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17 March, 2014 Posted by John G. Self Posted in Career Management, Healthcare

No Margin For Error

Posted March 17th, 2014 | Author: John G. Self

This is the first of a three-part blog theme with some ideas on how and why candidates must adapt to how market competition and the transformation of healthcare are rapidly changing the job market

Seasoned healthcare executives entering the job market, either through no fault of their own (restructuring/downsizing) or because they failed to deliver value, have something in common — increased scrutiny.

Candidates are facing a level of examination of their past performance, from the quality of the results they delivered to how they managed relationships that is more intense today than at any time in their careers.

On the client side healthcare systems, hospitals and other service providers are growing increasingly concerned with lower rates of reimbursement, the rapid shift from inpatient to ambulatory care settings, the impact of value-based payments, and in the future, even more financial challenges, all the result of anticipated deficit reduction measures on Medicare and Medicaid.  They are ramping up enterprise-wide reviews of expenses and trimming their head count in an attempt to prepare their organizations for what will be a wild transformation to a new business model.

This means executive recruitment will become more focused than ever before on connecting the needs of the client to the candidate’s relevant experience as well as their record of performance.   For candidates, if the resume does not reflect impressive results in the specific areas of need by the client, they should not be surprised if they do not survive the first round, the desk review of the resume.  That means candidates must do more research on the clients they are pursuing.  Candidates whose resumes list responsibilities versus accomplishments must change.

Several years ago, I had the opportunity to work with a respected physician executive who had an impressive record of leadership and performance in the medical service corps and an equally impressive run as a physician executive for a public health system in the south, rising to the level of CEO.  After some questionable dealings by the board and an amazingly inept (read: botched) annual performance review, he decided to leave.

After more than a year of disappointment in the job market, I had an occasion to offer what I considered was solid advice on adapting his style to the changing job market.  His response was not what I expected.

“I have been doing this all my life and I am not going to change now,” or words to that effect.

Too bad.  He was indeed a great leader but he didn’t think he needed to change.

That was his last job in healthcare.  He is now retired.

A dramatic increase in the competition for the top jobs and the intense level of scrutiny on a candidate’s performance and relevant experience are like two bright strobe lights on a dark night, warning candidates to change or else.  Healthcare organizations feel they have no room for error in making a hiring decision.

Wednesday – DOA:  The Cover Letter

© 2020 John Gregory Self


  1. carolyn tain says:

    I found this posting so interesting. I’ve worked in the financial industry for the past 30 years, specializing in healthcare finance. I have seen so many senior executives who have the same attitude. What’s is fascinating to me is that this attitude has been around for the past 20 years despite the fact that healthcare goes through these evolutionary changes every 7 to 10 years. When HMO’s came in and the focus (supposedly) changed to cost control and measurable patient care, senior executives just focused on cost control and forgot the rest of the dynamic. That old adage is rignt: the more things change, the more they stay the same.

    • John G. Self says:

      Great comment. Your reference to the old adage is dead bang on, if you will pardon the Texas phrasing.

      I think that this time it is different. The Great Recession and our near plunge over the cliff was different and the slow path to economic recovery has been markedly different. The realignment of labor market has contributed to this difference and, last but not least, the dramatic growth in the number of Medicare beneficiaries will make this 10-year change cycle in healthcare substantially different.

      I am among those who believe that we do not have a deficit problem, we have a healthcare cost problem. As I write this response, a new person qualifies for the Medicare program every 8 seconds. Within 10 years those numbers are going to be so big — even with our current costs — that the consequences for the federal deficit will become severe. In terms of spending, we are living in a dream world and the increasing outlays for the Medicare program will be the harsh reality that will force even greater cuts in funding. Sad to say, but you cannot balance the federal budget without cutting spending for defense, Medicare and Social Security. So look for a series of 1997-styled Deficit Reduction Act bills that will address the issue incrementally. Inside 10 years the industry we work in today will be dramatically different – value-based reimbursement, population health management and a restructuring of healthcare systems.

      Now that I have made that forecast, I will add that being a “futurist” is easy, being correct is the hard part.

  2. forney fleming says:

    John: As usual, an outstanding, informative post. Spot on!

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