The other day I was asked about healthcare compensation -- CEOs, physicians and insurance company executives -- and how we could address the seeming imbalance.
Physicians, who understandably are frustrated with the constant pressure of cuts in their payments, have become angry because they realize the deal is stacked against them. Most of their glaring and finger pointing is in the direction of hospital system CEOs, and, no surprise here, insurance company executives, some of whom earn remarkably large salaries. Senior executives in the health insurance industry where generous base salaries, bonuses, delayed compensation and stock options can drive up annual compensation in excess of $10 million fairly quickly, have become a lightning rod for physician frustration and anger. The pay for health system and hospital CEOs also has risen but not as much, and besides, hospitals do not deny physician payments.
The imbalance in executive and professional compensation is not an issue that will go away in the estimable future, especially in the healthcare sector. As lawmakers wrestle with issues, and one another, over how to cut the deficit and the long-term debt, healthcare executives, physicians and other healthcare professionals will find themselves at the nexus of tough debates and policy decisions regarding funding, compensation, quality and increased accountability.
Although the cost of healthcare -- specifically Medicare -- is one of the biggest problems in the deficit crisis and any solution to reducing the debt, healthcare providers do not live in a compensation vacuum. Hospital CEOs who see leaders in other industries making far more for managing less complexity in operations, want their fair share. Indeed, over the past 20 years, executive compensation for health system and hospital senior executives has gradually improved. Physicians, citing their years of education, sacrifice, the demands of a busy practice and the ever -present pressures of accountability, oppose any cuts. In fact, they want more. For a professional group that was once at the top of the healthcare compensation food chain, they are frustrated with the fact that they are being left behind. This is only natural.
Here are three thoughts that hopefully will help us begin the long, and perhaps impossible, journey to regaining balance in executive and professional compensation.
1. Executive, professional and sports figure compensation is hopelessly screwed up. They are so far out of whack that we may never recover. The phrases common sense and executive compensation should not be used in the same sentence. Common sense is such a misnomer. It is pretty uncommon when it comes to comp issues in all of these fields. I point the finger at professional sports as one of the most visible and biggest contributors to what has become a ridiculous imbalance between pay, performance and any hope of reasonable balance. Those of us who follow baseball need to remind ourselves that there are very few jobs in life where one can fail 7 times out of 10 and still be a star and make a huge salary. In a society that frequently relies on lawsuits to adjudicate a clinical outcome that did not meet a patient's expectation, however silly or unreasonable, the skyrocketing pay for many professional athletes must drive physicians nuts.
2. While I am sympathetic to the complaints of physicians regarding compensation, I know this will not be an issue that is never successfully resolved. As we amble through healthcare reform, whether it is with PPACA or the result of the debt reduction crisis, everyone in the healthcare industry will end up with less, unless they can demonstrate exceptional, measurable, verifiable value, and even then, they will probably still get less, just more than those who fail to meet tougher standards. Accountability, performance and results will be key for physicians and professionals who want to hold the line on what they charge or will accept. Our deficit/debt issues are so big, so potentially cataclysmic, that anyone in healthcare who does not believe that we will take a hit is just not in touch with the math. I wish there was way to avoid compensation pain, but I doubt there will be. Part of the problem is that hospitals, doctors and other healthcare professionals sit on the sidelines waiting for the change. We NEVER lead change. That is why we can be compared to the country dog that came to town: “if you run you get screwed, if you stand still you get screwed. “ We have become adept adapters, not leaders of structural change.
3. Mohamed A. El-Erian and his colleagues at PIMCO refer to our current economic mess as the "New Normal." PIMCO is the largest bond fund in the world and they just announced they are not buying any US Treasuries for a while. The rating agency, Standard and Poors, has now fired another shot across the bow of our government hoping to generate action on deficit and debt reduction. As I survey this economic jumble, our "New Normal," I am reminded of Winston Churchill's great line about the US: that we will do the right thing AFTER we have tried everything else. He may have been referring to our involvement in World War II, but his statement was prescient of the path to resolving problems that America tends to follow. Well, we have just about tried everything else and the options for cleaning the nation's financial disarray will be painful. Unfortunately, the coming economic reset for physicians and other healthcare professionals will be frustrating and unfair.
I thought about incorporating the theme of shared sacrifice as one of my three points, but that would only have earned me the tag of "insufferable idealist."
© 2011 John Gregory Self
The telephone interview is a killer.
More potentially good candidates are eliminated from consideration based on their performance at this stage of the recruitment process than at any other time.
Everyone is blind. You cannot see the candidate. They cannot see you. This gives the interviewer the advantage. But badly executed, the telephone interview can lead to premature elimination.
Game Plan: The interviewer must be prepared. Not only should they have carefully studied the resume, but an interview game plan is critical: What am I trying to accomplish? What do I need to know about this candidate to make a decision for continued consideration or elimination?
Selling-Recruiting: I believe that in the telephone interview stage, you are still very much in the selling-recruiting mode. Be sure to give the candidate a chance to ask questions. I prefer to do this at the outset to avoid wasting time if in the Q&A time it is determined that the job is not a fit. Remember, the candidate may be superbly qualified, but if you do not sell them, this interview could be a waste of time.
Provide the salary range: This is of critical importance. Be sure you provide the candidate with the base salary range. If there is flexibility, say so. If there is not, make that clear as well. I cannot tell you how much time is wasted qualifying candidates who would never accept a position with the established salary range. This is far too common even with contingency recruiters. Never assume that the candidate knows this critical piece of information. If there are other potential "deal breaker issues," this is the least embarasing time to disclose those as well.
Interview agenda: I am not a big fan of overly long telephone interviews. You will reach a point of diminishing return around the 90-minute mark. Most telephone interviews are much shorter -- between 30 and 60 minutes in length. With time constraints, you need to have what I call an interview agenda. When you start, tell the candidate what to expect in terms of the subjects that will be covered and in what order.
Interview forms: After interviewing five or six candidates for the same position, they all begin to run together. Having a complete, accurate record of the interview is important. It is also important to ask the same types of questions of each candidate. We develop a telephone questionnaire for each search. The telephone questionnaire is computerized. It is comprised of a chronological "walk me through your resume" section as well as questions that relate to specific job challenges. The questionnaire has protected form fields which allow the interviewers to tab through as they type notes of the candidate's responses.
Candidate screening process: You cannot be effective in recruiting without a defined processes. At JohnGSelf Associates, our candidate screening process is based on Dr. Brad Smart's Topgrading©, an exceptionally effective, but in-depth interviewing system. We break it down into a three-stage interview process. The resume review is the first interview. In the telephone interview, the second stage, we focus on prior employment, selected behavior and values questions and several questions designed to measure whether the candidates can actually do the job for which they are being recruited. The final stage, is a 3.5 hour in-depth face-to-face interview, a portion of which is videotaped for presentation to the client when they are selecting which of the recommended panel of candidates they want to invite for a site interview. I will address that interview in my next blog.
Grading the candidate: We grade candidate performance at each stage of the recruiting/interview process. That is why it is so important to have defined recruiting and screening systems. The grading process is linked to the selection criteria, prior experience and accomplishments and the performance deliverables. In a highly competitive search, this grade will determine which candidates are selected for continued consideration.
Respect the candidate: Finding a job is about dealing with rejection. Unless the position is super specialized, there will always be more candidates than positions. Treat the candidates with respect from the moment they submit their resume to the moment they are rejected or employed. How you treat your candidates is a very important component of your organization's recruiting brand. If you have a reputation for not responding to candidates and of not regularly communicating with them regarding the status of the search, you will find over time your recruiting brand will suffer.
There is no excuse for not treating candidates with respect.
© 2010 John Gregory Self
Seed Newsvine
But the storm clouds of change are forming.
On Wednesday I will introduce you to a new approach, transformational recruiting, that will produce superior results in these challenging times.
Next: Transformational
Recruiting
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Times are tough. The number of executives who remain out of work is staggering. They are, understandably, concerned. Some are scared. Others are panicked. You cannot blame them. Many people are at risk of losing everything they have worked a lifetime to accumulate.
Working from posh offices, Vultures posing as career counselors and coaches are luring out-of-work executives with phony job interviews. It is a scam. Here is how it works: The executive receives a call from a "Gina" or "Jan" -- personable and engaging assistants -- telling the out-of-work executive that their name surfaced in research and that the Senior Vice President or the Partner would like to interview them for a top-paying job that seems to fit their profile perfectly. When the executive arrives, he receives a little career insight about his resume or experience but, in the end, the meeting turns into a full-court press to have them sign up for job placement -- usually for a fee ranging from $5,000 to $6,500 as was the case last week in Houston. These people call themselves coaches, career counselors or some other catchy current title of the month but what they really do is take people's money and produce very little in return.
These "career coaches" have been at this "game" for a long time, and they are good at it. They are not to be confused with the thousands of outplacement counselors and career coaches -- certified or not -- who provide a legitimate service with real value. No, these people work for franchises of a company that traces its history back to the late 194os and which, for many years, provided a legitimate service, for a fee, to people who were looking for a job. However, along the way, some investors and executives with questionable pasts, hijacked the concept and they are hurting desperate executives and the reputations of honorable career consultants.
They justify their fees by saying that their "secret database" costs more than $200,00 a year to maintain. Some even suggest they know about jobs that no one else knows about, prompting one career counseling victim to call it "the phantom job market." In another case, an information technology manager, skilled in managing software developers, was told by "Gina" that they were calling about a great job with Hewlett Packard. They set up a screening interview with the Senior Vice President of the counseling company for the next day and the unsuspecting candidate walked in to a high pressured sales pitch to pay $5,500 to get access to HP's job. If the candidate had only searched the HP website, he would have seen a description for a position that sounded almost exactly the same. They even encourage candidates who are strapped for cash to borrow from their children, relatives or friends.
If you fall for the pitch and sign their contract, there is little anyone can or will do to help you get your money back. The contracts are virtually airtight, one state attorney general said. Some agreements even have non-disclosure clauses that preclude the duped job seeker from disclosing any of the company's information.
How do they get the candidate names? The Vultures, like legitimate recruiters, use job boards to find their targets which suggests that candidates should think twice about posting their career information in hopes of landing a job. What they are really inviting are telemarketing calls and email spammers.
So, if you hear from "Gina," "Jan," or some other assistant -- they are usually women -- with a friendly personality, slow down and start asking questions:
Outplacement consultants are paid by the employer and it is almost always a component of the severance package. It is better to find one who is industry specific. Legitimate executive or career coaches are not necessarily experts at helping candidates find a job. If you are out of work, and you feel the panic building, fight the temptation to want to believe some salesman's glib pitch. If you cannot find a colleague in your sector who has heard of, or been contacted by "Jan" or "Gina," or has heard of the organization's name, then, as my grandmother used to say: "If it sounds too good to be true, it probably is."
For all those legitimate counselors and coaches, pay attention. Your industry's reputation is being tarnished by skunks who prey on people's fears and vulnerabilities.
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There is opportunity for expense reduction with our people assets in many healthcare businesses and I am NOT talking about cutting salaries or benefits. For health systems, hospitals and other healthcare provider organizations looking to improve expense management of their human capital, one important answer can be found in developing a best-in-industry integrated onboarding program.
In some hospitals and healthcare organizations, the expense reduction potential is so plentiful that it is hard not to step on the low hanging fruit.
Why is onboarding the answer? Onboarding brings to the executive table a sense of strategy, focus and financial discipline in terms of talent acquisition and management that cannot be achieved by any other method. It also drives some important so-called hidden benefits.
In measuring the potential for your organization, you first need to focus in on your real cost of turnover. As a former hospital, EMS system and homecare pharmacy CEO, I cannot think of a good reason not to come to grips with this number. I will always remember the face of a CEO, when he was told by his CNO, and affirmed by the CFO, that the cost of nursing turnover – which at the time was running at 18 percent - was on average, $60,000 per nurse. He was stunned. When he did the math, he was appalled. Nurse turnover was costing his organization more than $7.8 million a year. When he combined the nursing division with other departments, where the turnover was admittedly much lower, his costs were more than $8.8 million.
A high turnover rate is one important measure by which you judge whether a comprehensive integrated onboarding is a smart investment for your organization. However, as the television hucksters like to shout, “But wait, there is more…”
There are other benefits that will produce significant improvements that will trickle down to healthier margins from implementing an integrated onboarding program. They include:
• Creates a framework of discipline for all the organization’s recruiting
functions. This translates into an improvement in the number of quality hires your organization makes. In an era when the war for talent will determine the winners and losers in a market, winning this battle for the best employees is mission critical. Better employees equal better results.
• Improvements in recruiting will result in lower cost-to-hire benchmarks as you rely less and less on external recruiters to identify managers, director-level candidates. Why pay fees of 25-30 percent of the first-year base salary when essentially what you receive from far too many recruiters is a resume? There IS a better, less costly way!
• Surveys show that more than 40 percent of hires produced by external recruiters – in all sectors at all levels -- quit, are forced out or are fired within 18 months. That is an astounding little secret that the recruiting industry would just as soon that you not know or act upon. (At JohnMarch Partners, our record of success is 4 times better than the national average.) A comprehensive, integrated onboarding program can help you dramatically improve your success rate in recruiting.
• The war for talent has already shown its ugly head with physician recruitment. Physician recruiters will certainly agree on that point. Recruiting clinical physicians is an extremely difficult, expensive and frustrating process, given the fact many physicians do not approach this from a business perspective. They may commit to your organization and change their mind – two or three times – without even bothering to tell you. Once you wrap up a deal, you not only have the Return on Investment target to achieve, but you also must protect the investment from poachers – other recruiters who will call weeks, months or years later and offer a better deal. A comprehensive, integrated onboarding program that creates an emotional family-like tie to your organization and helps protect this investment is one of the most inexpensive strategies available. Moreover, when a properly structured onboarding program is applied to physician recruiting, it takes the CEO and physician recruiter out of the unenviable role of being pressured by a big admitting physician who sometimes is less concerned with the government’s rules than the money (income guarantee). Moreover, it establishes a foundation for the medical executive committee and their representatives on the physician recruitment panel to clearly define what is, and what is not, acceptable. Given the federal government’s determination to go to the mat in investigating and prosecuting Medicare fraud, creating a comprehensive onboarding plan that establishes a formal structure for physician recruiting and includes all new physicians who join your medical staff, you are missing a potentially significant opportunity that most hospitals cannot afford to put off.
When you do the math – add up the direct savings from reduced turnover, etc. – and factor in the indirect cost management benefits of having better, more productive and empowered workers who make an emotional commitment to your organization, this proposition is, to borrow a sports phrase, a real easy “slam dunk.” A comprehensive integrated onboarding program is one of the few easy win-win decisions a Chief Human Resource Officer can recommend to his or her CEO.
Finally, when you select a consultant to design and implement your onboarding program, be sure they understand – deeply understand – human talent acquisition and talent management. Not every human resource consultant or organizational development specialist understands recruitment. The recruiting process is such an important part of the onboarding program.
You will not achieve the results you seek without a gold-plated recruiting program.
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.
John is a highly rated speaker on talent acquisition and talent management, on inspirational leadership, career brand management and the future of healthcare in America. To contact Mr. Self regarding a speaking date, contact him at JohnMarch Partners.
You can contact Mr. Self at 214.220.1234 or [email protected]. He is an active member of LinkedIn and a frequent editorial contributor. You can also connect with John through his Facebook profile.
He was an early adopter of social media through his membership in PLAXO.
Or, you can follow him on Twitter at Self_JohnMarch.
What does your recruiting process say about your company?
That is a compelling question that employers seeking top talent should ask themselves.
Why? Consider these recent, real-life examples. Then decide if you are paying enough attention to this critical issue, and whether your recruiting process is helping or hurting your company.
An experienced, respected practice manager applies on-line to a major ambulatory care provider which is touting itself as an employer of choice. The candidate, well aware of his value, never hears from the company. Not even the perfunctory automated response. The candidate researches opportunities with a competitor in the same geographic area, interviews and accepts a job. One way he then competes with the “employer of choice” is by partnering with his company’s human resources department to more effectively recruit top talent away from the ambulatory competitor that he contacted first.
An in-house recruiter responds to an excellent candidate’s on-line application. Invites her for a telephone interview and compliments the applicant via email. As requested, the candidate calls the internal recruiter and sends a follow-up email. The recruiter does not return the call. The applicant again follows up via email. The recruiter is never heard from again. The candidate, who is local, moves on to work for the competitor in another market. Months later, the company who advertises itself as patient and employee focused, must spend more than $15,000 in recruiting and relocation expenses to fill the critical position.
Executives submit their resumes, a recruiters call, they talk and then….nothing. Not a thank you. No regrets letter or email explaining why they are not interested. Nothing.
It is what candidates caustically call the “black hole of no action." It is this lack of consideration and professionalism – difficult job market or not — that they warn other executive and director-level candidates about in the rapidly expanding social networking process.
A company’s recruitment brand communicates its unique image to both employees and candidates. It reflects what the company stands for, why candidates should come to work for it and why they should stay. A company’s recruitment process is the first way it tells prospective employees if it lives up to its promises.
After spending thousands on brand advertising, recruitment tools, and internal and external recruiters, the company produces the opposite effect it desires by acting as if the talent pool is endless. In healthcare, it is not. Yes, for certain positions, the pool of candidates far exceeds the number of jobs, especially at the senior level. But not in nursing, allied health, laboratories, diagnostic imaging or ambulatory care management. How the company treats its candidates and its employees is critical to its recruitment brand and its ability to attract and maintain the best people…in the short and long-term.
One market leading company has such a bad reputation with their candidates and employees that an independent web site was created that is so disparaging of the company and is so negative that it is slowly destroying the organization’s recruiting brand. The CEO and senior management seem oblivious to the assault.
In healthcare, as reimbursements decline, there will be fierce competition for talent. Healthcare organizations with the best employees will have the best and safest care and the lowest costs. Their competitors, with an inconsistent work force and a higher turnover, will have lower quality and higher costs because there IS an established correlation between the two.
Managing your recruiting brand must become an important pillar in your organization’s strategy to hire and retain the best work force. That is why this is so important. That is why healthcare organizations, which will be forced to operate in a new economy of reimbursement, must move this issue into the top-tier of their priorities.
To be an employer of choice, to attract the best and the brightest, your brand must be the best of the best. You must support your brand, you must install and maintain a best-in-breed recruitment process. To get from where you are today, to where you will need to be in the next five years will require an investment in updated web technology and the implementation of best-in-breed recruiting practices. This includes candidate sourcing, consistent communication and screening, and processes that will insure that you take timely action so the best candidates are not swept away by your competitors.
You start by finding out where you are today. The big surprise for most hospitals will be that you can solve this problem without breaking your bank.
The cost of human capital is the biggest piece of every organization’s budget. This is why JohnMarch Partners has expanded its portfolio of services from executive search to offering Onboarding, recruitment advisory services and interim solutions.
John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is 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.
John is a highly rated speaker on inspirational leadership, career brand management and the future of healthcare in America. To contact Mr. Self regarding a speaking date, contact him at JohnMarch Partners.
You can contact Mr. Self at 214.220.1234 or [email protected]. He is an active member of Linked In and a frequent content contributor. You can also connect with John through his Facebook profile.
When then Governor Bill Clinton of Arkansas was running for President, his War Room led by political operative James Carville crafted a message that resonated with frustrated voters:
“It is the economy, stupid!”
Whether you agreed with Gov. Clinton or not, that theme made a huge difference with voters.
For healthcare today, in times of unparalleled challenge, there is a similar call to arms:
It is the people!
Those organizations who recruit, hire and retain the best people will win out in the market.
Human capital, our employees, are our most important asset. Apparently, we buy into that reality since hospitals print that very truth in their annual reports year after year.
We cannot control the actions of Congress, our physicians, or the insurance conglomerates that, for all practical purposes, dictate our financial future with the wackiest of rules. However, we can control the quality of our human capital. When we have the best people we can also control the quality of our care, patient safety, and patient and physician satisfaction.
Human capital – your employees – can differentiate you in the marketplace.
What are you doing to ensure that your people are the best?
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. He is an active member of Linked In and a frequent editorial contributor.
A valued CEO colleague and friend recently shared an amazing story. A multi-specialty clinic that is located adjacent to his 140-bed community hospital had recruited more than 40 physicians over the past ten years, an impressive number given the rural nature of the community.
Unfortunately, 30 of the 40 left the practice and the community. Others are on the verge of calling the moving van.
The reasons for the turnover are among the top 10 in the annals of dysfunctional physician recruitment: a compensation plan that clearly favored the senior partners whose productivity was slowing as they enjoyed their status, a misdistribution of Medicaid and uncompensated patients to the new recruits, and an arrogant managing partner who refused to listen to reasonable advice from the hospital’s leadership team, all the while bullying his partners into silence.
The clinic’s leaders were only too glad to take the hospital’s help when it came to providing hundreds of thousands of dollars in net-income guarantees and relocation assistance, but when it came to listening to the counsel of the hospital’s leadership team regarding strategies for eliminating or dramatically reducing the turnover, well, the managing partner was not interested. In fact, you might say they were downright rude.
What a shame. The hospital no longer is willing to underwrite the cost of recruiting for what could have been a powerhouse multi-specialty clinic. They are building their own group despite the angry protests from the clinic board that the hospital is engaging in unfair competition. The clinic’s senior partners, who seem to know everything they needed to know about management, clearly had not thought this issue through.
I am betting they never bothered to calculate their financial losses from such a horrendous turnover: more than $10 million down the drain.
That loss must be one of those hidden expenses that seem to drive up the costs of healthcare.
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. He is an active member of Linked In and a frequent editorial contributor.
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This post is the final installment in a series of columns on Onboarding, the process of acquiring, accommodating, assimilating, and accelerating new team members, whether they work within the organization or, in the case of physicians in private practice, are independent contractors. Today’s question is why would a health system or hospital invest in onboarding a physician they recruited for private practice?
There is obviously a host of reasons. For the purpose of this column, let’s focus on the obvious: that it makes economic sense. We are entering a healthcare era of increasing competition where the battle for talented physicians is intense and shortages are a reality. This competition will produce a new range of expensive challenges for health systems and hospitals that could affect market position or even their very survival.
While some hospital executives struggle with the question regarding who their customer really is – the physician or the patient – for the time being, we need to cut this debate short.
It is the physician. Occasionally the patient, but primarily most admissions come from physicians who are members of the active medical staff. Yes, these same physician customers can be our competitors, frequently in the same day. The physicians become our competitors when they actually admit patients to the specialty hospital, or ambulatory care or imaging center in which they have invested and realistically expect a distribution of profits versus the dreaded cash call.
This changing physician/customer landscape is frustrating for hospital CEOs. Hospital leaders seeking to solidify their physician relationships should focus on the physician’s underlying need – to improve financial security for their families and to enhance the quality of their medical practice experience.
While it is not realistic to assume that all of the physicians you recruit will forever resist the investor-owned lure of promises of higher profits and a more efficient work environment, CEOs are beginning to realize that an effective onboarding program – backed by a real commitment to a physician/customer-centered business model – will mitigate the risks. Like executive or employee onboarding programs, a physician program should not be a one-day, one-time experience. The first day should include a review of the hospital’s strategy, including their medical staff development plan, and a review of the organization’s mission, vision and values in terms of how those elements of the organization’s culture are integrated into all levels of the organization on a day-to-day operations and decision making. Meetings with key members of the leadership and management team with whom the physician will interact on an ongoing basis can be another productive part of a first-day schedule. Lunch with the Chiefs of Service and Medical Executive Committee who will emphasize the organization’s focus on quality and safety, and a special end-of-the-day dinner with key physicians, executives, and wives is a nice way to complete the first day of what should be an ongoing, relationship-centered process.
All physicians – but especially new recruits – should be assigned to a member of the executive leadership team who will take ownership of the relationship, much like bank officers nurture customer relationships.
Physicians, especially younger physicians and those who are starting out in practice are typically not equipped with necessary business skills. They do not always understand the importance of banking relationships. Practice and human capital management are generally not included in the pre-med degree plan and certainly is not part of the medical school curriculum. My 33 years of healthcare leadership experience has shown that the wizened physician practice veterans do not always take the time to coach the new recruits. In one rural group practice that has recruited 40 physicians over the past 10 years, more than 75 percent of the doctors who were recruited to the community at great expense have left the organization and the community, as the result of a strong non-compete provision in the employment contract.
Like executive and employee onboarding, a similar program tailored to the needs of your new physicians is an important strategy to maximize their community benefit and eliminate costly turnover.
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. He is an active member of Linked In and a frequent editorial contributor.
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].
CHICAGO (March 23, 2009) – As the American College of Healthcare Executives (ACHE) convenes its annual education Congress today, the military is out in force. These healthcare executives from the military’s highly regarded Medical Service Corp (MSC) run our Army, Navy and Air Force hospitals and ambulatory clinics at bases throughout the U.S. and around the world.
They are gathering with thousands of their civilian counterparts for four days of intense education covering topics such as quality, patient safety and satisfaction, physician-hospital alignment challenges, regulatory compliance, finance and even reimbursement. Military officers attend the same classes with their civilian counterparts because there are so many similarities between the two types of healthcare operations. Yes, there are some differences but those are far fewer – and minor in scope – than most civilian healthcare CEOs or their recruiters would imagine.
In addition to attending the myriad of educational sessions, many of the military personnel are here for career networking. Dozens are preparing to transition to, hopefully, a similar role in a civilian healthcare sector.
These officers are some of our best and brightest. They know how to lead. They know how to execute and produce anticipated results. They know how to work with physicians, manage to budget and compete for revenue. They have the same education and professional credentials as their civilian colleagues. Many have had the opportunity to pursue additional degrees and in-depth training programs to sharpen their leadership skills, their analytical ability, or to master the latest thinking concerning health system design and delivery.
The military does NOT cut corners when it comes to investing and developing their leaders.
Why, then, are these proven leaders not viewed as a choice “catch” for the executive teams of healthcare organizations in the U.S.?
The answer is that they face a wall – a formidable barrier -- built of years of accumulated myths, a lack of understanding of how military hospitals operate, or, often, even a preference for “safe” candidates, those candidates whose background and career path is like their own.
Some of these myths include:
1. Most military officers hold, on average, four jobs in their first seven years following retirement.
Yes, a study reported these results. However, those numbers are significantly skewed by including the officers from combat and support divisions where the command structure and leadership style are, in actuality, markedly different from the MSC, according to former officers I have interviewed and who have successfully completed the transition.
2. The military’s leadership structure, the privileges and the forced respect of commanders creates unreasonable expectations that are incompatible in the civilian workplace.
This myth usually draws the biggest smiles – even some hearty laughs – from military healthcare executives. On average, 65-70 percent of all employees at military healthcare installations in the U.S. and overseas are civilians. That fact alone illustrates why there is much less of the formal military culture in their hospitals – less saluting and less commanding personnel to perform.
3. MSC executives have a captive workforce that is compelled to follow orders. This makes running a military hospital much easier than a civilian facility.
This, too, is incorrect (See number 2 above). MSC civilian employees need and want the same type of inspiration, coaching, mentoring, and encouragement as their counterparts in civilian hospitals. Issuing commands, shouting orders, dictating performance, or other types of command behavior that is more evident in combat units does not work in military hospitals, Walter Reed included.
4. Military healthcare executives do not understand civilian labor relations issues.
Not true. Surprisingly, the civilian workforce at military hospitals in the U.S. and at many bases around the world, are unionized. Colleague and friend, Col Tom Driskill (retired), who was Chief of Staff at Walter Reed and Trippler Army Hospital in Honolulu, among others, said that labor negotiations in the military could be every bit as tough as those in a civilian closed shop union environment. Officers who do not maintain effective labor relations will have a tough time meeting their performance targets, and this could materially affect their career outlook.
5.The military does not hold its hospital executives to the same standard of accountability.
This myth is wildly off target. MSC officers know that they might survive one bad performance review, but not two. Two poor performance reviews typically means you will not advance to the next rank. In the military if you do not advance, you retire, you are asked to leave or you are forced out. If you do not qualify for retirement at that point, you will lose everything that you have invested in your career investment.
The military’s culture on accountability is tough. It is unforgiving. And it is very different from the civilian hospital culture where the “up or out” mentality does not exist. While this can potentially create transition problems for some officers, this can be handled through an effective “onboarding” program.
Are there bad leaders in the MSC? Yes, as is certainly the case within civilian healthcare organizations. Nonetheless, civilian leaders need to take a hard and long look at the MSC’s deep pool of talent. They will find great leaders with solid work experience who can and will deliver exceptional value.
They are, after all, among our best and brightest with solid work experience.
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].
