A major hospital is ready to make an offer to a prized senior leadership candidate. This is the candidate they want. The other finalist is impressive, but not a spot-on fit.

Then the worst possible thing happens. Problems with the number one candidate’s background check.

Two arrests.

This prized leader was not forthcoming concerning serious issues in his personal background. How could this happen? How could the recruitment process get this far only to find deal killer background issues?

The answer: a national search firm failed to vet their panel of recommended candidates prior to submission.

The most startling revelation is that this type of poor process, search consultant laziness or a combination of both is not that uncommon, hospital CEOs tell me. In three other national searches, candidates confided that their names were submitted to the clients without a personal, face-to-face meeting with the recruiter or having their references or background checked. This is wrong. For the client this is the executive search equivalent of Russian roulette.

Why is this happening in high profile, high stakes searches? What should clients expect from the search firm?

Without mentioning the well-heeled offending firms, here is a list of what clients should expect from executive recruiters, at a minimum:

1. MAXIMIZE VALUE, MINIMIZE THE RISK – Consultants should be willing to guarantee your satisfaction with their recommended candidate panel and offer an extended placement guarantee. With professional fees at most firms approaching 33 percent of the successful candidate’s first-year cash compensation (plus expenses), clients should expect their search advisors to own the quality of their work and the success of the candidate. The common search firm excuse that “We have no control over what happens after the candidate is hired” is simply outdated. If recruiters are thorough in their pre-engagement due diligence, they should know what type of candidate will be successful. As healthcare costs rise, consultants must be willing to share financial risks. After all, you are paying for their professional judgment.

2. REQUIRE CANDIDATES BE VETTED PRIOR TO SUBMISSION – Require that the panel of recommended candidates be vetted prior to submission. Candidate confidentiality is always a concern, but candidate backgrounds and representative primary and secondary references can be completed without compromising the candidate’s rights. Search consultants should check criminal, civil, credit and driving records for all jurisdictions in which the candidate has lived or worked in the past 10-15 years.

3. REQUIRE FACE-TO-FACE INTERVIEWS – There is no substitute for a face-to-face interview. Search consultants who are making candidate selection decisions on the basis of telephone conversations or videoconference interviews only are taking a big chance with the client’s money. At JohnMarch, we spend a minimum of three hours interviewing on the telephone before we meet the candidate in person. Our standard face-to-face interview is a minimum of three hours as well an additional 30 minutes in a video interview, a summary of which is submitted to the client when we present our recommended candidates.

4. VERIFY A CANDIDATE’S PRIOR SUCCESS – Most candidates finally got the memo concerning fabricating credentials. The most accurate predictor of future success is past performance. Taking a candidate at his word is not a successful search strategy. Even famous leaders have been known to lie or misrepresent their record. Just ask Sunbeam Corporation’s former board. A search firm’s candidate screening process should include a vetting of past performance, including checking on all those little dot-points that tout revenue growth, expense reduction, quality enhancement, etc.

5. EXPECT A TRUE PARTNERSHIP – If the only time you hear from your search consultant is when you call with another assignment, you probably are using the wrong firm. A true talent acquisition partnership incorporates shared financial risks and ongoing ownership of the organization’s leaders. A true partnership is more than sales talk in a glossy brochure.

I know this will not sit well with some of my colleagues. But we have entered a new era in healthcare. Quality, safety,and cost control are all big issues. The pressures on health systems and hospitals are immense.

Search consultants need to be more accountable for the thoroughness of their candidate screening and interview processes prior to submitting the recommended panel. The costs of their failures can be staggering for the client.

These are reasonable expectations. Demand change. Or, you can play Russian roulette…