John is an executive recruiter & speaker sharing his thoughts on healthcare, recruiting, digital technology, career management & leadership. 

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Michael Lewis: Boomerang: Travels in the New Third WorldMichael Lewis: Boomerang: Travels in the New Third World Next up on my reading list. Lewis, author of Liar's Poker, The Big Short and Money B
7 November, 2011 Posted by John G. Self
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22 August, 2014 Posted by John G. Self Posted in Career Management, Healthcare
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Traditional Outplacement: One Candidate’s Experience

Rebecca was devastated.  Losing her job had been a constant thought in the back reaches of her mind given healthcare reform and her hospital’s focus on reducing operating expenses, but she was always reassured by colleagues.  She was a top performer with great performance reviews.

employee terminationBut when the unexpected meeting with her boss came, the letter he gave her and the termination agreement made it all too real.  Nine months severance with health benefits and outplacement support gave her some financial cushion for her savings and help with finding another job.  She would have preferred to have had the money but the outplacement was a take it or lose it provision of her agreement.  The organization had a contract with a nationally known outplacement firm that happened to have a nearby office.  Again, there was no negotiation — use our firm at our price.

From there it went downhill.

She scheduled an appointment with the outplacement firm and was assigned a consultant.  When she arrived, she met with the consultant for about 45 minutes, a certified consultant, according to the business card.  The emphasis of this first meeting was on the resume.  She was given an appointment for a follow-up class.

When she arrived, four days later, she was ushered into a large meeting room.  There were rows of chairs and people milling around waiting for the class to start.  Instead of a room full of professionals, they seemed to be a hodge-podge of industries and different skills sets.  There were very few executives in the room; little of the information that was shared with the class was applicable to executives.  And that is when her sense of dread began to build.  In her second meeting with the consultant, she received more, non-specific guidance that did not seem to apply to an executive such as herself.  The certified consultant had little to offer except what was in the company’s scripted job search template.

In the end, Rebecca turned to a friend from another hospital’s HR department to fix the mess created by the outplacement firm and only then did she begin to get calls from potential employers.

It turns out that her counselor, certified by the company she worked for, had little healthcare experience and her focus on the resume and the company’s generic bag of job search tricks, reflected it.

How healthcare providers deal with severance for executives and managers covers the gamut, from nothing, to paying whatever the outplacement firm commands.  In the early days, the firms priced their services somewhat like recruiters, a percentage of the executive’s outgoing base salary, but cost concerns have all but killed that sort of fee structure and now the going rate seems to be $10,000 to $20,00o per executive.  However, that new range, too, seems to be under attack by shrinking reimbursement.

Here are some questions to ask a potential outplacement consultant:

  1. Have you had experience as a senior executive looking for work?
  2. How long have they worked in the outplacement industry and what relevant industry experience do they have?  (Hint: if they do not have a depth of knowledge of healthcare, that should be a red flag.)
  3. Who provided their certification and what were the requirements for obtaining the credential?
  4. Does the fee afford them ongoing career transition support, or is it limited to a certain number of hours/counseling sessions, etc?
  5. What is the emphasis of their advice?  Does it focus more on producing an updated resume rather than providing candidates with the concepts and relevant tools that can become a permanent part of career management knowledge?

Financial challenges in the healthcare sector means that executives who are part of a reduction in force need to be better prepared before agreeing to a severance agreement.

© 2014 John Gregory Self

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20 August, 2014 Posted by John G. Self Posted in Healthcare
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Healthcare Workers: It Is Time For A Little Honesty

To the employees of healthcare providers throughout America: It is time to be truly honest with yourself.  It may mean the difference between keeping your job or losing it.

Old Way or New WayDo you like change?  If the answer is an emphatic no, or perhaps the more benign, “no, not really” then ask yourself — again, be honest — can you learn to adapt?  If the answer to both questions is no and you are a manager, department director or a member of the executive team of a healthcare provider, then know this: the chances that you will survive the transformation of healthcare in the U.S. are less than 50 percent, according to the unofficial oddsmakers I know.

I know a lot of healthcare executives, directors and managers who admit they can change, especially with rumors of an imminent layoff circulating like a wildfire on a hot day, but in the end they cannot help themselves and they dig in their heels, either overtly or, more troubling, covertly (read: passive/aggressive behavior).

Here is the immutable truth you cannot change: the biggest disservice you can do to yourself — your reputation and your career brand — is to play along that change is OK, maybe even feign some excitement that it is necessary, and then try to ignore it, or worse, try to sabotage an organization’s efforts to adapt by not executing successfully.

The employee rating system popularized by Jack Welch, the legendary former Chairman and CEO of GE Corporation says:

  • A employees are the gold standard.  They embrace change, work in a self-directed manner, they volunteer for risky assignments and they welcome the challenges that economic, regulatory or competitive forces bring to the stage.
  • B employees are the salt-of-the-earth types.  You have to spend more time with them, directing and coaching, but they are conscientious.  They represent the largest percentage of your employees, if you are a Bell Curve devotee.  They may be fearful of change, but they can think things through and move forward with the support of their boss and A colleagues.
  • C employees require that you spend more than 60 percent of your time ensuring that they accomplish the basic stuff in a day’s work.  They mean well but they lack the internal drive to be an A.  With help they can become a B but it will take effort and time.  The vast majority of Cs specialize in fear and resistance to change and their subspecialty is passive-aggressive behavior.  This is the second largest group of employees in most organizations and it is this group that can sink your ship if you are a CEO.

So, if you tally up your fear-of-change employees in the B and C categories, you can easily see that is a big group that will need a lot of help.  Helping them overcome this deep-seated fear will take time and money.

Now is probably a good time to start.

© 2014 John Gregory Self

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18 August, 2014 Posted by John G. Self Posted in Healthcare, Leadership
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Breaking Eggs: Preparing Your Team For Change

There is an old cook’s adage — you have to break eggs to make an omelette.

As healthcare providers begin their uncertain journey from a sick care/pay-for-procedures business model, this phrase will become an immutable truth for healthcare leaders as they navigate the challenges of making transformative changes to how they deliver and staff the care to their customers.

How an organization responds to this oncoming freight train — we can see its light at the other end of the tunnel — is dependent, in large part, on how the Chief Executive Officer prepares their teams emotionally and intellectually.

Source: Flickr

Source: Flickr

Making these sweeping changes will require that we break some eggs.  We will have to change things we are comfortable with.  We will have to recognize that hospitals may not be our core business in just eight to 10 very short years.  We will have to do more with less because we are going to be paid a lot less.

Lets start by saying that the Patient Protection and Affordable Care Act, also known as ACA or Obamacare, for all of its benefits, has some serious flaws that should be addressed.  Now, this post is not intended as a camouflaged endorsement of, or an attack on, ACA.

There has rarely been a perfect piece of legislation voted on, much less approved, by the Congress that did not have flaws/issues, even silliness, that needed to be addressed when someone finally got around to reading what the law actually said.  That was certainly the case with the GOP sponsored Medicare pharmacy legislation, also known as the Medicare Modernization Act, which passed in 2003 during a highly unusual three-hour roll call vote in the middle of the night, and went into effect in 2006.  In fact, one of the last tweaks to that bill was contained in the aforementioned ACA, revising the dreaded, so-called Do-Nut hole covering beneficiary deductibles.

Even if the GOP wins the Senate and the House, unless they gain a veto-proof majority, or the Supreme Court mortally wounds it on their second bite of the appellate apple in a year or two, ACA is probably here to stay, the threats of Rush Limbaugh to leave the country notwithstanding.

So it behooves all senior leaders, their political point of view aside, to educate their employees, physicians and other community stakeholders with a matter-of-fact review of the various elements of this rather large bill, the even larger set of regulations, and the litany of potential and perceived unintended consequences.  Trashing healthcare reform in management and medical staff meetings and in community forums, as I recently witnessed, may make you feel better if you are opposed to the bill, but it will not serve you well when you have to begin adjusting your operating culture to make the new business model work.


Leaders need to be mindful of this key human law: the vast majority of people, and employees, are reluctant to change.

When leaders rant endlessly to their managers against a piece of legislation they do not like (ACA), when they regularly voice gloom and doom over a virtual certainty — that we will have to change the way we do business because we cannot afford not to — it will just make it harder to succeed when the time comes.  Not succeeding may mean that our patients are placed at greater risk or that a community which depends on their healthcare system to ensure a better quality of life, is poorly served.

We should be able to break eggs, improve our system and do a better job for our patients/clients.

© 2014 John Gregory Self

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