HealthCare Voice

MBA OATH: A Worthy Pledge In Troubled Times

CHICAGO (June 28, 2009) -- “…my purpose is to serve the greater good…this oath I make freely and upon my honor.”

At first read, I thought these words must have come from an oath for politicians, far too many of whom will eventually succumb to the temptations of public office or the corrupting influences so inherent in the re-election process.

No, surprisingly, these words come from the Harvard-inspired MBA oath that more than 1,100 MBA graduate students around the world have signed as of last Tuesday, according to Financial Times Columnist Michael Skapinker.

That these students felt compelled to write such an oath in the first place clearly shows how far our nation has slipped over the past four decades. But here we are.

The Oath is a remarkable document, and worthy of your review. It exudes a fervent hope that these future business leaders can help us move to a better place, away from the business shenanigans of the past 4 decades.

A startling theme of this Oath is the implicit rejection of the shareholder-first way of thinking that has shaped, controlled, and, over time, allowed for Anglo-American business values to be twisted in a way that bred greed and corruption.

Graduate business students around the globe have pledged to “…safeguard the interests of my shareholders, co-workers, customers and the society in which we operate. I will manage my enterprise in good faith, guarding against decisions and behavior that advance my own narrow ambitions but harm the enterprise and societies it serves” and includes a commitment to pursue “…sustainable prosperity” while promising to “…take responsibility for my actions, and that I will represent the performance and risks of my enterprise accurately and honestly.”

“It would be easy to dismiss it (the Oath movement) with an indulgent smile. Easy but wrong. The MBA oath comes at a time when capitalism’s claims to efficiency and legitimacy have been shaken,” Mr. Skapinker writes.

While the Oath was conceived and written by Harvard MBA students, they were inspired by business professors Rakesh Khurana and Nitin Nohria who argue “… that the answer to business’s crisis is to turn management into a profession like medicine or law”, according to Mr. Skapinker.

While physicians and lawyers may cross the ethical or legal boundaries by putting moneymaking ahead of patients and clients’ interests, they have codes of conduct by which they must abide if they are to continue to practice, the legal consequences notwithstanding.

There is no question that there is a measure of idealism at the core of this Oath, but keep in mind that MBA students tend to be considerably less idealistic than their graduate school counterparts in the liberal arts. The key to the success of this Oath movement will be how these students react when, upon entering the real world of Wall Street, for example, they confront a boss who, with an eye on his bonus, agrees. Then he smiles and winks while crossing his fingers.

It will take a long time to override the me-first entitlement culture that is so pervasive in business today. That assumes that our acceptance of the greed, patterns of bad behavior and ethical lapses can ever be reversed.

BRAVO HARVARD! I am hoping this Oath will become a driving force in business, not a passing fad. Some idealism may help us reach a better place.

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is a Co-Founder of the Firm. A former investigative reporter and crime writer with more than 30-years of healthcare leadership experience in public relations, national marketing, business development and as Chief Executive Officer of hospitals and consulting firms, Mr. Self is highly regarded for his keen insight into operations, business culture and for his ability to consistently select the right leaders. You can contact Mr. Self at 214.220.1234 or [email protected]. Or you can follow him on Twitter at Self_JohnMarch.

Seed Newsvine

Credit Report: A Blunt Weapon in Hiring

DALLAS (June 17, 2009) -- For years, corporate recruiting executives and managers barely checked candidate-provided references – much less criminal, civil or credit records before making employment offers. Now, in a country known for not finding the middle ground if it had a map, a compass and a finely tuned sense of direction, companies are eliminating otherwise qualified candidates who are out of work. The reason? They are behind on their bills and some are in bankruptcy trying to save their homes. Why? Because they are out of work.

Today, 33 percent of all companies are using credit checks as part of their employment screening process. Use of credit record checks in the pre-employment process is up by 55 percent over the past five years, according to a June 7 story in the LA Times authored by Tiffany Hsu.

According to this dispatch, companies are finding the so-called red flags in criminal records 9.5 percent of the time. Employment verification issues are a problem 48.1 percent of the time and problematic credit reports raise red flags 42.9 percent of the time.

I am not opposed to comprehensive background reporting. My firm, JohnMarch Partners, is known for its rigorous background checks. There is no shortage of candidates who have consistently demonstrated bad judgment. They have made decisions that were illegal or ethically questionable. At JohnMarch Partners, we look at criminal, civil, and driving records in all jurisdictions where our top candidates have lived or worked. We look at credit histories as well. Of course, we validate credentials, prior employment and we require eight references – two superiors, two peers, two subordinates, and two personal references. We also check secondary references – those individuals with whom the candidate has worked in the past but are not listed on the candidate’s own reference list. We insist on this three-dimensional review to be sure the candidate’s story “hangs together.”

I want to focus in on the use of the credit report. If the candidate will be a C-suite or senior level executive, the credit report findings are important. If the candidate will handle money, it is very much an issue. However, for others, we look at the credit report to corroborate bad behavior – fraud, theft, or a history of bad judgment. We know that otherwise good people can encounter tough times, especially now, in this devastating depression brought on by runaway government spending, incompetent regulatory enforcement, the greed of the entitled investors and a total lack of accountability on the part of the leaders we elected.

In our searches we have encountered executives with otherwise impeccable records who have run into a buzz saw of plummeting real estate prices and job loss that was related to the economy, not performance. To use a credit report to deny employment to someone whose record is otherwise acceptable is to misuse this tool. Employers should look for patterns of bad behavior or repeated poor judgment, not circumstances out of the candidate’s control.

It is a highly competitive job market. Employers are certainly well within their rights to make the argument that they should not have to take on new employees with financial problems, even if they were caused by the aforementioned incompetent oversight by a list of leaders that is long and “distinguished.” That is certainly their prerogative.

I believe that there is a more rational roadmap when making employment decisions. Check the references. Get the 3-D perspective concerning performance. Check for drug use and criminal or civil issues. Look at the credit report. If there are no patterns with bad judgment or behavior, then rely on reasonable judgment.

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is a Co-Founder of the Firm. A former investigative reporter and crime writer with more than 30-years of healthcare leadership experience in public relations, national marketing, business development and as Chief Executive Officer of hospitals and consulting firms, Mr. Self is highly regarded for his keen insight into operations, business culture and for his ability to consistently select the right leaders. You can contact Mr. Self at 214.220.1234 or [email protected]. Or you can follow him on Twitter at Self_JohnMarch.

HUMAN CAPITAL: Time To Invest Is Now

DALLAS (June 14, 2009) -- As I think about the best Chief Executive Officers and senior executives with whom I have had the pleasure of working, there are several qualities that come to mind: their depth of understanding, their attention to detail, their ability to communicate ideas and their passionate emphasis on recruiting and developing their team.

Some of these leaders are tough. They establish high standards of performance and do not suffer mediocrity gladly. Subordinates who do not perform at a high level will hear about it. These leaders know the detail and are comfortable deep diving to get the information they want, when they want it. They can be very specific about how they want certain things accomplished. While their direct reports may feel like they are being micromanaged, the CEO justifies this style based on his or her self-confidence and, of course, the results they achieve. That they occasionally chastise or ream out a vice president or other direct report in front of their colleagues is the price of an honest open dialog. When things are going well, this type of leader has no incentive to change. “This is just who I am,” is a favorite response. Leaders who rely on this model may get results but they rarely earn the trust of the people they lead. Nor do they see leadership development as an essential strategic initiative for success.

Can you imagine how much more successful an organization could be if the foundation of the leadership culture was built on respect and trust? That is a foundation with exceptional downstream value for the organization. In healthcare, it will foster improved quality of care, patient safety and satisfaction.

Outstanding leaders spend the vast majority of their time communicating with and developing the team. Jack Welch, one of the twentieth century’s most successful executives, certainly understood that point. He frequently said that developing his team was one of the most important things he did as a CEO, and the time he spent teaching at GE’s leadership development institute, which is located on 53 acres in Crotonville, N.Y., remains as evidence of his profound passion and commitment.

There was no confusion about GE’s vision, mission, or values. There was no mistaking its cultural pillars of execution and accountability. “Best effort” – an excuse for not achieving corporate goals -- cannot be found anywhere on GE’s web site or in its education materials. It is not surprising, then, that today, years after Mr. Welch left the scene, 90 percent of GE’s top 600 leaders are promoted from within.

Far too many CEOs are not engaged in leadership development. It is no wonder that leadership development is seen as an expense, not as an investment.

Last year as the seriousness of our current recession emerged, I wrote that it was time for CEOs to dump weak leaders and their poor performers and to strengthen their teams to weather the coming storm. While there is ample evidence that many organizations shed what they felt were marginal performers, or executives who were not essential during a period of no growth, there is little to suggest that healthcare organizations made widespread investment in their leadership engines.

Now, as the economy appears to be on the verge of a long and arduous recovery, CEOs who are prepared to act to invest in and strengthen their leadership teams will emerge as strong winners. For some this may seem counter intuitive in tough economic times, but, believe me, it is one of the best decisions a CEO will make in his or her career.

Now is the time to invest in human capital, one of the most frequently overlooked assets on an organization’s balance sheet.

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is a Co-Founder of the Firm. A former investigative reporter and crime writer with more than 30-years of healthcare leadership experience in public relations, national marketing, business development and as Chief Executive Officer of hospitals and consulting firms, Mr. Self is highly regarded for his keen insight into operations, business culture and for his ability to consistently select the right leaders. You can contact Mr. Self at 214.220.1234 or [email protected]. Or you can follow him on Twitter at Self_JohnMarch.

SWAN DIVE: From the Frying Pan Into the Fire

FORT WORTH, Texas (May 27, 2009) – One of the toughest career management decisions is when to leave your current organization. Chief executive officers, vice presidents, and even department directors all agonize over this call.

So many factors cloud our thinking.

Based on my interviews with senior level candidates over the past several years, I am finding that there are many reasons/excuses that give us pause when deciding to move on. Leaving when things seem to be going well at work is counter-intuitive. Perhaps our kids are in good schools, they are probably involved in sports or other activities; they have wonderful friends and they are adamant in their opposition to relocation. Or, the spouse is happy with his or her job; there is a great support group of friends and an ideal quality of life. More than likely there is some mixture of all of the above.

There are risks in staying. There are risks in leaving.

Business is changing. So, it is not surprising that there are non-family factors that are equally important to consider when making a decision to stay or leave. Let us look at the CEO turnover rate. The average CEO tenure is 2.5 years over all sectors, according to several recent studies. If that is not disconcerting enough, the average recruitment “stick rate” – the average tenure of all executives and managers who are recruited to new jobs – is a shockingly short 18 months. This number covers all facets of recruitment – from retained and contingency contracts to internal recruitment. Presumably, the contingent recruitment of lower level department directors or managers is driving the overall stick rate down. Nonetheless, these are troubling numbers if you sit on a board selection committee or run a company, and worrisome if you are a CEO or other executive or manager who is trying to plan the right time to move on.

No one wants to execute the perfect swan dive from the frying pan to the fire.

When I entered healthcare in the mid-1970s, the gold standard for stability in employment – and thus making you more attractive to executive search consultants – was 7 to 10 years in one job. That tenure reflected a level of stability and accomplishment, recruiters thought. Today, if you are seeking a senior level position in a healthy system or larger hospital, recruiters want to see diversity in experience and accomplishment – between five and seven years. They reason that this demonstrates that you can master a multiple of cultures and challenges, thus increasing your chances for success in a new environment. Candidates who have stayed in one job for more than 15 years could be in trouble, one career coach said recently. After 20 years in one job, pray that you can retire because your desirability as a CEO or other senior level executive is greatly diminished.

The trick is to have a career plan that is married to reasonable, grounded expectations. It is critical to have your family on board with these new career realities. They are frequently the reason a CEO stays too long. One bad departure – with nasty press reports that will almost certainly find their way on to Google – is a career limiting or ending event.

I know this sounds very unfair, even uncivilized, when it comes to what is in our family’s best interest. After all, these were not the career rules 15-20 years ago when most senior executives began their climb to leadership.

Regrettably, the market is changing. This change, especially as it relates to career management, is accelerating. If you are a healthcare executive leading a not-for-profit hospital, the challenge of managing your career is going to change again as we emerge from this deep recession. These CEOs will probably find themselves in an environment that is akin to working in a public company – more pressure to produce solid financial results and to meet rising community benefit expectations that is now a hot button with the IRS and Congress. And to do it every quarter.

Now here is the kicker. As Medicare and Medicaid payments are reduced, which will occur regardless of what happens with healthcare reform, the demands on not-for-profit hospitals for charity or deeply discounted care will only intensify.

All of these issues are forcing the CEOs of tomorrow to adjust their life and career plans. Twenty plus years in one organization may be a thing of the past.

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is a Co-Founder of the Firm. A former investigative reporter and crime writer with more than 30-years of healthcare leadership experience in public relations, national marketing, business development and as Chief Executive Officer of hospitals and consulting firms, Mr. Self is highly regarded for his keen insight into operations, business culture and for his ability to consistently select the right leaders. You can contact Mr. Self at 214.220.1234 or [email protected]. Or you can follow him on Twitter at Self_JohnMarch

The Role Leaders SHOULD Play

SAN FRANCISCO (April 16, 2009) – Long airline flights are conducive to swollen feet and great periods of reflection. I have been thinking a great deal about the important role that leaders play in moving their organization to best-in-class status. Or, the blame they deserve when their organization’s fail to deliver.

For health system or hospital Chief Executive Officers, best-in-class performance means meeting a robust set of standards for patient care quality, safety and the satisfaction of their customers – from the physicians, their patients as well as family members. The best of the best organizations also focus an enormous amount of energy and resources in achieving through-the-roof scores for employee satisfaction.

Let’s be clear. When we talk about best-in-class performance, we are not talking about best effort. No, we are talking about a record of consistently delivering perfection in patient care, safety and customer satisfaction, or as close to perfection as humanly possible.

This type of extraordinary performance does not happen by accident. The CEOs who hope to get anywhere near this level of accomplishment must build exceptional teams who are passionate about this vision. Then, the CEO must champion significant investment in education and development – in the current bad times as well as the good. Without this type of investment in human capital development, best-in-class results cannot and will not occur.

A great many CEOs, when pressed on the issue will most certainly boast that they spend an enormous amount of time on developing their people. OK, let’s face it, far too many CEOs – a startlingly high number – are blowing smoke. The clinical quality and poor financial results just do not support any other conclusion.

There are two ways to ferret out truth from fiction.

1. Does the CEO (and the CFO) view spending money on developing their leaders and managers as an investment or an expense? Again, one only must look at how little is budgeted for human capital development at so many hospitals. This certainly helps explain why we have so many continuing problems with quality care and safety, including preventable deaths. I do not mean to unfairly demean, but is there any other conclusion?

2. In his wonderful book “Talent Is Overrated,” Geoff Colvin writes that companies like to brag about their commitment to human capital issues. Colvin quotes Noel Tichy, a University of Michigan professor and top authority on this subject: “Testing their commitment is easy. Just show me the CEO’s calendar."

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is a Co-Founder of the Firm. A former investigative reporter and crime writer with more than 30-years of leadership experience in public relations, national marketing and business development and as Chief Executive Officer of hospitals, and consulting firms, Mr. Self is highly regarded for his keen insight into business culture and the types of leaders who will succeed. You can contact Mr. Self at 214.220.1234 or [email protected]. Or you can follow him on Twitter at Self_JohnMarch.

Twitter Is Not A Social Disease...

TYLER, Texas (March 28, 2009) -- I am back in Tyler at the weekend house. Two weekends in a row. That is a non-holiday record for me. It is cold today but we have a nice fire in the fireplace and some good music from iTunes. Just think, yesterday I was lamenting the end of winter in Texas and kidding my colleagues in Buffalo, NY. They are, no doubt, enjoying some satisfaction.

On Friday I met with a new networking group that my partner, Gary Pfleiger, is helping to put together. Actually it is more than networking. We are focusing on aggregating intelligence that will facilitate client acquisition. Joining us was PerotSystems networking ace, Bethany Williams, Kurt Young of engineering giant Walter P Moore, Wayne O'Neill, a consultant who specializes in this new field of expertise, as well as Marc Leediker and Jan Blackmon of the architectural firm Rees. It was a fascinating session.

On Wednesday night I returned from the ACHE Congress in Chicago where I spoke at three sessions. During my drive this morning from Dallas to Tyler, my experiences in Chicago, together with my networking session on Thursday morning, caused me to revisit some earlier thoughts I have had on the social networking phenomena. Social networking is sweeping the nation, from college campuses to the halls of staid law firms. That there are valuable business applications for these networks is an important heads up for CEOs, marketing executives, recruiters and those executives who find themselves in the job market.

Over the next three to five years, we will see exponential growth in the numbers of professionals who use online networking sites – Linked In, Facebook, Plaxo, – as well as platforms we have not even considered. These sites will dramatically change the way we relate with clients, colleagues and, in our case, the candidates we recruit.

In addition to authoring this blog and serving as Chairman and Founder of JohnMarch Partners, an innovative international search consultancy based in Dallas, Texas I also write tweets for Twitter and update my Facebook and Plaxo networking sites. Yesterday, business leaders thought a tweet was something impolite best avoided in public. Facebook and similar sites were dismissed as a college craze that would never amount to much.

Twitter serves as an instant blog that is limited to 140 characters. You learn to be brief! I encourage you to visit Twitter and become a member. You can get up to the minute information on searches that we are leading – from Hawaii to Abu Dhabi. When I add a “tweet” – the new word for a message -- it automatically updates on this blog. You can also follow me on Twitter at http://twitter.com/Self_JohnMarch.

Just as social networking platforms are becoming significant drivers for how we form, expand, and sustain our contact relationships, my professional world – executive search – is in the early stages of transformation. The current economic downturn is prompting some larger traditional firms who have not changed much over the past 30 years, to relook at their business model. But these social networking platforms will also play an important role in forcing the white shoe firms to relook at how they act and communicate. Right now they smile knowingly but most think this is just a fad that will pass - that participating will only diminish their brand.

Transformation of the existing executive search business model is inevitable. To ignore that fact, and the emergence of social networking sites, would be a mistake.

Currently, this transformation is being led by small boutique consultancies like JohnMarch. From the way candidates are screened and the depth of the background and reference inquiries, to the use of video summaries of our final interviews with recommended candidates to assist clients in determining which candidates to invite for a site interview, we, as executive recruiters, are looking at ways to enhance value and manage costs and delivery. JohnMarch became the leader of this innovation 15 years ago when the firm was launched. Today we are continually searching for ways to improve process and enhance value. Twitter and other sites will play a key role.

This is a great time to be in healthcare and the executive search business. There are enormous threats. There is chaos. There is opportunity.

My goal is to collaborate with my network to take advantage of the opportunity. But, creativity is not an endeavor best performed in a silo. So please share your thoughts with me.

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is a
Co-Founder of the Firm. A former investigative reporter and crime writer with more than 30-years of leadership experience in public relations, national marketing and business development and as Chief Executive Officer of hospitals, and consulting firms, Mr. Self is highly regarded for his keen insight into business culture and the types of leaders who will succeed. You can contact Mr. Self at 214.220.1234 or [email protected].

Somewhere in Tupelo, Mississippi...

ANN ARBOR, Michigan (March 18, 2009) I am at the University of Michigan to speak to graduate students in the nation's top ranked healthcare graduate management program. My host is outstanding teacher and friend, Dr. Christy Harris Lemak. Over dinner, we exchanged stories about our beloved industry, the leaders who have contributed so much, and some of the funny stories that we have encountered through our disparate careers.

As we enjoyed a wonderful meal, I mentally recalled one those classic moments that, if it had been told on the Tonight Show with Johnny Carson by someone with far more talent than me, would have made that infamous anniversary show reel of spectacular highlights.

It was a wonderful, hilarious moment for me. For the "victim," the newly appointed Director of Materials Management at Methodist Hospital in Memphis, it was a bleak, career limiting moment.

The year was 1978. I was the national marketing manager for Rocky Mountain Helicopters' hospital based air ambulance program. I just had lunch with Texan Chester Ayres, a vice president of the Methodist system who had once worked for LBJ at his Austin television station. We had just returned from a lunch where martinis had been consumed. We were both catching flights -- me to LA for a closing dinner at Memorial Medical Center in Long Beach. Chester was flying to New York.

We returned to the Methodist Hospital central unit to fetch my luggage. We had plenty of time, but Chester, a Texan with the bark on, who still had plenty of political stories to tell, wanted to get to the airport so we could continue our conversation over additional adult beverages. Standing between my luggage and Chester's determination to get to the airport was the aforementioned Director of Materials Management, holding court in the main hallway wearing a flashy plaid sports coat on his first day on the job. When he found out who I was, he immediately launched into a lecture on how he was going to control the bid and specification process. Once he got started, he would not shut up. Chester became more impatient by the moment. Finally, he started rubbing the lapel of this awful plaid jacket.

After a few minutes, this fashion king stopped talking – thankfully – looked down at Chester’s hand and asked: “Do you like my coat?”

Chester quipped, “Son, somewhere in Tupelo, Mississippi there is a '57 Chevy that ain’t got seat covers.”

Sudden Silence. I grabbed my bags and we fled the scene. We made it to the airport in time for one more great story about former President Johnson. On the down side, I don’t think the new Director lasted too long at Methodist.

Life is full of amazing stories. And some very clever punch lines. In these tough times, we need to remember that important fact.

Listen for the stories and laugh when you can.

John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry.

Leadership Without Accountability

DALLAS, Texas (Feb. 21, 2009) -- Accountability seems to be in short supply these days.

Last weekend, CNBC presented a one-hour documentary, House of Cards, a fascinating look at the real estate fiasco that fueled our current economic decline. Reporter/anchor David Faber interviewed key people who were involved, from former Fed Chairman Alan Greenspan and Ira Wagner, the Senior Managing Director at Morgan Stanley who created the formulas for the complex, mystifying Collateralized Debt Obligations that were at the core of the irrational transactions that doomed our largest investment banks, to a sales manager from one of the less than ethical subprime originators.

Alessandra Stanley, reviewing the documentary for The New York Times, wrote:

“Almost like the Spirit of Christmas Past, Mr. Faber visits homeowners, lenders, bankers and Wall Street dealmakers to collect a Dickensian cast of characters who explain how they were sucked into an “affluenza” bubble that seemed unbreakable. The gullible range from (Mr.) Wagner… to pizza delivery men who became loan officers, that is, salesmen, with no training, regulation or even a dim understanding of what Wall Street was doing with the mortgages they handed out like supermarket coupons.”

When Mr. Faber confronted those mostly directly involved in creating the financial havoc, no one would accept responsibility or ACCOUNTABILITY for their actions except a couple of the gullible and irresponsible homeowners who were losing everything. The most common excuse was, “Everyone was doing it.” I still vividly remember a stern tongue-lashing that I received as a youth. It came from my beloved mother when I evoked that very same defense after being caught doing something I knew was wrong.

This week President Obama will attempt to focus the nation on our other very serious financial crises – the mounting budget deficit and overcoming the staggering cash shortfalls in our entitlement programs, including Medicare, Medicaid and, to a lesser extent, Social Security. We have these cash shortfalls because, for years, our leaders have spent funds that should have gone into Medicare and Social Security trust accounts on something else, including wars, bridges and highways to nowhere, and shockingly expensive wrenches, hammers and toilet seats for military jets.

I cannot help but wonder if our congressional leaders and the new executive team at the White House will have the political courage to address these extremely critical problems now, or will they hide behind the unwashed mob of special interests, evoking the now infamous “Everyone Was Doing It” defense.

The definition that a good leader is a work of art, and that a bad leader is a tragedy, ideally frames our current woeful mess. Leadership without accountability is fast becoming a business and government contagion that WILL end badly for us all.

I welcome your thoughts.

John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry.

Nursing Shortages, Retention and Diploma Schools

The following dispatch from the Associated Press caught my attention this afternoon:

Facing a nursing shortage, hospitals seek to retain new nurses by easing transition

By RASHA MADKOUR
Associated Press Writer

5:48 PM PST, February 15, 2009

MIAMI (AP) — Newly minted nurse Katie O'Bryan was determined to stay at her first job at least a year, even if she did leave the hospital every day wanting to quit.

She lasted nine months. The stress of trying to keep her patients from getting much worse as they waited, sometimes for 12 hours, in an overwhelmed Dallas emergency room was just too much. The breaking point came after paramedics brought in a child who'd had seizures. She was told he was stable and to check him in a few minutes, but O'Bryan decided not to wait. She found he had stopped breathing and was turning blue.

"If I hadn't gone right away, he probably would have died," O'Bryan said. "I couldn't do it anymore."

Many novice nurses like O'Bryan are thrown into hospitals with little direct supervision, quickly forced to juggle multiple patients and make critical decisions for the first time in their careers. About 1 in 5 newly licensed nurses quits within a year, according to one national study.

The critical shortage of nurses in the general acute care hospital setting is an issue that continues to draw much public attention and debate within the healthcare industry.

One factor in the stress turnover equation is that BSN programs do not provide their students with sufficient clinical training.

__________________________________________________________________________________

In the mid-1970s, Hermann Hospital in Houston launched a nursing residency program because the clinical skills of graduates from the four-year nursing schools were, in a word, WEAK. The BSN students knew more about management theory than patient care.

Once upon a time Hermann Hospital, like many other hospitals in the U.S., operated one of the most successful diploma schools in Texas. The clinical skills of the graduates consistently topped those from the BSN programs. I appreciate why the diploma schools faded from Americana… their demise ranks right up there with the demise of the kid on a bicycle who delivered our afternoon newspaper.

The diploma school phenomenon apparently was a strategy for training and developing clinical nurses that is no longer practical, especially when you consider the federal government consistently tries to cut reimbursement funding for graduate medical education. Hospitals saw the financial writing on the wall: diploma schools were going to be too costly to operate.

Today, Associate Degree RN and BSN programs struggle to find qualified educators and to get more funding to expand the size of their graduating classes. Huge numbers of potential nurses reportedly are rejected in many states because the nursing schools cannot absorb the numbers of people who want to enter the nursing profession.

For years we relied on overseas recruiting – from Canada to the Republic of the Philippines to South Africa – to solve our staffing problems. But with tougher immigration rules, this is no longer feasible – at least not for a quick fix.

I am not going to ask for a clean neat solution, because I know one does not exist. But I would like to hear your thoughts.

John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry.

"Rain" - Lessons From A First Business

As I was flipping through the Dallas Morning News this morning, a small book review caught my eye. "Rain," is a new business parable that uses paperboys and the business of newspaper delivery as a case study. The author's 10 Customer Service Commandments are worthy of review in this rotten economic environment, where companies must compete more aggressively for the available business.

On a personal note, this review resonated with me. In my junior high and high school years, I, too, delivered newspapers for the Tyler Morning Telegraph in Tyler, Texas, a small city 1.5 hours east of Dallas. This was a time when kids on bicycles were a key part of the news distribution system. Not anymore. This is just another part of Americana that has faded from view.

Today, as Chairman of JohnMarch Partners, an international executive search consultancy based in Dallas, we have developed our own customer commandments. Our commandments govern our service, the quality of our work product and being accountable for the tenure and performance of our recommended candidates. Most search firms brag about service and quality. Few mention the word accountability.

With credit to the Dallas Morning News and the reviewer, Jim Pawlak, I want to share the book review with you:
_________________________

This business parable takes many of us back to our first job – paperboy. We didn't just deliver newspapers; we ran a business. We had to increase our customer base if we wanted to make more money. We learned and practiced customer service skills.

We dealt with our supplier (the newspaper) and knew the importance of on-time delivery (especially in bad weather). We managed delivery schedules around customer needs. We learned accounting and collected money.

Rain, the paperboy in this tale, reminds us of what should be done to build any business. Rain's 10 Customer Commandments provide the key to customer satisfaction: 1. Thou shalt not fail to deliver. 2. Thou shalt not be late. 3. Thou shalt not be sick. 4. Thou shalt not be on vacation. 5. Thou shalt not be at camp. 6. Thou shalt not deliver wet, damaged or incomplete papers. 7. Thou shalt not have bike trouble. 8. Thou shalt not get lost. 9. Thou shalt not be tired. 10. Thou shalt not make excuses.

Think about how these apply to your business.
_____________________________________________

In a final personal note, I must confess that at 4 AM, I struggled with Commandment number 9.

Jim Pawlak reviews business books for The Dallas Morning News.

John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry.

On Reference Checks, Background Investigations and Telling the Truth

This is the last in a three-part series on the resume. I hope some of these hints will be helpful to you in your next career search. Please let me know what you think.

References, Credential Verification, Background Investigations

These are important issues for candidates entering the job market. Managing this part of your job search is critical to your success. Before discussing the guidelines for these issues, it is important to establish some context concerning the job search process.

First, most jobs are not filled by outside recruiters. That is why establishing and maintaining a robust network of contacts is so important.

Second, when a recruiter contacts you, it is important to understand the type of recruiter you are dealing with – Retained or Contingency. Retained firms are client centered. This means that they are engaged by the client to fill a specific position or number of positions. The vast majority of the time, retained recruiters hold the exclusive rights for the position(s). They are paid for the work they perform regardless of whether the position is filled by the firm. Contingent recruiters, however, are paid only if their candidate accepts the offer. It is more common for clients to use several contingent recruiters for the same position. When this happens, it is possible to be contacted by different recruiting companies for the same position. Contingent recruiters who do not have an exclusive for a specific position are reluctant to share too many details about a job posting until they have your resume. The problem is that if two recruiters have your resume, and submit it for the same job, there is a chance that a disagreement over “ownership” may result if the client does not keep accurate records concerning who submitted the resume first. Clients do not want to find themselves in the middle of a fight between recruiting agencies over candidate ownership. If this does occur, the candidate may discover that they have been eliminated from further consideration. If a recruiter calls and offers an opportunity that sounds similar to a position for which your resume has already been submitted by another recruiter, ask the recruiter to name the city. Candidates do not want to give the second recruiter too much information because they may attempt to obtain the rights as a competing recruiter to work on the same assignment, thus creating more competition for the position. Use discretion.

When giving your resume to a contingent recruiter, always specify that your resume cannot be distributed to other clients without your prior verbal or written approval. Include that directive in your email when sending the resume. The vast majority of contingent recruiters are ethical professionals. However, there are numerous examples of situations where recruiters have used resumes, sometimes with all contact information, as a “tease” to capture an assignment.

References

There are no standards on the number of references a candidate should have. At a minimum, it is four or five. JohnMarch Partners requires eight: two superiors, two peers, two subordinates, and two personal references. Recruiters for certain positions may require additional resumes from former bosses.

The timing of the submission of references depends on the process used by the employer or the recruiter. Our Firm requires four references during the vetting process. Confidentiality – and possible negative repercussions from a current employer – is always a concern for candidates who are currently employed. This is understandable. In our case, we wait to check current employer references until an offer has been extended and the candidate has notified their current employer. However, as a rule, these offers are contingent on final background and reference verification.

Candidates should be very clear that the current employer or related parties should not be called. You should only provide initial reference information from colleagues who will respect your confidentiality. Recruiters will try to accommodate candidates who express concern that their interest in a new opportunity will compromise their existing employment relationship. However, candidates need to understand that few recruiters will submit a candidate without vetting their previous performance, which is why candidates should always be candid and forthright when asked about prior performance and professional employment relationships.

Secondary References

Ninety plus percent of the time, references provided by the candidates are favorable. Clearly, candidates are not inclined to provide the names of former employers or colleagues unless they know what will be said. That is why recruiters and the best employers will attempt to collect additional names to verify this information. These are commonly referred to as secondary references.

When asked to name others you have worked with in the past, candidates should be aware that these individuals might be contacted to verify certain information concerning your scope of responsibility, performance and even reporting relationships. A rule of thumb is to only mention names in your interviews that you know will be supportive if they are contacted.

Recruiters increasingly require candidates to sign release of information forms before they check references. This typically allows them to talk with anyone excluding those references that you exempt to protect confidentiality of your interest. If you mention a name that may have a connection with your current employer, specifically tell the recruiter not to contact that individual based on those ties.

Credentials

After several highly publicized events where candidates misrepresented credentials, employers and recruiters now routinely verify this information.

Remarkably, recruiters or employers will need your social security number and date of graduation in order to verify degrees. Most colleges and universities now use a national database company to process these inquiries. A valid social security number is essential in order to obtain that information. This raises the fear among some candidates of identity theft. That is why it is important to verify your recruiter, especially if you are dealing with a contingent fee firm about which little is known. There have been examples of people posing as recruiters asking candidates for social security information and even driver’s license information in order to conduct a preliminary background check. If this occurs, candidates should take steps to verify the authenticity of the recruiter and the assignment before complying with this type of request.

A common candidate mistake is to list a credential related to a professional association whose membership renewal was forgotten or allowed to lapse. It points to a candidate’s lack of attention to detail.

Background Checks

With increasing regularity, recruiters are now conducting background checks of their candidates. Fifteen years ago, recruiters who drilled down to this level were the exception. Eight years a recruiter with one of the largest healthcare search firms even asked me why I went to the trouble since the clients did not seem to care and were not requesting that service. Hopefully, times have changed for that firm.

Background investigation firms report continued incidents where candidates fail to disclose material issues: undisclosed arrests,material problems with personal finances, problems with credentials or unreported employment that is relevant to the search.

Contingent recruiters rarely go to this level of detail because of time and financial constraints. They have to move quickly to submit the resume in order to get the credit —and to be paid --if the candidate is hired. More often than not, employers are left with the responsibility for more in-depth candidate screening as well as the all important background checks.

At JohnMarch Partners, we complete a background review prior to the candidate’s face-to-face interview with the Engagement Partner. We routinely verify previous employment, academic and professional credentials, civil and criminal court filings, driving record, and credit history. Because we use outside investigators to conduct this work, our Firm falls under the rules of the Fair Credit Reporting Act of 1998. That law specifies the language of the release of information form. It also establishes rules concerning what information can be shown to the client. For example, credit reports may not be duplicated and can be seen only by the company making the request. At JohnMarch we report to the client only if there are any material findings related to employment, and we are precluded by law from providing the client with a copy of the actual credit history report.

Disclosing a prior mistake is not necessarily fatal to a candidate’s chances of landing the job. Failure to disclose usually is a deal killer. We view disclosure as a positive sign of the candidate’s integrity. However, there are certain types of issues that will disqualify a candidate, depending on the job. This will vary based on the ownership of the company, the job title, and/or scope of responsibility.

John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry.

Constructing A Resume

Last week, I posted some general comments on developing a good resume, and its importance in defining one's career brand. Today, I want to provide some specific suggestions.

There are a ton of so-called resume experts or resume doctors peddling their services. Some are good and some are worse than terrible. Everyone has an opinion on this subject so take what you read or hear with a grain or two of salt. These are my thoughts.

Use of templates

As a rule, candidates should avoid using templates that come loaded with the computer. Most of these tend to be dated or are inappropriate for a senior level executive. Most professional associations have career centers with on-line resume tools. There are a number of relatively inexpensive software programs for resume creation for those who are not part of an organization that offers this type of career support.

Formatting the resume

Rule number one: make it easy to read! White space is good. Judicious use of boldface and italicized type can help make the document more readable. The operative word is judicious.

In selecting a typeface, be cautious. This document was created using Verdana. The font size for this guide is 10 point because that is the default of this particular blog format. If you prefer a more traditional appearance, Times New Roman and Georgia are two excellent choices for traditional fonts. It is important to note, however, that Times New Roman is more difficult to read when using the 10-point size that many candidates select in order to squeeze their career into two pages. After you have read 30 resumes, the smaller the type, the bigger the chance that the researcher who is screening the document will miss something of importance.

Candidates should never use script or any of the stylized typefaces. Frankly, those typefaces scream, “Do not take me seriously!”

Length of Resume

There are no hard and fast rules for the length of the resume other than it should be proportional to your years of experience and accomplishments. Far too many candidates find themselves eliminated from consideration because they submitted a resume that did not provide sufficient information concerning experience or accomplishments. Remember, the resume is your first interview.

Use of Key Words

Some larger companies and recruiting agencies use computer screening tools for staff and entry level management jobs. That is why some resume experts recommend the use of keywords. However, resumes for executive positions typically are personally reviewed by a researcher or recruiter. Loading your resume with “keywords” in an attempt to grab the attention of a software screening program diminishes the brand of a seasoned executive.

Use of Career Objective Statement

I advise against including an “Objective” description at the top of the resume. Recruiter Larry Tyler once said that objectives are either too general to serve any useful purpose or too specific and will lead to elimination from further consideration.

Career Summary

I am not opposed to the use of the career summary. However, there is reasonable debate on both sides of this issue. I come down in favor of the summary if the summary provides an accurate and relevant description of a candidate’s experience and career progression. In other words, the summary is beneficial if it helps the recruiter quickly gain a sense of the candidate’s experience and accomplishments.

Contact Information

Candidate identification information – name with professional credentials, address, telephone number and email address – also known as the stack, should be constructed in a simple format. Candidates who attempt to be creative in hopes of attracting attention should remember that formatting which might elicit a negative impression is not worth the effort. Less is more.

John G. Self
325 North St. Paul, Suite 3910
Dallas, Texas 75201
(214) 220-1234 (o)
(214) 577-5540 (c)
[email protected]

Education and Credentials

Unless you are a new graduate, education credentials should be listed at the end of the resume. A master’s degree is NOT a professional credential and should not be used after the name. Only doctoral degrees should be used after the candidate’s name.

Fellowship in a professional organization like the American College of Healthcare Executives (ACHE) or Healthcare Finance Management Association (FHFMA), or certification as a public accountant, or clinical qualification such as RN, for example, should be placed after the name.

Employment

Again, make it easy for the recruiter and/or employer. I prefer a listing format that includes the organization, title and a brief italicized description of the business and scope of responsibility. It is important to include key metrics.

Clarity is very important. If you held more than one title (job) with a company, you should list the tenure with that company and then separately list each job with the dates you held that position. Listing multiple positions in one company – versus individually accounting for each job separately – will help avoid the appearance of job hopping.

Dot Pointing Accomplishments

One of the most common resume mistakes is to mix scope of responsibility with achievements in the dot points.

While candidates should list their jobs chronologically – from most recent to the first employment – a candidate’s accomplishments for each position should follow an old journalistic rule -- inverted pyramid. A candidate should always list their most significant accomplishment for each position first, not chronologically.

John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry.

Your Resume, Your Brand

GAINVESVILLE, Florida (Jan. 30, 2009) -- Today I spoke to graduate healthcare management students at the University of Florida. The seminar room was located not far from “The Swamp” – Ben Hill Griffith Stadium, home of the University of Florida Gators, our current national champions of college football. These are bright, motivated students, the future leaders of the U.S. healthcare system.

The topic of my talk was Career Management – Your Brand, Your Success, Your Life. At first, I sensed they were not really connecting with part of my title – the Your Life, Your Success part. After all they are young, attractive/handsome, energetic and bullet proof. What’s up with this talk on success? Isn’t success for a well educated graduate student a foregone conclusion? Not really, and I said so. They smiled, most nodded, but few were buying! I continued to try to make the connection, however, a certain sinking feeling led me to believe that I was sounding like someone’s father, a deadly comparison. They were polite. I plowed on and they begin to engage.

I spent a lot of time talking about the resume, that document which I describe as the core element of an individual’s brand statement. As senior executives we continually add to our brand through books published, articles written, blogs posted, and speeches presented, as we move through life. But the resume will forever be the root document of an individual’s professional brand.

Since the resume is so important, and given the vast amount of misinformation floating on the Internet and through so-called resume doctor consultants, I have decided that over the next several blog posts to offer my perspective on the resume – that of a partner in an executive search firm.

Let’s begin with an overview:

The resume is the candidate’s first interview.

OK, I have said this already, but let me blast this into your psyche one more time: the resume is the core document in clearly defining a candidate’s professional brand.

That is why the resume must be constructed with clarity and accuracy while emphasizing the candidate’s progressive scope of responsibility and record of accomplishment. The ideal resume should detail the career progression and accomplishments, beginning with the most recent position. The resume should include all positions of employment. It is critical that the resume be accurate concerning title, dates of employment, scope of responsibility and accomplishments. The standard of honesty and clarity applies to the listing of academic and professional credentials and affiliations as well. Statements that are cleverly (ambiguously) worded – designed to allow the employer or recruiter to make their own assumptions concerning degrees earned or credentials held, are in today’s market easily vetted and almost a certain guarantee of elimination from future consideration.

It is imperative, when sending a resume to a recruiter or potential employer, that the resume be current as of the date it is transmitted. One of the most common mistakes is to send a resume indicating current employment even though tenure with that organization has ended. This speaks to integrity and/or lack of attention to detail.

There are no hard and fast rules concerning the length of a candidate’s resume. It should be proportional to the years of experience, number of positions held and accomplishments. It is silly to suggest that a 30-year executive with a successful record of accomplishment can incorporate all relevant information into a two-page resume.

One final comment today: Always keep your resume up to date. You never know when that dream job will come along or, in this economy, when you get word that your job is being eliminated.

On Tuesday: Organizing the Resume
John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry

Wouldn't It Be Nice....

DALLAS, Texas (Jan. 12, 2009) Wouldn’t it be nice to use a search firm that provides you with video summaries of their interviews with the recommended candidates?

Wouldn’t it be beneficial to your organization if your search firm was willing to share the risks of the recruitment – financially speaking – and guarantee that you will be satisfied with the quality of their work product and the candidates they recommend?

Wouldn’t it be reassuring to work with recruiters whose candidate screening process is among the most in-depth in the industry and, accordingly, were willing to guarantee their C-suite placements for 36 months? Wouldn't a search firm that was willing to put a portion of their fee at risk, based on the success of their recommended candidate be a breath of fresh air in industry where many firms get paid whether they produce value or not?

Don’t you wish your search firm was so focused on your success that they constantly were looking for ways to improve service and to help you build a team that enhances your competitive position in the market?

John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry.