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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6 March, 2015 Posted by John G. Self Posted in Recruiting, Uncategorized
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5 Questions to Ask Your CEO Recruiter

Posted March 6th, 2015 | Author: John G. Self

Every year, hundreds of hospitals recruit a new CEO. And every year, a surprisingly high number of the successful candidates fail to survive two years. Even more disturbing, many who do survive are marginal performers – they are not good enough to take the hospital to the next level of performance but they are not bad enough to be immediately fired.

RecruiterThe politics and the fallout of failing to hire the right candidate can devastate an organization.

So, why do so many boards struggle with this their most important responsibility?

Most lack the knowledge of, and experience with, a gold-plated recruitment process. They sometimes worry about the costs and do not fully realize the critical importance of comprehensive due diligence, a quality recruitment process, in-depth candidate screening, and rigorous vetting methods. More often than not they believe that hiring a nationally known firm will ensure success. That is no guarantee of anything. So what factors should boards bear in mind?

Here are five important questions they should consider:

  1. How much time will the search firm spend learning your organization – values, culture, how you do business as well as the concerns of your medical staff? Hint, this cannot be accomplished in a day or a day and a half. Moreover, it is shocking how little many search consultants actually know about their clients. Most will rely on their cookie cutter approach when what most hospitals need is a customized solution. Do not let this important engagement become just another transaction.
  2. Who will do the work? Will the consultant who conducted the due diligence visit be the one making key decisions regarding which candidates to present? For most search firms, the answer is no. This is one reason so many searches produce mediocre results. Think cookie cutter.
  3. Will the partner responsible for the search meet the candidates face-to-face before recommending them to the board? Do not work with a recruiter who relies on videoconferencing interviews. That one dimensional format is not ideally suited for making such an important decision. Candidates who have experienced that type of screening often say they never personally met the search consultant and complain that the search process was more about convenience with little emphasis on transparency.
  4. Will the search firm conduct an independent background investigation before recommending a candidate? Many firms, including some of the so-called industry leaders, do not provide that level of service unless the client makes a specific request. Checking three references does not constitute an in-depth vetting process.
  5. All search firms tout their experience and recruitment process as being the best. No surprise there.   So then the important question to ask is, if it is so good, will they share more of the risk for recommending candidate who does not work out? Hint, a one-year placement guarantee is the industry standard. The problem with that is that research shows that most of the issues that lead to termination arise in the 12 to 18 month range. One highly regarded national firm reported that 40 percent of their placements had left within 18 t 24 months. One year is not a good standard for shared risk. You should ask more questions about the scope and depth of their screening process if they are reluctant to share the risk with you.

© 2015 John Gregory Self

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4 March, 2015 Posted by John G. Self Posted in Healthcare, Leadership
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The Customer Is King

Posted March 4th, 2015 | Author: John G. Self

The customer is King. That is an immutable truth in business.

In healthcare, like every other business known to mankind, we have customers.

customer is kingIn business there are two groups of leaders, one that understands and respects that truth and then walks the talk. The other, the one I label as misguided group B, believes, consciously or subconsciously, that they know best and that the customer should agree and compliantly respond, or to sit down and be quiet.

In the end though, the customer is always right and hell hath no fury like a customer scorned, ignored or otherwise disrespected. That, too, is an immutable truth.

The reason this concept is so important is because of something called population health management. In the past, healthcare was a wholesale enterprise. We focused on independent physicians who controlled the patient flow into the hospital. They were our primary customers; the patients were, in effect, end users. As long as the physician was satisfied, presumably with the feedback from their patients, all was well and life was good for the hospital CEO. We had marketing programs but our model was still a wholesale-based approach. While that model has slowly changed over the years, population health management will, based on how I see this concept unfolding, dramatically change our business model from wholesale to retail. For some, this doesn’t seem to be a radical change from where we find ourselves today, on March 4, 2015. But nothing could be farther from the truth.

Health systems and hospitals now employ or rent physicians and that variation to the traditional relationship gives hospital executives a false sense of security. If we own, rent or control the physicians, then we have control of their patients, or so goes the reasoning in many hospital/health system circles.

In fact, this new business model will make the hospitals/health systems and their physicians, function like true business partners, rather than a variation of their traditional wholesale arrangement, because population health management will sooner, rather than later, disrupt traditional patient/physician/hospital loyalties and service migration patterns. Like banks, auto dealerships and other retail businesses, we will have to compete for customers – and compete aggressively.  To retain their loyalty and their business,  it will all boil down to price, quality outcomes, level of service and satisfaction.

In this new healthcare economy, that the customer is King takes on new meaning. Those who do not understand that dynamic will face an uncertain career future.

© 2015 John Gregory Self

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2 March, 2015 Posted by John G. Self Posted in Healthcare, Leadership
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An Employee Engagement Turnaround Story

Posted March 2nd, 2015 | Author: John G. Self

A wise and seasoned, if not a little cynical CEO I know, once described the payroll process at a former hospital as “distributing cash to zombies” or “paying people for something we are not getting.” In other words, paying employees just to show up.

turnaroundHe also described that hospital’s payroll and benefit plan as the biggest “entitlement and giveaway program in healthcare. These employees are not engaged in any shape, form or fashion. They do not care and the quality, service, satisfaction and financial performance is proof positive.”

He was not normally that cynical or outraged but when he uttered this biting assessment of his workforce, he was in week six of a massive operational/financial turnaround. This hospital was as bad as it could get without collapsing into default, bankruptcy and liquidation.

While his assessment was spot-on – I was brought in to conduct several executive searches – there was a reason that the morale/engagement/performance was in the trashcan, top to bottom:

  • A series of previous CEOs did not view their employees as an important strategic resource. Instead, they were considered an expense that had to be controlled. One CEO was described as the phantom since few employees never saw him.
  • A startlingly large number of employees had never received a performance review, at least not in five or six years.
  • There had not been a merit pay increase in more than five years.
  • If there was an employee performance review completed on time, I couldn’t find the evidence, including the board’s review of the most recent CEO.
  • Most of the top performing employees (and physicians) had long since left the building. No surprise there. The remaining A and B employees had to be among the most optimistic, hopeful people on the earth.
  • Filling the vacancies was the number one, all-consuming priority for the internal recruiters.

I think the one thing the organization did well – well, passable – was skating through the regulatory surveys, always with exceptions that required arduous correction plans and always promises to improve.

Five years later, the hospital is still open and operating, sometimes in spite of itself, but the tide was turned. That turnaround CEO was successful and on his last day he reported that he repeatedly said, “Never again. Never, ever again,” as he walked to his car.

How did he do it? He quickly rebuilt the senior leadership team. The departed leaders had lost their way, their self-confidence and their credibility. Then he began to work on the hard stuff beginning with employee engagement.   There was no magic bullet there, no sexy expensive program that would somehow woo the mediocre and poor performers to get back in the game. It took backbreaking work, seven days a week at first, then a relentless, sometimes noisy effort, to communicate and enforce the new core values. The team put in long days reviewing and improving processes, and focusing on performance improvement from housekeeping to patient care.

It was this CEO who coined the phrase for me, “traveling evangelist” to describe what his job became. “It is one of the hardest things in the world to get people to care again.”

While this hospital was a worst-case example, there are many hospitals and other businesses in America where employee engagement is not just bad but shockingly abysmal.

Overall, 70 percent of the workforce is not reaching their full potential or are actively disengaged, according to a Gallup survey. That is a lot of waste, waste that healthcare providers cannot afford in a post-reform economy.

That fact is also why we continue to struggle in healthcare with quality and safety.

© 2015 John Gregory Self

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