HealthCare Voice

Recruiting by Videoconference Saves Money, But at What Cost?

Editor's Note:  As of Friday, HealthCare Voice will end publication with Typepad and move exclusively to JohnGSelf.Com.  To continue to subscribe, you must go to the web site, click the BLOG link in the navigation bar and resubmit your email or RSS subscription. My speaker's blog, JohnGSelf, will remain a featured blog with Typepad.

______________________

As anyone who has lost data in a hard drive crash can attest, technology can be our friend as well as our enemy. Healthcare has been accused of playing catch-up to the technology bandwagon, and losing out on a lot of efficiencies as a result. But for some processes, the old-fashioned way is still the best way. Hiring is one of those processes.

I’m not saying that technology in recruiting is all bad. My smartphone is my constant companion, and the ability to research organizations, locate potential candidates, build networks, and receive a resume or reference list in an instant makes the process infinitely faster than  in the past. That’s a win for everyone involved. But when we start to rely on technologies such as videoconferencing to replace face-to-face interaction, we as recruiters have gone astray.

At first glance, recruiters’ clients may like the idea of videoconferencing because it’s much cheaper than flying in a recruiter to meet with candidates or clients. But what’s gained in money is lost in quality.

For example, while it may be acceptable to use videoconferencing for some business meetings, the technology just isn’t good enough for those “getting to know you” meetings in which recruiters meet with boards of directors and the executive team to find out what they need in a new leader. The clients can run through their list of operational and financial targets on camera, but the recruiter won’t experience the interpersonal interaction in the halls or the tension around the coffeemaker in the break room. These are the things that make up an organization’s culture, and a new hire’s cultural fit is just as important as his or her ability to improve patient care or boost the bottom line.

A good recruiter’s position prospectus runs 25 pages or more for C-level positions. To ensure that the right person lands the job, that document should reveal both the face the client shows the public and the not-so-positive things going on behind the scenes. It’s impossible for a recruiter to draw out an honest assessment of a job’s potential negatives with a group of strangers through a wi-fi connection.

For the same reasons, videoconferencing is a weak way to interview candidates. Those who conduct interviews this way are missing out on the subtle cues that human beings naturally rely on to evaluate another person. They don’t connect with the candidate in a real way. It’s like trying to view someone through a layer of gauze: You get a general impression, but it’s frustratingly difficult to get the complete picture of who they really are.

Some executive search firms never actually meet their candidates in person until they present them to the client, and by then, it’s too late. Some firms’ early screening interviews consist of a videotape of a candidate reading his or her answers to a list of questions. That’s the epitome of lazy recruiting, and it’s unfair to both the client and the candidates, who aren’t given an opportunity to put their best face forward.

The typical videoconference delay of just seconds is enough to create awkwardness that can cast an otherwise confident candidate in a bad light, and the short length of a typical videoconferencing session doesn’t allow for the in-depth conversations needed to make a good judgment call about a person. There is just no substitute for shaking hands and sitting down to really talk with someone to learn about their passions, emotions and values, and to see how they respond under pressure.

Sure, videoconferencing can save the client some money. But is it really worth the price of misunderstanding the job, the candidate or both, and hiring the wrong person? When you compare the cost of a few plane tickets to that of replacing a senior-level executive with a six-figure salary, it seems pretty simple. In the end, cutting this particular corner is just not worth it.

© 2012 John Gregory Self

Executive Search: The Model Is Broken

Editor's Note:  HealthCare Voice, John Self's  healthcare blog, will be moving to the web site, JohnGSelf.Com in two weeks. The blog will run on the web and here  for a couple of weeks and then the content will be exclusively on WWW.JohnGSelf.Com.

John G Self is a frequent speaker and lecturer.  He has a new blog,  John G Self.  It features stories of hope, redemption, and humor of every day life.  His latest blog, URBAN SNAPSHOT: We Assume, We Are Surprised posted on Monday.

_____________

Candidates complain about recruiters – how they do not communicate effectively, how they do not provide real transparency, how they gloss over critical cultural, political and operational issues because to acknowledge them would complicate the search, or because the search consultant simply did not take the time to understand the underlying challenges.

The statistics tend to support candidate concerns.  According to several industry studies, more than 50 percent of candidates recruited from outside an organization quit, are pushed out, or are fired within 24 months when you look at all sectors and all management levels. Heidrick & Struggles, the industry’s second largest executive search consultancy, admitted in 2009 that in an internal study of 20,000 assignments, 40 percent of their senior leadership placements were out the door within 18 months. 

The record of internal recruiters is not much better.  Apparently, the weaknesses that afflict search firms also infect the leadership talent acquisition function of many large corporations, health systems and not-for-profit organizations. 

Aside from these periodic studies and an occasional blog or article, the search industry is strangely silent on this dirty little subject. 

At the core of this industry failing is a broken business and process model which has existed for nearly 50 years. There are precious few industries in the world that have not undergone multiple transformations over the same period.  But not executive search.   Yes, there have been technological advances – the faxmachine, computerized databases, the Internet and email, but these developments have not changed the fundamental structure of this industry.

When you look at this problem, which has significant implications for a client's profitability or, in some cases, their actual survival, you have to consolidate the processes and results of both internal recruiters and outside search consultants.

Here is what the candidate’s are saying and have been saying for quite some time:

• There is a lack of transparency.  Search consultants rarely tell you the whole truth.

• Recruiters place the burden on the candidate to sort out things like corporate culture, how decisions are made, how success will be defined, and the hurdles to success.  The recruiters either were not perceptive and failed to ascertain this information or they made a financial calculation that to know and to tell would only delay the search and erode profitability of the engagement. Internal recruiters, like their external cousins, did not want to ask the tough questions regarding the search or share unflattering (but truthful) information for fear of rocking the boat. 

• There is poor communication between the candidate and the firm once a resume has been submitted.  That is perhaps the most common complaint and virtually everyone who practices in this profession is guilty as charged.  Weekly email updates should be the norm, candidates say.

• There is a lack of accountability for the quality of the service provided by the recruiters and for the outcome of their work, and candidates believe this contributes significantly to the problems they encounter in the recruiting process.  Here, corporate clients join the chorus of criticisms.  There are rarely any fee concessions if the client is unhappy with the quality of the panel of recommended candidates.  The placement guarantee -- the industry standard is 12 months at the executive level -- is really no guarantee since the vast majority of candidates do not leave an organization until the 18 to 24-month period, an insufficient length of time for the client to regain their investment.  Candidates and clients say the problem seems to be a focus on the process and filling a job order, rather than spending the time it should take to produce the right outcome. 

Now the good news:  These are problems that can be fixed.  These are not rocket science issues.  The real challenge will come in changing the culture of how talent acquisition -- external and internal recruiting -- works.  There is resistance to change, especially in the large firms where partners earn substantial six or seven figure incomes.  The people who should lead the change have a vested interest in protecting a business model that works well for them.  You can almost hear it now:  If it is not broken, don't fix it.

But the system is broken and in this period of business transformation spurred by prolonged financial uncertainty owing to world economic conditions and the debt crisis, corporations, especially healthcare providers, cannot afford business as usual.

© 2011 John Gregory Self

CEOs, Meet The Millennials

There is an age-old conflict in business:  the friction between the established leaders of today and the newest crop of the leaders of tomorrow. 

Meet the Millennials.

This large generation of rising adults, born since 1982, are starkly different from their older managers, teachers, and colleagues. Also known as Generation Y and the Echo Boomers, several million of them have joined the adult world since 2000, and they are entering the workforce faster than you can say “retiring Baby Boomers,” according to a research report from the former MillennialGeneration.Org site.

This group poses a unique set of hurdles for today’s leaders in terms of attitudes and practices in how they work and communicate.

Facing “big ticket” challenges, not the least of which are significant reductions in spending on Medicare and Medicaid over the next 10 years, CEOs and Chief Human Resource Officers aren’t always attuned to the nuances of a particular age group, most especially how to recruit, develop and retain the top talent from this working class.  This is a critical consideration.

The payor’s focus on customer service and the negative financial implications that will occur for those hospitals who do not achieve top scores in service and satisfaction, will require the leaders of today to harness the incredible intelligence and remarkable creativity of this new generation. 

For someone who frequently lectures to graduate management students, my only advice is to pay attention and engage your "up and comers" about what they think and believe, not what you want them to think.

© 2011 John Gregory Self

Seed Newsvine

Video Summaries of Candidate Interviews Leads To Greater Success

Video Summaries of your search firm’s recommended candidates can help organizations avoid a costly leadership miss-hire; not video conferencing, which is widely overused in executive search, but edited video summaries of your recruiter’s in-depth face-to-face interview with the candidate.

Using videoconference technology to conduct the defining interviews that will be used to select their recommended candidates is a big mistake, the purported cost expense savings notwithstanding.  Reviewing an edited version of the interview allows the client to make an informed decision as to which of the four or five candidates on the panel should be invited for a site interview.

The proof is in the record of success.  Clients who have used search firms that incorporate video summaries as part of their candidate presentation say that it is “incredibly helpful” in selecting the right candidates .  “In the past, we had to rely solely on the recruiter’s judgment, and in many larger firms, the partner has only limited exposure to the candidate in the screening process,” one CEO said who asked that I not use his name out of concern that there might be negative repercussions.  Anyone who understands how most large consultancies work -- and search firms are consultancies -- knows that the partner is a rainmaker first, a client relationship manager second, and a working consultant a distant third. 

Providing clients video summaries is a game changer in the client-search firm relationship.

The CEO continued that over a seven-year period and 12 searches, “having the videos helped us avoid some big mistakes.  Over that period of time we only had one candidate who did not work out and that individual left after two years and the search firm provided a replacement.”  He is not alone in his assessment.

The cost of a miss-hire at the executive level is extraordinarily costly, from 50 to 500 times the failed executive’s annual base compensation, depending on the size of the company and the that individual’s scope of responsibility.

Using videoconference interviews between the recruiter and candidates for the final panel is penny wise and pound foolish.

© 2011 John Gregory Self

Seed Newsvine

Taking Time For Others

Some days can provide an important reminder of the significance of taking time for others.

While waiting in my hotel for a candidate to arrive – stormy weather slowed air traffic into New York’s congested airports – I decided to check my email.  After reviewing and processing emails for 15 minutes or so, I ran across a message with an attached story from a former boss who I greatly admire.

Who knows or cares whether this particular story is true.  There are some stories where “the uplift” is far more important than the authenticity.  For years there have been stories with this theme that have been bouncing around on the Internet.  Periodically they emerge in various forms – irritating chain letters, personal testimonies, or even for political gain.  Naturally they are treated as if this is the first time the heart-warming facts have been shared. 

This story, in this telling, is uplifting, minus the cynicism.

It reminded me of an important point in my life.  I have been fortunate to be in a career position where I can help people -- providing support when they have been unexpectedly fired, when they cannot find a job, or to give some coaching advice that might help them find one.  The only requirement I have is that when the caller finds a new job, that they take the time to pay it forward, to help someone else.  Sure I like the money in the business, but it is the chance to help that makes my job so special.  I am sharing this story with you because if you do not get it, now is a good time to start.

-------------------------------------- 

“One day, when I was a freshman in high school, I saw a kid from my class was walking home from school.

“His name was Kyle.

“It looked like he was carrying all of his books.  I thought to myself, Why would anyone bring home all his books on a Friday?  He must really be a nerd.

“I had quite a weekend planned (parties and a football game with my friends tomorrow afternoon), so I shrugged my shoulders and went on.

“As I was walking, I saw a bunch of kids running toward him...They ran at him, knocking all his books out of his arms and tripping him so he landed in the dirt.  His glasses went flying, and I saw them land in the grass about ten feet from him...

“He looked up and I saw this terrible sadness in his eyes.

“My heart went out to him.  So, I jogged over to him as he crawled around looking for his glasses, and I saw a tear in his eye.  As I handed him his glasses, I said, “Those guys are jerks.  They really should get lives.”

“He looked at me and said, “Hey thanks!”  There was a big smile on his face. It was one of those smiles that showed real gratitude.

“I helped him pick up his books, and asked him where he lived.  As it turned out, he lived near me, so I asked him why I had never seen him before.  He said he had gone to private school before now.

“I would have never hung out with a private school kid before. We talked all the way home, and I carried some of his books.  He turned out to be a pretty cool kid.

“I asked him if he wanted to play a little football with my friends .  He said yes.

“We hung out all weekend and the more I got to know Kyle, the more I liked him, and my friends thought the same of him.

“Monday morning came, and there was Kyle with the huge stack of books again.  I stopped him and said, Boy, you are gonna really build some serious muscles with this pile of books everyday!  He just laughed and handed me half the books.

“Over the next four years, Kyle and I became best friends.  When we were seniors we began to think about college.  Kyle decided on Georgetown and I was going to Duke.  I knew that we would always be friends, that the miles would never be a problem.

“He was going to be a doctor and I was going for business on a football scholarship.

“Kyle was valedictorian of our class.  I teased him all the time about being a nerd.

“He had to prepare a speech for graduation. I was so glad it wasn't me having to get up there and speak.

“On graduation day, Kyle looked great.  He was one of those guys that really found himself during high school.  He filled out and actually looked good in glasses.  He had more dates than I had and all the girls loved him.  Boy, sometimes I was jealous!

“Today was one of those days.

“I could see that he was nervous about his speech.  So, I smacked him on the back and said, 'Hey, big guy, you'll be great!'  He looked at me with one of those looks (the really grateful one) and smiled....

“Thanks,” he said.

“As he started his speech, he cleared his throat, and began ... “Graduation is a time to thank those who helped you make it through those tough years.  Your parents, your teachers, your siblings, maybe a coach, but mostly your friends.

“I am here to tell all of you that being a friend to someone is the best gift you can give them.  I am going to tell you a story.”

“I just looked at my friend with disbelief as he told the story of the first day we met.  He had planned to kill himself over the weekend.  He talked of how he had cleaned out his locker so his Mom wouldn't have to do it later and was carrying his stuff home.  He looked hard at me and gave me a little smile. 

“Thankfully, I was saved.  My friend saved me from doing the unspeakable.

“I heard the gasp go through the crowd as this handsome, popular boy told us all about his weakest moment.  I saw his Mom and dad looking at me and smiling that same grateful smile.

“Not until that moment did I realize the depth of importance of a kind act or the friendship you share.  Never underestimate the power of your actions.  With one small gesture you can change a person's life.

“For better or for worse.”

© 2011 John Gregory Self

Seed Newsvine

Leadership and Executive Search

I have always believed that a good leader is a work of art, and that a bad leader is a tragedy -- for the organization and for the people with whom they interact. 

There are far too many leaders who cannot see beyond their own office. They do not engage employees in a consistent and meaningful way.  They offer any number of excuses for their lack of visibility and engagement, including that they do not feel "comfortable" communicating in that setting.

How senior executives interract with their teams -- their visibility and their ability to communicate the mission, vision and values of the organization in every-day conversation -- is an essential element in employee engagement.

At JohnGSelf Associates, we have an entire 45-minute block of questions in our comprehensive 3.5 hour face-to-face screening interview that zeroes in on this critical leadership issue. We believe that this competency is absolutely critical to the success of any organization.

When I tell people that our firm offers a three-year placement guarantee, my capable competitors ask how we can possibly make such an offer. They feel it is too risky. Actually, if you dig deep enough in the face-to-face candidate interview, there is virtually no risk. But it takes time and a great deal of research into relevant issues. 

In 15 years, we have had only a small handful of candidates who did not work out in our C-suite and executive practice. Luck? Perhaps. Too risky? No. From my point of view, offering your clients a long placement guarantee is about taking ownership of what we do, recognizing the impact we can have on an organization and its employees if we do not get it right.  Relying on video conference interviews to select which candidates to recommend to the client may save on the expense budget and make it easier for the recruiter, but it diminshes the quality of the screening and substantially elevates the risk of a miss-hire.  I do not know one search firm that will offer their clients an extended placement guarantee when they cut corners.

I share this to encourage my colleagues in the search industry to look at what they are doing with their candidate screening process and seek meaningful ways to offer clients greater value. 

As hospitals and physician practices experience significant reductions in funding and other disruptions that will surely occur as we navigate healthcare reform, executive recruiters and other consultants who work in this sector need to step up and own the the quality of the service we offer -- and the outcome.  

© 2011 John Gregory Self

Seed Newsvine

Hospital Golden Rule: Simple Innovation for Quality, Safety

When I moved from the news business, writing about crime and investigating corrupt politicians and police officers, to the healthcare industry in the mid-1970s, we measured only the basic hospital performance indicators -- including census, staffing, inventory, days in accounts receivable and average length of stay.  The data was not in real time by any stretch of the imagination.  By the time the information was produced and distributed to managers, the horse was already out of the barn and in the next county.

Today, we measure almost everything.  The question is: are we getting any better in terms of quality and safety?  Are we now paying too much attention to the numbers and not enough to the people?

We are certainly better at collecting and producing data in a timely manner. Financially, most hospitals are better.  But what about the quality and safety issues?  Are our patients safer? Do they receive better care?  

It is not like we don't have a multiple of compelling reasons, including financial survival. Quality, safety, and patient satisfaction will drive future levels of reimbursement from the government and commercial payors.  It is imperative that we get on top of this problem once and for all.  

Before we start talking about the costs of achieving success, we should remember that it all revolves around people and process.  As an industry we have spent hundreds of millions of dollars trying to address quality and safety issues and we are still not even close to where we need to be. Maybe it is time to try a new approach.

A leading chemical industry safety expert who consulted with several hospitals on quality and safety said she was stunned to see how little transparency there was in the hospital quality improvement process.  After the attorneys and risk managers charged into the breach, scrubbed the scene and admonished the participants, there was very little honest discussion about what went wrong and how it could be fixed so the events did not happen again.  Her overarching theme is startlingly simple: what we have been doing is not working and the outcomes will not change unless we rethink our entire quality improvement approach, sans the lawyers and risk managers. It is not that difficult, she said. Do what other industries are doing.

Proctor & Gamble Chairman and CEO Bob McDonald emphasized in a recent speech that innovation was the way of the future.  Only 10 of American's Fortune 50 companies in 1955 are still in business today.  The rest failed to innovate, he said.  Hospital leaders, especially those who feel invincible, should take note.  The speed of change is moving at a significantly faster pace today, especially in healthcare, and the demise of organizations will come much sooner. 

If we cannot innovate to solve our troubling quality, safety and cost challenges, who will be around in 10 years?  What can we do now that successfully changes our current performance trajectory and inevitable failure rate?

Maybe we should start by making it mandatory for every nurse, doctor, pharmacist, patient care aide, and housekeeper to think of each patient as a member of their family, someone they love and want to protect -- a new hospital Golden Rule.  The other obstacles to quality and safety that we have created – complexity, cost, alignment – are just excuses for not trying to innovate. Often, doing the simple stuff is the better way to care for our patients.

Maybe it is all about people, process, and a willingness to innovate. 

© 2011 John Gregory Self

Seed Newsvine

Steve Jobs' Legacy For Healthcare

If you are a hospital CEO who touts customer service -- the customer experience -- and you have not heard about Apple's remarkable product innovation, their laser commitment to service, and their remarkable out-of-the box retail experience, you are probably so far inside the box that you are immerdiately vulnerable to competitive market forces.

Apple redefined the customer service experience. Not just for the computer industry or the technology sector. Steve Jobs and his colleagues raised the bar for everyone in business. From their technical support access, which is far and away the best in any industry, to the amazing Apple retail experience, this company is about delighting the customer. They thrive on that sense of accomplishment.                                   

When I think about the  average hospital admission process and the endless waits in the ER that can be made worse by, in many cases, the absolutely terrible customer service and non-existent communication from the staff, I wonder why the healthcare industry seems so afraid to explore game-changing innovations.   

When we talk about Apple it is easy to say, "Oh, computers, that is different. That industry is not anything like healthcare," as if to say that Apple wanted to emulate the mediocrity that has come to define Microsoft. The beauty of Apple is that Steve Jobs empowered his people to redefine the customer satisfaction experience from a standard that said satisfactory was OK to one in which anything less than delightful was unacceptable. Outsourcing his customer support through terrible telephone connections to some  remote outpost in India, which is how so many companies attempt to maxmize profitability, was not in the Jobs' playbook.  He drove profits by doing the opposite -- spending money on taking care of his customers.

Apple became a bigger company than the once invincible Microsoft in terms of market cap as the result of its passionate commitment to focus on game-changing design and a level of service that delighted their customers.  

As we mourn the loss of such an incredible innovator, it behooves those of us in healthcare to pause and to think how our industry can bring a little of Steve Jobs' keen insight for innovation and a customer-centered delight into our complex organizations, and to think how we can offer our customers -- doctors and patients -- service that delights and surprises. 

He showed that it can be done.  And he offered some compelling words during a Stanford commencement speech in 2005 to help guide the way.

"Follow your heart...Your time is limited so don't waste time living someone else's life. Don't be trapped by dogma which is living with the results of other people's thinking. Don't let the noise of others' opinions drown out your own inner voice..." 

What are we waiting for?

© 2011 John Gregory Self

Seed Newsvine

How Important Is Your Human Resource Leader?

"If businesses managed their money as carelessly as they manage their people, most would be bankrupt."

That is the opening sentence in Bill Conaty's and Ram Charan's book The Talent Masters:  Why Smart Leaders Put People Before Numbers. If that does not make you uncomfortable as a healthcare CEO, then you must be in the above average category in terms of hiring, training and retaining the best talent.

Mr. Conaty, who was Jack Welch's Senior Vice President of Human Resources at GE, and Ram Charan, a top business advisor/author/speaker, have written one of the best, if not the best, books on talent management.  They argue that the best companies are those which excell in identifying and developing raw talent.

As healthcare providers enter a period of financial uncertainty and turmoil, the quality of an organization's talent will be the single most critical determinant of an their success; not their location, the stylishness of their big box facilities or their existing reputations.  Those will seem so insignificant when the fight for survival turns deadly serious. Less you think that all the big healthcare provider success stories of today will be around in five to 10 years, think about the hundreds of former market leaders in retail, services, computers, consumer products or even banking that are now but a distant memory, an "oh yeah, whatever happened to those guys?" They didn't find or keep the best people.

It always comes down to that fuzzy, soft concept of talent management. Organizations that fail to build their talent management around an exemplary CEO/Chief Human Resource Officer partnership, are running down a risky path.

The hospital Chief Financial Officer is the trustee of the financial resources. "The human resource function will only be as strong as the CEO wants it to be. If the CEO does not have high expectations for HR, then it will be second tier," even reporting to the COO or some other vice president, Charan and Conaty write.

"Why wouldn't the CEO want an HR function that is as important an managing the financial resources?  HR is, after all, the trustee of an organization's human capital."

Being a talent manager -- becoming a talent master -- is now an essential leadership comptency. 

© 2011 John Gregory Self

Seed Newsvine

Integrity, Consistency and Walking the Talk

Integrity is a much admired and sought after characteristic in leadership.  When you ask board members or employees about the ideal characteristics for a new leader, integrity is almost always number one on the list, rarely lower than number three.  So since it so critical, what is it?  What does it really mean when a CEO or other leader is said to have great integrity?

Yes, it means telling the truth.  It also means doing the right thing, even when no one is looking.  It means giving credit to others when they deserve the recognition.  It means being authentic.  It means living your personal and professional life in balance, honoring your commitments.

It also means being consistent.  And for some leaders, that is where the rubber skids off the road.

Here is a classic example for healthcare: hospital leaders love to say that their employees are their most important asset.   These kinds of statements are a verbal tip-of-the-hat, an acknowledgement that it takes hundreds or thousands of employees to make a hospital operate.  The real question is whether a hospital can be successful without great employees?  As we grapple with the storms of change generated by impending reductions in reimbursement from deficit reduction programs, the answer is a resounding “no”!

Hospitals talk about the value and importance of their employees.  Rarely is a hospital annual report produced without that perfunctory claim.  More to the point is the question of how many CEOs walk the talk?  How many leaders tell their employees that they are truly the heart and soul of the organization and then back it up, day in and day out, with words and deeds to reinforce that claim?  How many CEOs make daily rounds, engaging their employees in meaningful ways?  How many come in overnight to bring coffee or cold drinks and snacks to the nurses and other support personnel who are there for the patients?  Not once or twice in their tenure, but on a regular basis?  How many leaders visit patients on a regular basis, to say hello and to ask how well the organization is doing to help them get better? 

As a CEO, or any leader for that matter, when you make grand statements statements regardiong your vision and values, then you must personally follow through.  That is called being consistent.  Employees pay attention to it because they know it reflects a leader’s integrity.    

© 2011 John Gregory Self

Seed Newsvine

Bad Firing, Good Firing and the Company Brand

Why would you fire your chief executive officer over the telephone?  Why would anyone want to work for a company that would treat its CEO so shabbily?  Why would you do business with that company?

The sudden dismissal of Yahoo CEO Carol Bartz, reportedly an outspoken, combative, occasionally arrogant and sometimes profane executive, prompted me to think about how companies fire people, and the fact that how companies execute the termination can define an organization's corporate image and recruiting brand.

To be fair to the Yahoo board, Ms. Bartz was reportedly failing to meet performance expectations established by the Directors. There are many on Wall Street who argue that her termination was justified.  Others say that her style made it inevitable. That said, the issue should be not the "why" but the "how."  

There are reasons, justifications -- excuses -- as to why the board acted the way it did. Central among them was that Ms. Bartz was traveling and the board did not want word of their decision to leak before they had spoken to their CEO.  Others speculate that she may have had a clause in her employment contract that required immediate notification of termination. Fine, those are important issues to consider. But here is another:  if the intent was to rid the company of a leader who was failing in order to protect the interests of the brand and its shareholders, why would the board execute their plan of termination in a way that would cast a darker cloud over the already troubled company? 

That Ms. Bartz fired off an email broadside to her employees explaining that she had been fired over the telephone should not have been a surprise to the board or its advisors.  Nor should the resulting damage to  the organization's image.

Boards frequently hire CEOs with fanfare for what they hope will be strong operating results, favorable press, and a strengthening of the corporate brand.  They are almost always disappointed, frustrated, even angry when their best layed plans fall short.  But there is no excuse for the board to make a bad situation worse with a poorly executed plan.

How an organization terminates employees says a lot about the real heart and soul of the company. Taking the high ground may not make the person or persons who have made the decision and who are notifying the employee feel less frustrated, but how they perform this important role will shape the image of the company.

Yahoo is not the lone offender in American business. Thousands of times each day, someone is fired for a myriad of reasons, from poor performance to unethical or inappropriate conduct. There may be reasons to immediately remove the employee from the workplace.  There may be ample justification to have security personnel available.  Even when companies try to terminate someone in the right way, things can go wrong. Fortunately these incidents are the exception.

But companies who do not take the high road, protecting the dignity of the outgoing employee including complimenting the employee for their accomplishments and wishing them well while keeping security out of the room and the prying eyes of their colleagues at bay, are being short-sighted.  

Miss-hires, at whatever level, are a costly mistake, but to make the matter worse by ending the employment relationship badly simply multiplies the problem.

© 2011 John Gregory Self

Seed Newsvine

4 Questions Physician Candidates Should Ask Recruiters

There are four critical questions I believe that physicians should ask before submitting to the wooing calls of a recruiter.

I need to disclose that I began my search career recruiting physicians. Secondly, while I no longer recruit physicians strictly for clinical practice, I am involved in recruiting physicians for C-Suite and executive leadership positions. 

The American College of Physician Executives' LINKEDIN site is currently featuring an interesting discussion on this very subject.  I made some comments there but I wanted to bring them across to my blog for your review and comment.  If you are a LINKEDIN member I urge to visit this page.

Physicians can quickly and effectively "qualify" the recruiter and the opportunity by asking these questions. 

1.  Is the recruiter working on an exclusive, retained basis or with a non-exclusive contingency contract?  

Be wary of the non-exclusive agreements. Success in the latter case comes by submitting as many "qualified" candidates as possible, as quickly as possible. In this scenario, it is primarily a metrics game -- if a recruiter submits more candidates before their competitor, they will have a better percentage of closing the deal.  With this approach the physician's interest typically becomes secondary. It is about the commission and recruiters working in this environment, and in a few of the big "mill" retained firms, are pressured to close deals. 

 2.  What type of placement guarantee is the recruiter offering the client?

As a candidate, this is one of the most important questions you can ask.  Why?  No placement guarantee, or anything less than a 1-2 year guarantee, means they do not have much skin in the game, except their reputation.  Research suggests that most physicians stay at least a year so equal or less time is not much of a guarantee. Physicians should care because the more risk the recruiter has, the more concerned he or she will be in ensuring the "fit" is right and that the physician candidates have a complete and accurate understanding of the opportunity. In other words, alignment of interests.

3.  Are you getting full disclosure?  

Every organization, from Mayo and the Cleveland Clinic to a multi-specialty clinic in rural Alabama, has issues that they would rather physicians not know about before they sign. I refer to this as the "good, the bad and the ugly." One clinic did not like to disclose their turnover rate -- it seems their attractive comp plan was attractive on paper, not in practice. The recruiter, who had a 6-month placement guarantee -- which is to say no guarantee -- was practicing the search equivalent of "don't ask, don't tell." In one year, 6 physicians left the practice. Their turnover was 50% at 24 months, according to the CEO of the neighboring hospital who quit providing income guarantees until the parnters in the practice agreed to full disclosure of their good, bad and ugly issues. 

4.  Is the recruiter going to send you written information disclosing all the essential elements of the practice -- salary, benefits, and the good, the bad and the ugly?

If they can't or won't, run, do not walk, away. 

Some recruiters will argue this is an unrealistic model. I would argue that is exactly why this segment of the recruiting industry "enjoys" so much criticism.

Physicians, who were once at the top of the healthcare food chain in terms of earnings and importance when I began my career in the mid-1970s, should not be treated less appropriately in the recruiting process than other healthcare executives. But that is exactly what is happening in far too many cases day in and day out.

© 2011 John Gregory Self

Seed Newsvine

Annual Performance Reviews: The End of an Entitlement

Employees cherish a gross sense of entitlement in the form of their annual performance review and the almost certain yearly raise.  In many organizations, this “right” extends to  the very job itself, regardless of performance or economic conditions.

 The irony in the odd conceptual evolution of annual  performance reviews and obligatory raises, is that we are not talking about a unionized workforce. 

 In good economic times, this sense of entitlement in the workforce grows.  In bad times, it is the source of enormous friction and decline in employee morale, both of which create a distraction from the organization’s mission.

In many U.S. Hospitals, the system has been in place so long that employees cannot imagine any other alternative.  As long as hospitals are doing well -- defined as having ample days of cash on hand -- there is no sense of urgency to change.  In this misaligned employer-employee relationship, the business principle that cash covers a multitude of sins could not be more accurate. 

As healthcare providers we know, or should know, that we are on the verge of a tsunami of change that will, sooner than later, force an overhaul in our business model, a variation of which we have used since the arrival of Medicare in the mid-1960s, with a course correction in the mid-1980s with the implementation of DRGs.  Congress and regulators have tweaked the model so many times that we now operate business systems that are so complex that our patient bills are almost indecipherable.

The Patient Protection and Affordable Care Act, which in theory is designed to reduce healthcare spending, may or may not be fully implemented.  In the end, that will be up to the 12 wise men on the Supreme Court, but that is not the big game changer that will blow up the current system of how we deliver care and how much we are paid.  The bomb is the inevitable sharp and ongoing reductions in Medicare and Medicaid payments that will be necessary to control the annual deficit and long-term debt which are, previous Congressional cuts in spending notwithstanding, still very much out of control.

So the day of entitlements as evidenced by so many current dysfunctional performance review and annual merit pay programs, will require a shift in the traditional top-down, command-and-control relationship  that we “enjoy” with our employees today. 

When the next round of federal reimbursement reductions, that will be steady in their frequency and painful in their impact, begin, it will be too late to recover if you are not prepared. 

The smartest guys in the room, those CEOs who understand that this inevitable storm is building on the horizon, are already beginning to think about what the next generation of health system will look like, how it will be organized, and what all of this will mean to their employees, increasing numbers of whom will be physicians. 

On Friday I will outline an essential first-stage employee strategy.  Until then, I would like to hear what you think.  How do you see the deficit/debt crisis affecting our existing business model and what would you do to prepare for a challenging future?

© 2011 John Gregory Self

Seed Newsvine

Customer Satisfaction Programs: There Is No Silver Bullet

Success of a brand-name customer service/satisfaction initiative is not based on which pricey program a healthcare organization buys, but the commitment, the passion and the skills of the Chief Executive Officer.

Healthcare organizations looking for the magic silver bullet, should understand that it does not exist.  

Quint Studer was a very successful President of Baptist Hospital in Pensacola, Florida, not because of some template or costly consulting package.  No, he succeeded because of his commitment, his drive and deep understanding of common sense leadership principles. There is nothing magical about his very popular approach, or of those promoted by his able competitors.  They provide a solid framework for cultural transformation.  But without a strong CEO, no army of cosultants can produce an environement that fosters clinical excellence, patient safety and exceptional patient satisfaction scores.  

There is no substitute -- none whatsoever -- for a dynamic leader who can craft and communicate their vision, and who can successfully build a strong leadership TEAM that, day in and day out, delivers exceptional results.  

If you need to believe that there is a silver bullet, then there it is -- hard work and personal involvement by the CEO.

© 2011 John Gregory Self

Seed Newsvine

Going Out On A Limb...Not Really

In one of the silliest of debates in the world of healthcare, challenging economic times and the inevitable cuts in reimbursement from healthcare reform and deficit reduction have fueled a renewal of the endless haggling over who is better: not-for-profit or investor-owned hospitals?

Let's cut to the chase:  the winner is/will be those hospitals that achieve superior results in terms of quality, safety and patient satisfaction.  Who cares about the ownership structure?

I have worked in the healthcare industry for more than 30 years.   When I first went to work for Hermann Hospital in Houston as a young PR director and the first director of Life Flight in early 1976, there were actually more investor-owned hospitals in the market than the staid non-profit behemoths of tertiary care.  While the big tertiary care facilities that took care of the sickest patients were tax-exempt, the hard-charging investor-owned community facilities reshaped the market dynamics in terms of competition, the speed with which business decisions were made, and their ground-breaking efficiency.

Today, the pros and cons of which ownership model is superior are once again being debated.  The truth is that both ownership structures are fraught with weaknesses that healthcare reform and the ongoing deficit/debt reduction efforts will challenge.  

Who will win?  To borrow a line from the late Molly Ivins, a newspaper columnist who covered Texas politics for decades, "I am going to go out on a limb and tell you that I haven't a clue."  That said, I do know what will be the deciding factor.  Quality people.  Organizations that recruit and retain the best talent and who understand the consequences of the "new normal" and the lower rates of reimbursement, will end up on top.  If you do not hire and retain the best people, it is impossible to compete in a hyper-challenging financial/business model transformation.

Eventually, when the financial squeeze reaches painful levels, ownership structure will certainly come into play.  I think I know how it will play out, but that is a conversation for a different day. There are so many policy/reimbursement issues about which hospital CEOs have so little control   For now, if you are a hospital CEO, pay attention to the most important variable you can control:  the quality of people you hire and the rate of retention. That is one of the most important things you will do as THE leader.

© 2011 John Gregory Self

Seed Newsvine

EXECUTIVE RECRUITMENT: Can You Afford Average?

It is a recurring question -- how can I be sure that I am hiring the right executive and that once they join will they stay?

In all honesty, when dealing with people, there are no absolutes.  But with the right search consultant -- internal or with a firm -- and a gold-plated recruiting/candidate screening process, you can substantially mitigate the risks. However, let the buyer beware:  if your executive search firm uses terms like “job order”, “hiring authority” or “fill rate”, more than likely they are a placement agency or staffing company trying to move up the financial ladder.  

The real secret to success in executive search is to select a partner or search consultant who possesses some important skills.  First and foremost, success in executive search is not tied to the number of years of experience.  That is helpful, but if the consultant lacks a particular set of skills necessary for success, years of experience will ensure only that you are buying experienced mediocrity.  Nor is the size of the firm of any consequence unless your organization is a multinational operator and geographic reach is important.  No, the secret lies in the search consultant who will be doing the majority of the work.  Does this person possess a deep understanding of the culture of the organization -- the values, the rules governing interpersonal relationships, and how decisions are made?  Do they require complete transparency regarding performance expectations, details regarding the hurdles that must be overcome to achieve success, and identification of the always dangerous sacred cows?  The consultant must insist that the client lose their natural desire to put their best foot forward while obscuring important problems or challenges that will become the organizational equivalent of an IED - improvised explosive device -- with career-limiting consequences.

Is the consultant who will do most of the work on your search, save perhaps the candidate's final interview with the engagement partner, present for the all important site work, or are they closeted away in the Firm’s office working on other projects?  (That is the most common model in the search industry.)

If your consultant does not force you to deal with the tough issues, do not be surprised if the outcome is only average.  Executive search is like dating and marriage -- decisions are made after four or five dates.   If the search does not force the client to deal with always-present nasty little details in advance of the marriage, there is a good possibility that it will not be a long and productive relationship and the divorce will be messy and costly.  

The truth is that far too many executive recruiters practice what I call “don’t ask, don’t tell”  recruiting. The partner signs the engagement, a consultant who may, or may not have been present for the site work, prepares a superficial job description and if the candidate doesn’t ask about the culture or potential problems that could affect their success, the search firm does not tell.  Oh, the big firms deny that is the case, but I have interviewed far too many candidates who say otherwise.

How confident is the search firm in their ability to find a candidate who will deliver value to the organization?  To test a search firm's true mettle, ask the partner in charge if they will guarantee their work for an extended period of time and listen for the reasons they do not.  Most firms offer a 12-month placement guarantee.  That is average.  There are one or two firms competing in the healthcare provider segment who will offer an extended placement guarantee, but they are the exception.

So the answer to the question is, in the end, really this:  Given the cost of an executive search -- professional fees plus an overhead assessment and travel costs:  Can you afford average?

© 2011 John Gregory Self

Seed Newsvine

Five Reasons Hospital CEOs Get Fired

From Anchorage Alaska

Hospital CEOs have their hands full.  They face a boiling cauldron of operational, financial and competitive challenges – any of which could prove career limiting.  Surprisingly, however, many CEOs fail not because they lacked knowledge or expertise in running a hospital or dealing with the myriad of threats.  Rather the fastest-track to a severance agreement, or unceremoniously escorted from the building, can be found in five major failings.

 The overarching principles on this subject are two-fold:  First, CEOs and senior executives should know themselves. The second “first” rule is that CEOs should do no harm to the employees they lead or the customers they serve.  CEOs who keep their eyes on these balls will typically do well, all other things equal – knowledge, talent, and expertise.

So why do CEOs get fired?  More often than not it is style, or lack of political sensitivity, that will be a CEO’s undoing.  In more than 30 years in healthcare leadership – 17 years in executive recruiting – I have seen senior executives run aground many times over because they lacked the sensitivity to read, understand and adjust to the shifting political and marketplace sands that exist in virtually every health system or hospital, from the governing board and medical staff to the hourly employees who do the really important work.

Here are the five sure-fire issues that will get a CEO fired.

1. Micromanage your team - Micromanagers are like amateurs masquerading as "in-the-know" leaders. Let's be honest, if you have to get that involved in the operations of the enterprise, you are not hiring the right people.  When you micromanage, you destroy morale, and disrupt service.  You show me a hospital CEO or COO who is a micromanager and I will show you an organization that is, or will, suffer quality and  patient safety problems, and, eventually, poor financial performance.
2.  Be a Bully - There is no place in leadership for bullies/abusive leaders.  If you have to use anger, intimidation, or abuse to achieve targeted results, or if you enjoy calling out subordinates and humiliating them in front of their peers, you might want to reconsider changing careers. Your employees -- and your customers --  will be delighted you have left. In short, if you think that approach to management is smart leadership, you do not belong in healthcare.  Management and employee turnover is dangerous for your patients and it is very expensive.  The only way a CEO with this particular mortal sin can hold on to their job is if they work for an incredibly toxic board or a ridiculously misguided corporate entity that equates this type of boorish behavior with “tough” leadership.  There is no accounting for stupidity that manifest itself in this type of misguided and misinformed corporate or governing board oversight.
3. Ignore Your Customers – That is perhaps one of the biggest – and most common – sins in healthcare today.  Take care of your customers. They will take care of you (and your career).  Steve Jobs and Apple blew past Microsoft in terms of market cap, not because they treated their customers with dismissive indifference, but because they were passionately focused on offering an extraordinary customer experience – exceptional quality and best-in-industry service.  Day in and day out, Apple employees focus on their customers – meeting their needs with enthusiasm that is fueled by a belief that they are working for an outstanding company “that gets it.”  Fighting with your customers (read: physicians) – even though they may also be your competitors at some point in the day – is a bad idea.  It demonstrates, without equivocation, that you do not get it.  As a savvy politician once said, never fight with a man who buys printer’s ink by the barrel.  Taking a my-way-or-the-highway posture with the people who admit patients and generate revenue or the board members who evaluate your performance is a really bad idea.  As CEO, you are supposed to be on top of the emerging trends.  If your physicians are concerned with their revenue, be a partner, not an adversary. That point is not rocket science but you would be surprised how many CEO terminations can be traced to an arrogant belief that you can fight with your customers and still be a winner.
4. Excel in self-importance – CEOs, you should (read: must) check your ego at the front door.  It is not about you.  It IS about the people you serve.  In a crummy economy, the smart leaders are the ones who walk the floors and talk to their employees – on all shifts, all the time – looking for ways to improve quality and service, how they can make a meaningful difference in the lives of those who, day in and day out, actually do the work.  CEOs should regularly visit their physicians – all of them – on their turf.  Listen, learn.  This is not for show.  The employees and the physicians know when they are being taken seriously and they appreciate the effort.  So many CEOs fail to build this reservoir of goodwill that will be essential to survive the inevitable crisis that will occur during a standard tenure of five to seven years.  CEOs have all sorts of excuses why they can’t do this (I have heard most of them), but when the board makes the decisions to terminate, remember your lame excuses and then decide if you like the feeling of getting the boot.
5. Be a Phantom CEO -- You cannot lead from behind closed doors and a cadre of assistants who shield you from your customers and those who actually do the work that generates the revenue.   Stop trying.  In plain terms, do not build walls or a honking big silo of reinforced concrete around yourself.  CEOs should not let their fears or insecurities make them a prisoner of the executive suite, venturing out only for the weekly manager’s meeting or occasional hospital-wide event.  A CEO once told me, “I just do not feel comfortable interacting with the employees without others being with me.”  Insecurity is the stuff that walls and silos are made of.  Get a coach and get over it. Or get an outplacement adviser.  You will need one

Bonus Reason:  Avoid Accountability. Blame others for your failings.  Your       subordinates will really love you for that one.  Do the opposite.  Be accountable.         No one likes a leader who is full of excuses, who dodges accountability.  Revel in       being responsible for the success of the organization. Take joy in the challenge.         Talk about it constantly and hold others accountable.  That is a powerful       message.  No one likes a dodger who is better at excuses than results

© 2011 John Gregory Self

  Seed Newsvine

Health Systems, Hospitals Got It Right

Because I am not shy about criticizing or challenging my industry – healthcare – when we fail to live up to our mission of quality/safer patient care and support for the communities we serve, I owe it to my colleagues to voice my support when I believe they get it right.  They have in one very important area.

Executive compensation continues to be a hot subject both in the U.S. and Europe.  Not a week goes by without a news report, analysis or essay on the subject. While the current lightning rod is the large investment banks, there are far too many public corporations that are guilty of bad practices in how they pay their executives and how they explain it publicly.  

The central issues giving life to this continuing flow of coverage on the subject are the size of the base salaries and/or bonuses, the relationship between the pay for some easily understood performance metric, and the rights of shareholders – or the lack thereof – when the “owners” of the company are not happy with size or justification for the genrous awards.

Executive compensation issues and the financial community’s sense of entitlement, continues to irk regulators, millions of small business owners and “average Joes” everywhere.  The large banks single handedly drove this country to the verge of a global credit market contagion.  However, the continuing problems and lack of transparency in executive compensation are not confined to the banks.  There are hundreds of examples of corporations throughout the U.S. and Europe that treat shareholders as troublemakers of the worst sort if they deign to believe they are entitled to any rights  to have a meaningful say on this issue.

In healthcare delivery, we have kept our wits about us on executive compensation when other industrial and service sectors lost their way. We are not perfect, but our industry does remarkably well, all things considered. 

While there are health system and hospital CEOs who earn high six and low seven-figure incomes – and they are the exception – there are few examples where the size of compensation of a hospital CEO is inconsistent with the scope of responsibility and the complexity of the challenges these executives face.  In fact, there are examples aplenty of hospital CEOs of difficult-to-manage public and mid-sized community hospitals who are underpaid for the work they do and the results they produce. 

I am not going to discuss the payor or pharmaceutical segments because I lack the expertise.  My search firm does not work in those areas, but I believe there are certainly examples of these bad  compensation practices in the health insurance, technology, and pharmaceutical segments.

Health system and hospital boards, for the most part, are responsive to their communities and tend to be prudent in evaluating the CEO and how they pay him or her for the results they produce.  No, community boards are not as transparent as they should be in some markets, but even in the worst of cases, they are infinitely more responsive than the boards of far too many major public corporations who have created more rules and hurdles to block true shareholder input into how the company is run.  It is a maddening situation for many mom and pop investors, and increasing numbers of institutional investors, who are tiring of the corporate arrogance and greed.

Hopefully, as community healthcare organizations deal with the immense challenges that are part and parcel of our “new normal” economy, persistent high unemployment and anemic growth rates, their boards will become more transparent, not less, and more communicative, not less, regarding the size and scope of their community benefit which is how they justify their tax-exempt status.

Big corporations may have a legal requirement to be more forthcoming, but community healthcare providers have a moral and ethical duty.  And there is a big difference. 

 

© 2011 John Gregory Self

Seed Newsvine

Take The Time

Today I received a thank you card via PLAXO, one of a number of social networking sites, thanking me for being thoughtful.  It was from the CEO of a health system in the Mountain West who appreciated the fact that I remembered her birthday. "Thank you for your thoughtfulness."

Tough and challenging times lie ahead for healthcare leaders.  We will see unprecedented reductions in Medicare and Medicaid funding, the promises of the Patient Protection and Affordable Care Act notwithstanding.  These reductions will force providers to embark on structural reforms that most never imagined in their lifetime.  

There will be pain caused by our instincts to resist complicated reforms that upset our values. These changes will be especially hard on many of our key stakeholders such as our physicians and our employees.

Senior leaders who focus solely on strategy, the daily, weekly, and monthly metrics, and the month-end results, will not be as successful as those CEOs and their teams who keep their employees and customers front and center.  When the crunch hits, we must all resist the temptation to view maintaining these important relationships as an expense, a secondary priority, or something that can be all together forgotten in the name of "making the hard financial choices."

In the end, those healthcare organizations that thrive in an era of radical and painful change will be those who have employees who have been engaged and empowered to make their organization the best.  

To be a successful healthcare organization over the next 10 years means investing today in people and relationships. At the core of this effort must be developing a reservoir of goodwill with those stakeholders.

CEOs who understand that they must focus on their role as a strategist, resource coordinator, and chief relationship/communications officer will thrive, provided they delegate daily operations to a competent management team.

Leaders who focus on the big issues but remember the small things -- sending an employee a birthday card, a congratulatory note for going the extra mile, or making an unannounced visit to a department to recognize someone for a job well done is such a minor event in an otherwise busy day, but pays huge benefits. 

Effective, successful executives and thoughtful leaders are one in the same. Over the next 10 years, this leadership truth will become very apparent.

IMPORTANT QUESTIONS

1.  Do you regularly make rounds on all shifts?  Do you require your executives and managers to visit employees and physicians on a regular basis on all shifts?

2. Do you take the time to listen to what employees and physicians are telling you?  Do you follow up in a timely manner?

3. Are you promoting bottom-up innovation?  Top-down organizations will struggle to keep pace with sweeping changes over the next 10 years. You cannot turn this essential cultural orientation off and on like a light.

4. Are your employee-stakeholder communications leading edge and effective? Is there substance that engages employees, physicians and community stakeholders on important issues?  Do your distribution platforms connect with the age cohorts of your audience?  

5.  Do you have a weekly communications plan that always emphasizes the organization's core values, the more immediate key issues and performance targets, or do you work off the cuff?   Are you promoting real transparency or are you playing the transparency game?

© 2011 John Gregory Self

Seed Newsvine

Businesses Oppose Repeal of Healthcare Reform: Poll

Depending on your source of news and information, you either believe that the Patient Protection and Affordable Care Act (PPACA) is destined for repeal or almost  certainly will be overturned by the Supreme Court, or that this hallmark legislation was a much needed, albeit imperfect, first step in helping improve healthcare delivery in the nation.

Regrettably, the news reporting and opinion “analysis” fail to provide a full picture.  We tend to listen to what we agree with – when we have a choice. At the core, I am really no different, but as a former reporter, I tend to visit the other side.  I rather enjoy pushing myself out of my safe zone.  Safe can produce amazing mediocrity and more often than not I am pleasantly surprised with what I find -- at times, new facts or a different perspective that helps shape my point of view.

There is one survey that you may find surprising if you are pro-business conservative:  Only three percent of business leaders surveyed by the HR Policy Association favored repeal of the PPACA.  The HR Policy Association consists of over 300 of the largest corporations doing business in the United States and globally. Collectively, their members employ more than 20 million employees worldwide and have a market capitalization of more than $7.5 trillion.

Writing in Human Resource Executive, Jared Shelly, benefits columnist for that publication, reported that businesses did offer several suggestions on how to make the bill better:

• Remove the 1099 reporting requirement for vendors paid more than $600 or more.  They argue that large businesses could be forced to issue millions of 1099s each year. 
• Create limiting stipulations for PPACA’s provisions for coverage of children on their parent’s benefit plan up to the age of 26, excluding those who get coverage from their own employer or those who are married.  Businesses feel this provision will increase their health benefit costs.
• Move away from the hospital/physician fee-for-service model, a system that fuels dysfunction.  “There is a lot of care that isn’t needed and can be downright harmful,” said Helen Darling, President of the Washington-based National Business Group on Health. “We are paying for services whether they are needed or not, whether they are effective or not.  It’s a mess," she told Mr. Shelly.

It is a fool’s errand to make firm predictions regarding what Congress and the Supreme Court will or will not do.  Unless there is a major shift in political power or the Supreme Court rules that the use of the commercial clause of the Constitution to support mandates for insurance purchase is unconstitutional, PPACA, while not perfect, is apparently better in the eyes of business than doing nothing.

© 2011 John Gregory Self

Seed Newsvine

Talent Academy Summit Focuses on Critical Issues for Healthcare HR Professionals

As the nation’s overwhelming debt crisis looms, and as the immediacy of healthcare reform’s reimbursement reductions come into focus, healthcare human resource executives are zeroing in on strategies to acquire and retain the best talent ahead of their competitors.  As they begin this battle for the best people, most understand that they will have to do more with less, no small feat when you consider the organization that captures the top talent will be the market winner.

Meeting in a talent management summit this week in Houston sponsored by Talent Management Academy, participants from San Diego to New York and Boston listened to presentations on a wide range of issues -- healthcare reform; the potential for a cataclysmic debt crisis that will force dramatic reductions in Medicare; recruiting; and  leadership development and the need for retaining the best talent. 

 Here are some important takeaways:

• Healthcare reform and the potential for a debt crisis that could severely cripple Medicare reimbursement rates making hiring and retaining top talent – now more than ever -- a strategic imperative
• More non-executive hiring is moving to cloud recruiting
• In-house recruitment databases that include features for automated candidate messaging and options that empower qualified candidates to schedule convenient interview times rather play telephone tag with a recruiter, are gaining traction
• Tracking top performing employees who leave the organization through an “alumni” web portal in the hopes they will achieve “boomerang” status – return to the fold – is but one strategy that some leading healthcare systems are implementing to enhance their talent brand and to double down on their commitment to recruit and retain the best possible people.  Consulting firms and non health-care corporations have been doing these things like this for years.  For hospitals and other service delivery providers, this strategy will be a talent management imperative
• Recruiting support firms are incorporating these types of connectivity features, integrating with comprehensive employee communications and onboarding programs

In a time when healthcare executives are fiercely scrutinizing costs in anticipation of severe reductions in payments from the government, this type of expensive investment seems counter-intuitive, but nothing could be further from the truth.  Many leaders in the field believe the longer that hospitals delay in developing best-in-class onboarding, recruiting and retention programs, the bigger disadvantage they will face in the area where it counts the most:  Finding and keeping the best, from the most highly skilled clinicians to the people who cook the food and clean the building.

© 2011 John Gregory Self

Seed Newsvine

Why Do We Forgo Transparency In Recruiting?

Executive candidates continue to write about their frustrations with healthcare organizations that are unwilling or unable to disclose material issues regarding executive or management positions for which they are recruiting.

This is not a random, occasional occurrence.  These continued comments from frustrated executives come at a time when healthcare organizations need to find and retain the best people, not drive them away because the job was not appropriately represented by internal or external recruiters. This is a common reason why executives fail to stay in a position beyond 18 to 24 months.  In fact there are documented cases where the newly employed executive did not stay in the position beyond 180 days.  That is an extremely costly miss-hire.  Other times, the candidate may stay but there is a certain sadness emphasized with a resigned shrug of the shoulders when asked if they were satisfied with the recruiting process.  “Well, I am here now.  I never should have left, but the door has closed on that part of my life.”

Somehow there is this misguided belief that it is perfectly acceptable for organizations to mask negative factors about a job, thinking that their omissions of important information is really OK, and that everything will work out in the end.  An executive begins a new job filled with hope that they can make a positive contribution.  They are attracted to the organization usually because they are painted an attractive picture, and they are wooed mightily in one-on-one meetings with key leaders and at dinners with the CEO or board members.  They want to believe the best about their new employer. They are excited that they are beginning a new career with an honorable organization that is committed to doing the right thing.

It is devastating for the new executive to learn that the part about doing the right thing did not include being transparent about the pros and cons of the organization, the challenges the position would pose, the true scope of responsibility or even the compensation package.

In my conversations with candidates, I have found that this has been and continues to be an across-the-board problem:  both internal and external recruiters engage in these practices.

By way of example, in a recent interview, a Chief Operating Officer complained that a potential employer’s best offer was $45,000 less than what they were told by the recruiter, a partner with one of the largest firms in the executive search industry. That is no insignificant amount. The candidate walked away and the frustrated client was forced to restart the search while the expenses once again began to mount.  “If I had known the truth, I would have never gone through the process,” the former candidate lamented.  In many lower level searches – for managers or directors -- this is a very common problem because most candidates, eager to advance in their career, do not know that it is OK to ask for the salary range up front.  Hint:  If the recruiter does not know, tell them to find out and call you back.

On the other side, Chief Executive Officers and Chief Human Resource Officers must demand better of their internal search team or their hired headhunters.

I cannot control what candidates are told by prospective employers, but as a partner in an executive search firm, I can insist that clients be transparent, so I can deliver appropriately qualified candidates a detailed Position Prospectus that outlines the critical information the candidates need to know, such as:

     1.    Selection criteria

    2.    Compensation package with a specific range for the base salary

    3.    Profile of the corporate culture

    4.    Performance expectations

    5.    Hurdles to success

    6.    Project schedule

Making assumptions is never a good idea, and what I am finding is that it is a fool’s errand to believe that all candidates understand how the executive search process works. 

Let me know what you think.  If you would like to learn about a candidate’s recruiting rights, or questions candidates have the right to ask, let me know.  I would be happy to extend this conversation.

© 2011 John Gregory Self

Seed Newsvine

Curiosity Killed the Cat But Saved the Recruiter

What makes a good recruiter? How do you define a good recruitment program?

As increasing numbers of healthcare systems, hospitals and other providers focus on reducing costs by bringing the executive search function internally, there are important factors to consider in identifying the person to handle your director-level and executive recruitment projects as well as for developing a process that will yield results that are better than the average recruiting agency.

Consider these points in developing your interview process:

1. Employment of hourly or supervisory personnel, given the numbers of people hired in most organizations each year, emphasizes the process. Successful executive search also relies on process and judgment, but requires more in-depth analysis and research.

2. Focusing only on a candidate's experience is a mistake. The high turnover of candidates recruited from outside an organization – estimated at 50 percent in 24 months in several studies – is typically not due to organizations hiring inexperienced managers and executives.

3. Personality of the candidate matters. Personality is not a component of the resume.

4. Curiosity may have killed the cat, but it also has saved more than a few recruiters from making costly mistakes. Ask the questions that are begging to be asked.

5. Don’t rely on just the traditional or base questions. Look for details or events in the candidate’s earlier life that helped shape who they are today.

6. Explore their failures. Everyone has had their flops, career disappointments or performance flameouts. Investigate what happened and why but the main point is understand what the candidate learned from the situation.

7. Know what the hiring authority wants. Develop a deep understanding of their personality and style, performance expectations, problems in the division or department and hurdles that must be overcome to achieve success (what will success look like?). 

8. Candidates should be told the salary range before organizations invest time – the candidate’s and the recruiter’s –in going through the interviewing routine. (I am amazed at how many stories I hear of candidates, primarily at the management and director level, who currently earn more than the top end of the employer’s range and no one bothered to address that important issue until the end of the recruitment cycle.)

9. Be prepared. Once the primary screening interview is over, it is too late, or too embarrassing, to re-interview and follow-up on all those issues that jumped off the paper like a flashing strobe light once the telephone call has ended.

10. Be sure your references include secondary sources – those recruiters develop in the candidate interviews, especially for those candidate employment tenures where there may be issues that should be resolved. Remember, smart candidates – which may or may not be the best candidates – will provide references that are usually positive. No one is perfect. Address all the issues.

 

© 2011 John Gregory Self

Seed Newsvine

To Be Or Not To Be...TRANSPARENT

Transparency in recruiting is essential, yet many organizations, and their recruiters, play fast and loose with the term or ignore it altogether.

Lack of transparency in the recruitment process is one of the principle reasons that more than 50 percent of all candidates recruited from outside an organization quit, are pushed out, or are fired within the first 24 months, according to employment industry studies.

In more than 17 years in the executive search industry, I have heard candidates describe horror story after horror story regarding how the truth about a company, a job or even the compensation plan was covered up or, at times, distorted. When a frustrated candidate approached her new boss about an intractable problem that would dramatically affect her tenure – the boss replied with words to the effect:  If we had told you the truth you would not have taken the job.  If I had $10 for every time I hear that line from candidates, I would be on financial easy street.

Some CEOs and/or their well-intended but misguided minions will cover up any number of issues to avoid admitting the worst kept secret in the world:  that they have problems – from leadership dysfunction;  the bloody and brutal nature of inter-office politics; the management silos that squash innovation, drive up costs and harm patients; and the immovable barriers that stymie performance. The inventory of issues are endless.  In some organizations so is the list of problems that everyone knows but are not allowed to disclose to potential new employees.

Some organizations decry the practice of being deceived by fraudulent references but will go to great lengths to cloak the truth about their shortcomings to their potential employees.  It is as if the companies are playing a massive and costly game of “you figure it out.”  This practice is not just limited to a few complex hospitals or other healthcare service businesses.  It is a widespread problem across all sectors.

For companies who are honest about their issues, who practice full disclosure, they typically are able to recruit and employ candidates who stay longer and produce greater value. Honesty contributes to a sense of belonging for employees as well as a deep pride to be working for a company who walks the talk.

I can think of no reason for any organization to engage in a recruiting process that is anything less than completely transparent about the good, the bad and the ugly of an organization.

The upsides in this environment are endless.

© 2010 John Gregory Self

Seed Newsvine

The Ethics of Providing Misleading References

One of my mother’s oft repeated lines, reflective of her status as a true Southern Lady, was, “If you can’t say anything good about a person, don’t say anything at all.”  Hardly her original line but it is certainly a standard of conduct worthy of practice. 

There is a variation to this standard in the recruiting industry.  When giving a reference, recruiters would prefer that executives adopt this rule:  If you can’t say any good about a former employee, don’t lie.

I know of cases where exasperated executives, so happy are they to be rid of a troublesome or poor performing hospital executive or manager, that they have given remarkably favorable references.  Perhaps a sense of guilt led them to do what they thought was a good deed.  “I didn’t want to hurt his career,” one CEO said.  I guess that CEO did not think about the next CEO who would have to deal with his now departed employee’s problems.

We do that a lot in healthcare – say nice things to an unsuspecting future employer about a candidate.   Truth is we need to stop this. Giving a good reference when the former employee’s performance has been less than stellar is not doing anyone any favors, especially to the person who was sacked.

Verifying the performance of a potential employee is one of the age-old struggles of talent acquisition.  Recruiters are seeking good information to avoid a costly hiring mistake.    Companies that erect Chinese Walls to protect themselves against a lawsuit for a bad reference do not help the process even though these “walls” rarely prevent an enterprising researcher or recruiter from trying to dig out the truth.

If you feel compelled to support a former employee who did not succeed in your organization, then find those traits  that you liked and politely decline to answer each question regarding performance in which your response might be negative. 

This might be equivalent to “damning by faint praise” but at least you have done the right thing.  

© 2010 John Gregory Self

 

  Seed Newsvine