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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23 April, 2014 Posted by Becky Pearce Posted in Career Management, Healthcare
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Career Management Homework

John is in San Antonio to speak to the Association of Imaging Management’s spring conference.

SAN ANTONIO, Texas – If you had a blank sheet of paper and a pen:

  • How would you redesign America’s healthcare system to ensure high quality, lower costs and increased patient satisfaction?
  • How would you redesign your career – your area(s) of interest, education and skill sets necessary to be successful in that new model?

I am someone, perhaps in the minority, who believes this exercise may have more real value than just a writer’s prop inserted to make a point, which is that the early stages of what promises to be a transformation of the healthcare business model – how care is delivered and paid for – has started down the tracks.  There is ample evidence:

  • Trends reflecting continuing declines in inpatient admissions and lower revenue
  • The shift from fee-for-service and the emergence of value-based reimbursement models
  • Introduction of Accountable Care Organizations
  • The rise of palliative care programs, some of which incorporate physician house calls
  • Use of reimbursement penalties to reduce “never events” and to cut the frequency of readmissions inside of 30 days of discharge
  • Innovative house call programs using EMS and other resources to cut down on the number of unnecessary ED admissions
  • Increased usage of less costly care settings, including primary care clinics in retail places like Target, or the development of acute care protocols for a new type of nursing home as well as private residences
  • Creation of new technologies, models and services to support existing infrastructure such as telemedicine networks.  These technologies will be increasingly important with the anticipated shortages in primary care physicians.  For some communities, this will become the family doctor, minus the house call
  • Development of population health management networks that will apply the concepts of hospital case management to the entire community
  • Continued industry consolidation and a reduction in the number of “big box” hospitals, as predicted by an increasing number of industry analysts


Healthcare costs, although lower over the past two years, are still increasing at three times the rate of inflation.  Even at this lower rate, compared with 9 percent as late as 2008 and as high as 17 percent in the 1980s, we are high tailing it to a fiscal crisis within 10 years given the record number of new Medicare beneficiaries – one every 8 seconds.  The Obama administration and Congress, at the expense of their victims, the American voters, are more interested in ideological purity and/or re-election.  In kid-speak, it is called kicking the can down the road.  This impending crisis will drive transformation, whether we like it or not. 

While we are not always able to influence the politicians, we can exert more control over our professional development.  I think executives who begin to think about their careers in terms of adapting to transformation will be far better off than those who sit back, hope for the best and then react. 

So, how would you redesign the American healthcare model?  More importantly, how will you alter your current career track given these trends?

© 2014 John Gregory Self

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21 April, 2014 Posted by Becky Pearce Posted in Career Management, Healthcare
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Results Are Important, But So Is TRUST

The early signs of the transformation of healthcare are powering the drumbeat of career management essentials: performance, performance, performance and the ability to adapt.

In an increasingly crowded healthcare job market – consolidations and layoffs are up and hiring has declined for three consecutive months – outplacement consultants, career brand coaches and recruiters are zeroing in on quantifiable results.  It is no longer enough to possess a deep and varied portfolio of experiences, even with top-tier organizations, employment experts say.  Executives must clearly demonstrate that they can produce value through a verifiable record of results. 

That is all true.  But even that is not enough. 


There is, and will always be, more to leadership than just hitting the numbers, especially in a period of transformation of a business.  Equal to a candidate’s ability to produce results is their level of Emotional Intelligence (EI).  In a time of major industry shift, EI will be more important than ever.  Without getting bogged down, Emotional Intelligence is defined as “the ability to monitor one’s own and other people’s emotions, to discriminate between different emotions and label them appropriately, and to use emotional information to guide thinking and behavior,” according to the Oxford Dictionary of Psychology.  Daniel Golemon, writing in 1998 for the Harvard Business Review proposed that in addition to the two established EI models, a third, the mixed model, is a combination of both ability and trait, as well as an array of skills and characteristics that drive leadership performance.  Today, in sorting through a candidate’s various layers of traits, skills and the results they have recorded, I am also looking for the one EI element that I value the most – the ability to instill and nurture trust. 

Trust is not a leadership given, I assure you.  Just as the yelling executive of the command and control school of leadership will no longer be able to achieve sustainable results in an era of reform, those who lack the character traits and skills to build a strong bond of trust with their leadership teams and employees, will not be the type of people we will want to recommend to clients, especially under our Firm’s three-year placement guarantee.  They simply cannot succeed in an environment of unprecedented change. 


So much of what will determine success in the future will be centered on the quality of the employees that an organization recruits and retains.  The health systems with the best people will produce the best results and that will be the make or break market differentiator.  Now here is the key: the best people only want to work for the best leaders, those people with the traits, skills and record of results they can trust.  When the earth seems to be shaking under their feet, people cannot successfully perform if they do not have a leader they can trust.

This is a two-way street:  If you cannot trust your leadership colleagues or the key directors and managers who report to them, then you have the wrong people working for you. 

© 2014 John Gregory Self

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18 April, 2014 Posted by John G. Self Posted in Career Management, Leadership
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Customer Service: A Real Differentiator

You cannot be perfect at customer service.  The real fun comes, I believe, in the trying to be perfect, being passionate about achieving that which is impossible to attain. 

That companies understand they cannot achieve service perfection but still keep trying, is an amazing thing to me.  Contrast that with the many organizations that harp and hosanna about their customer service but seem always to have their fingers crossed.  Right behind an illusionary curtain, there is often someone focusing on a cost-benefit analysis.  They are the people that dumb down service to the extent that it is little more than an afterthought in the company values statement.

Those cost-benefit accountants say that service perfection is impossible to achieve and too expensive to even think about.  Fortunately there are companies that reject that idea.

Organizations like Apple, while they know they are not perfect, invest serious money in developing customer-centered systems and staff training, trying to be the best they can be. It shows in their customer service, from the retail stores to their technical support people who are NOT warehoused in some remote part of the world, available only through inconsistent satellite telephone link.  Compare Apple to Microsoft, with its still impressive profit margins and a large horde of cash.  Microsoft still refuses to invest in trying to have top-tier customer service.  Is it any wonder that sales of their tablets are less than impressive?  Why buy a device from a company whose customer service for their core product, software, seems to be based on the concept of a necessary evil? 

Even in your own neighborhood, you do not have to look long to find frustrating examples of a so-so commitment to service, even in businesses that should be all about service.  Waiters in a fashionable hotel restaurant swap tables without bothering to tell dinner guests who grow frustrated trying to understand why the person who took their order is now ignoring them.  Or bartenders fail to smile or call a regular guest by name when presenting their bill, and seem more interested in when the shift ends than ensuring a good experience.  You can tell customer service is more of a slogan than a deeply ingrained value.

I love to be associated with clients and their employees who believe that while they may not be customer service perfect, it is wonderful and important to keep trying.  They understand, delightfully, that it is that philosophy that separates them from their competitors who spend more time and energy trying to figure how much service they can afford to give. 

These ideas are just as important in career management.  In a period of continued high unemployment, it is interesting to me why more job candidates do not tout their customer service values and record of success.  Now there is a real market differentiator.  

Sometimes it is the little things that can make a big difference.

© 2014 John Gregory Self

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