One of the most common mistakes hospital boards make in hiring a recruiter is a preference, or impression, that the size of the firm counts.  A big national firm, they reason, will have access to a broader array of candidates.

That is not true.  Size has no bearing on access to candidates, especially the best candidates, because in those large firms, like larger corporations, the left hand is usually unaware of what the right hand is doing; they are siloed from office to office.

recruitingWhat really counts is the subject matter expertise of the firm and specifically the person who will be doing the work — not the partner selling the deal — the person who will be researching and screening the candidates.

Avoiding the pitfalls of being swept away by the sparkling glitter — thinking bigger must be better, or that a big national reputation will guarantee success — is critical to conducting a successful national search.

In the case of CEO searches, you want a search consultant who will tie his or her reputation to your organization’s future success.  Most recruiters today reject that perspective, arguing that their job is simply to provide qualified candidates and they cannot and should not be held accountable for a candidate’s performance.  For those firms and recruiters who want to remain trapped in the tired, old business model they will push back against any change.  But new dramatic challenges in business require a fresh approach to executive recruiting, a new recruiting paradigm in which the client and the recruiter form a partnership and share the risks.

This new partnership is especially effective for boards which oversee rural/community hospitals that require special leaders to deal with the unique challenges that are emerging as the result of healthcare reform.  A qualified candidate is not always the right qualified candidate, especially in the world of rural community hospitals.  To be successful, a CEO must possess the right blend of knowledge and experience and have a leadership style that focuses on the mission, and the needs of the community they serve.  They must be leaders who truly place patients/their physicians at the center of the enterprise and provide employees with the resources they need to excel.

Here are the key questions rural/community hospital boards should ask when deciding which search firm to hire:

  1. Does the firm work on a retained basis or are they a contingency fee agency?Contingency firms get paid only if they find the candidate the client hires.  Typically their processes are not set up for in-depth vetting, nor do they spend much time understanding the client organization.  In the world of contingency search, it is all about speed, submitting a candidate before they apply directly or are submitted by a competitor.  A full-service retained firm works on an exclusive basis.  They should spend at least two to three days on site with the client learning about the challenges and opportunities and gauging the organization’s culture.  They typically, but not always, do a better job screening the candidates and vetting their prior performance which should be a mandate in any letter of engagement.
  2. Does the firm have experience in recruiting CEOs to rural/community hospitals?  How much rural/community hospital (search) experience does the associate doing the work have?  How many searches have they conducted where their candidate is still in place three years later?  Have they ever worked as a CEO or manager in such a facility?This is critical.  Smaller hospitals, especially those in rural areas, are very unique.  The person who successfully recruits for a 500-bed academic medical center, or 300-bed community hospital,  does not necessarily comprehend the nuances of running a smaller hospital.  That lack of understanding can, and probably will, produce some negative consequences.
  3. How does the firm screen and vet the candidates — the tools they use and the step-by-step  processes their recruiters follow to ensure the candidate selected is who he or she represents they are?This is where assumptions and misunderstandings can lead to embarrassing, if not disastrous consequences.  Firms should screen candidates for relevant experience and a verifiable record of accomplishment.  In other words, do their experiences and successes align with the needs of your organization?  If there is discord among board members and/or the medical staff about the future direction of the organization you want to be sure that the CEO has experience successfully navigating those types of challenges and achieving outcomes that align with the organization’s objectives.Vetting does not always mean that the recruiter will check federal and state criminal, civil and CMS databases (fraud and abuse), or search the Internet for uncomplimentary articles concerning the candidates.

    That lack of thorough candidate vetting recently resulted in a couple of highly publicized embarrassments for hospital boards — a CEO candidate who touted his financial management skills was pushed out of his last job because of a $30M accounting error, and a board in Montana was caught flat-footed when they learned the CEO they hired had prior felony convictions.  Both of these blow ups were easily discoverable if only the recruiters had done basic homework.

  4. How will the Firm screen the candidates who will be recommended to the Board?Meeting the candidates in a face-to-face interview is the best method, bar none.  Videoconference/Skype interviews are one-dimensional in perspective and you cannot always pickup the important non-verbal communication features.  If the search firm, or the recruiter prefers the videoconference approach, dig in to find out why they feel that approach will suffice.  The truth be told, it usually revolves around convenience for the firm or the recruiter, not because it will produce a better result.Do they use a DiSC© or some other behavior and values tool to assess a candidate’s match potential?  DISC© or a similar assessment tool is now a common, standard of practice feature.  By contrast, do not trust firms that rely almost exclusively on psychological testing in making their recommendations.  This, too, is a one-dimensional approach that tends to emphasize the psychological profile over relevant experience and achievements.
  5. How long is your placement guarantee?  Why do you use this term?Here is where the old-line traditional firms — those who are transactional in their style and approach — would just as soon you not ask this question or ask for an explanation.  Those who extend their guarantee on a search by search basis just to be competitive probably do not have a candidate screening process that is robust enough to routinely offer three years.  There are other firms that believe that a three-year placement guarantee should be a standard of practice.At JohnGSelf + Partners, we have offered that level of client protection for more than 18 years with only minimal risk because we designed our candidate screening process to ensure the interests of our clients are protected.