidst the 90 percent of startups that fail (National Library of Medicine, 2023)—Movva reflected, “We had no shot of building a valuable company without this approach to hiring. I recommend it to every entrepreneur I care about. I have never heard of a manager or CEO using this method and it not working. CEOs tend to focus on other areas—products, finance, etc.—but the ones who focus on talent are the ones who build the most impactful and biggest companies.”

The year 2021 saw a record-breaking nearly $30 billion in funding across healthcare startups (National Library of Medicine, 2023). However, according to an Accenture report, 51 percent of those startups will fail within two years (Mobi Health News, 2015). To maximize the probability of success, technical experts transitioning from the clinic to the C-Suite are encouraged to heed Movva’s prescription for success: prioritize hiring.