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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27 July, 2015 Posted by John G. Self Posted in Technology
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Good Technology, Bad Technology

Posted July 27th, 2015 | Author: John G. Self

Technology and automation have revolutionized the world.  Technology and automation also have enabled some very bad habits that can have nasty consequences.

A captain with a major US airline once told me that the Airbus jet he flies, is one of the most automated, technologically advanced airplanes in the sky.  He added, however, that there was a downside to that level of sophistication.  “It makes a bad pilot average.  It makes a great pilot average.”

healthcare technologyYears earlier, a General Motors CEO spent heavily on automated technology in the form of robots to assemble cars in hopes of reducing the power of his nemesis, the United Auto Workers Union and to enhance quality.  He solved neither and the financial consequences for GM were disastrous.

I believe we can find some parallels in healthcare.

When you depend so much on technology — whether it is the Cadillac of the electronic health record systems, the latest patient monitoring devices or state-of-the-art computerized diagnostics, all with hot and cold running automation, there is no guarantee this technology will improve quality of care or enhance patient safety.

At the end of the day, healthcare is, and always will be, an industry that depends heavily on the skills, judgment and deep commitment from those who take care of patients.  For those who choose this profession, like the airline captain, it must be more than just a job to pay the bills.  Mistakes can have massively serious consequences.

During a recruiting trip to Manila, The Republic of the Philippines in 1992, I interviewed a very bright and passionate registered nurse.  She had just completed a 12-hour shift in a 12-bed intensive care unit at one of the nation’s largest public hospitals.  This facility lacked most of the modern technological equipment that American care givers have long come to rely on.  She and four patient care technicians — she said she was the only nurse in the unit — had to manually check vital signs, manually monitor pressures and other requirements for care.  She looked forward to moving to the US where she would earn five times more money so that she could support her family in Manila,  and she was excited about having access to the latest technology and equipment she had read about in nursing school.  But she was also concerned that with all that technology, her nursing skills would suffer.

Whether her concerns are accurate or justified, or not, it made me think about the state of healthcare and the proliferation of technology — our version of the global arms war —  where organizations spend millions upon millions of dollars to have the latest and the best equipment.  Yes, they spend it for the patients, but they also want to beat the competitor hospital down the street.  It begs the question, is it making our care better, and safer?

We have the highest healthcare costs of any industrialized nation but we have significant problems with quality and patient safety and our life expectancy is less than those nations who spend so much less.

Depending on technology without a passionate commitment to quality and safety — to make the care of the patients a personal commitment — will not solve our growing cost and value problem.

© 2015 John Gregory Self

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24 July, 2015 Posted by John G. Self Posted in Leadership, Recruiting
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Interim Candidate Selection:  A Better Way

Posted July 24th, 2015 | Author: John G. Self

TYLER, Texas — When selecting an interim executive, there is always the risk of making a bad choice.

Too often the decision is based on the resume and the advice, slanted or not, from the interim company executive touting the candidate list.  Frequently these decisions are made at a time of crisis and with a sense of urgency, and the organization is already looking forward to starting the permanent search.  It is as if they are thinking, oh well, how much damage can the interim do?

interim candidateA lot, actually, but that is another story.  However, that fact does underscore the importance of having a best-in-class interim candidate selection process underlying the recommendations you receive.

Barry Dykes, FACHE,  Managing Principal of Westwind Advisors in Conway South Carolina, and a former hospital CEO, says that selecting an interim candidate, whether for human resources, nursing or finance, is critically important. Once you have made the decision that you must bring in an interim to help the organization transition or expand, there is usually a sense of urgency that precludes the same thoroughness of an executive search.  “This is a critical time and making the wrong choice for the interim role can be a huge, costly setback.”

“Selecting executives to lead a turnaround is one of the most critical decisions a governing board can make,” says Ian E. McFadden, FACHE, President of HRM Solutions, LLC of Valpraiso, Indiana and a veteran of six successful turnarounds. “The wrong choice  can lead to closure of the hospital. There are vacant lots where hospitals use to be for that very reason.”

What if you could review the resume, the interim’s skills/experience assessment by the recruiting company and references, as well as watch a short video of the candidate answering key questions? Would that help you make the right decision?

Our research shows that clients tend to make the right choice when they see videos of the candidates before either inviting them to interview, or, in a time sensitive rush situation, making a choice and offering a contract.  This has to be better than sight unseen.

In times of urgency, you do not always have the time to bring two or three candidates in for an interview.  But here is the problem, interim firms, like executive search organizations, are not keen on innovation.  Why bother when what you are doing works just fine, revenue-wise, they argue.  So, you are forced into a decision structure that is fraught with risks.

The interim recruitment business and its high society cousin, retained search, rely on the same business model that they have used for the last 40+ years.  It is working, some say, so why would you want to change — don’t fix it if it is not broken.

That has the ring of an excuse, not a rationale.  Only the brave search consultants will reluctantly admit that this is the way it has always been done, but the industry practice of the majority of firms suggests that is how they feel.  They are content to keep doing what they have been doing for years.  If the clients aren’t clamoring for something better, we must be pretty smart, right?

First, just because a client isn’t asking for better service doesn’t make you smart.

Secondly, conventional wisdom and conventional recruiting practices have something in common: they are not always right.

Third, finding, screening and presenting interim candidates in the conventional manner does not necessarily serve the best interest of the client.  So why be content to do something because this is the way it has always been done?

I could not agree more.  And we have a plan, the flexibility — and the technology — to change the game.  For more information, contact me.  If you are an interim candidate, and would like to be included in this innovative initiative, send me your resume.

I believe the JohnGSelf + Partners approach will better serve the needs of our clients for less cost than what some of the national firms charge.

The this is the way it has always been done approach needs to change.

© 2015 John Gregory Self

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22 July, 2015 Posted by John G. Self Posted in Healthcare

Setting A New, Higher Standard For Patient Safety

Posted July 22nd, 2015 | Author: John G. Self

LAS VEGAS — Why do we insist on making the goal of improving quality of care and enhancing patient safety into such a complex and expensive task?  It is such a waste, and broadly it does not appear to be working

patient safetyJust make it personal.  I believe that if every doctor, nurse, patient care assistant, labor worker, imaging technician and anyone else who has impact on patient care and safety would think of those patients as a beloved family member or a close friend and the thought of making a preventable mistake such as leaving a bedside down would be so painful that they could not bear it, then, and only then, would quality of care improve and patients be safer in our hospitals and nursing homes.

I have written this before in connection with my mother’s death, but today I am urging my colleagues to make it personal.  On Tuesday this theme was an important part of my speech to the AHRA, the association of healthcare imaging executives and managers who are meeting here through Wednesday.

Ridiculous, scoff the consultants who make millions from quality of care engagements.  Such a simple answer to such a complex problem could not possibly work.  Healthcare is complicated, one of the most complex of human organizations ever created by man, according to Peter Drucker.  But not all complex organizations and their problems require complex solutions, and I believe this is one of those.

Personal Commitment.  What does this mean?  Well , it is certainly not some throw away phrase.  It means that nurses and other patient care professionals are compassionately tending to the needs of their patients as if they were members of their family who, if a care mistake was made and caused harm, they would not be able to bear the pain.

Impossible!  It is not fair to ask nurses to take on that kind of burden.  Really?

When I speak to healthcare organizations, I cite the Journal of Patient Safety study that reported the number of preventable hospital deaths as being as high as 400,000 a year and the reaction of my audience is almost always one of acceptance.  They know the numbers.  Even when they push back, they know, deep down, that there is a serious problem.  It is more outrageous when you consider that the numbers cited by the Journal of Patient Safety are the equivalent of a jumbo jet crashing every day of every week of every year, and all souls on board are lost.

How can we in good conscience accept that horrific outcome?

If you are a CEO, a CNO, a physician or other member of the patient care team, I urge you to stop accepting this horrible reality of our industry.

Set a high standard every day.  Make it personal.

© 2015 John Gregory Self


  1. dan Ford says:

    Good for you, John!! I commend you, and understand/share your passion.
    Is your speech shareable?
    I would suggest and encourage every hospital/system CEO and Board Chair to finally get outraged and have the courage/backbone to lead the way along with medical and nursing headship, middle management and front line nursing…everyone, as you suggest, make it personal: “No more, none, not in our hospital!”
    Likewise, every health care search consultant on every search, whether the client specs require this or not.
    Thank you!!

    • John G Self says:

      Dan, you have been an inspiration for me — your willingness to share your story and to give back to an industry we both love. I think healthcare leaders have become too numb or, worse, too “sophisticated” to be passionate about an issue. I have nickname for a CEO who is out an about talking to his or her people about values, quality of care and safety: the “traveling evangelist model.”

      I would love to co-present with you sometime. Now that would be great honor for me.

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