Healthcare leaders are facing management complexities that are intensifying. Lower reimbursement rates and increased labor and supply costs are threatening operating margins. Physicians, historically the customer for healthcare providers, are, with greater frequency, becoming a competitor, and finally, there are rising manpower shortages in clinical and key leadership positions.

 At the core of this emerging perfect storm is the human capital component.  Healthcare providers must improve their skills in identifying, recruiting and retaining clinicians, managers and executives to achieve sustainable success.

 Search firms, and increasingly, internal recruiters, are finding themselves in the spotlight.  When a major search firm announced last year that 40 percent of its senior level executive placements quit or were forced out after only 18 months, there was hardly any notice or comment.  But things are changing in healthcare, and hospital CEOs and the chief human capital executives are beginning to recognize the magnitude of the financial and political consequences when the wrong candidate is hired.

“We can no longer afford to be passive buyers,” said a senior vice president of a New York health system.  “We need to start asking questions of our search professionals – whether we use internal recruiters or go to an outside search firm – to help us mitigate the risks.”

 Here, then are some suggested questions that came from hospital executives across the country.  I have added explanations and comments.  On Wednesday, I will deal with questions for your internal recruiters.

  1. How big is the “lock up” or “do not contact” list? 

Search firms are ethically precluded from recruiting candidates from organizations with whom they have done work in the last 12 months.  Some firms have a 24-month lockup rule. Increasingly, hospital executives say that they seem to see the same type of candidates over and over.  Before you hire a firm, ask to see their lockup list.  You are entitled to know how big the list is because that will affect the candidate pool. 

  1. How much involvement will the engagement partner have in the search? 

Presumably you make a hiring decision based on the relationship with and the reputation of the partner or consultant who is making the proposal.  But how much time will they actually spend on the search?  If you hire a search consultant based on your faith in the partner, then be specific: how involved will they be in selecting the final panel?  If you are hearing from the senior associate regarding the progress of the search, it is a safe bet the partner is not that involved, or will not be involved until it is time to present the candidates.

  1. How does your search firm screen candidates? 

Topgranding© based chronological in-depth interview process with a detailed leadership assessment, backed up with deep background and reference checks, is one of the best ways to screen candidates.  This is a time intensive process but the results are exceptional, based on the experience GE has had.  (My own track record in using this type of candidate screening system is outstanding.)  Process counts.  How recruiters screen candidates is a big factor in the success of the search.  Ask questions about what type of candidate screening tool the recruiter will use as well as what issues the recruiters plan to cover in their interviews.  Be sure you are on the same page with the consultant who will be conducting interviews regarding performance expectations and any challenges to success.  The firm should share this information, but if they don’t, then ask.

  1. How does the firm communicate with candidates concerning the position description? 

Candidates are voicing complaints about how poorly many search firms disclose information about the position and the organization.  One candidate described this as the recruiter equivalent of Don’t Ask, Don’t Tell.  A great number of recruiters argue that it is up to the candidate to conduct their own due diligence regarding a potential employer, the culture and the risks.  Easier said than done, most candidates say.  In fact, the entire search process limits how much information a candidate can actually obtain.  One reason that candidates leave within the first two years is that they find problems that were never disclosed by the recruiter or the employer.  My research found that these “surprises” ranged from turmoil in the boardroom and executive suite to major regulatory and quality of care issues.  Disclosing to candidates the problems and challenges within the organization on the front end of the search process is the least embarrassing and costly time for them the find out.

  1. What types of information should be included in the dossiers of potential candidates?

At a minimum, the search firm should verify academic and professional credentials.  They should vet the candidates stated accomplishments from the resume, and they should perform a background check extending back 10 to 15 years.  They should look at information that could show patterns of inappropriate behavior –from managing personal finances to conflicts with the board, physicians, employees and key stakeholders.  The dossier should also include some type of behavioral and values assessment tool with written analysis regarding the potential for a successful “fit” with the new organization as well as an assessment from the engagement partner.  Finally, one of the most useful tools a search consultant can provide, is a video summary of the firm’s final face-to-face interview with the candidate.  This will help the client in selecting from the recommended panel which candidates they would like to bring on site for interviews.

  1. What is the recruiter’s placement guarantee?

Most firms provide a one-year placement guarantee.  Since the “stick” rate disconnect usually occurs in the 14 to 24-month range, why not request a longer guarantee?  Some firms offer up to 36 months for C-suite placements.  If a search firm’s candidate screening and selection process is as good as they claim, then a longer placement guarantee is not much a of a risk, especially when you realize that for a senior executive earning $500,000 a year, the search firm will earn $150,000 to $165,000 or more in professional fees.

  1. Does your recruiter understand Onboarding?  Does their position disclosure and candidate screening system integrate with this important program?

Onboarding is a proven strategy to significantly enhance the talent acquisition process. A well designed integrated onboarding program will not only improve a new employee’s transition process, it can accelerate performance and provide an important foundation for long-term tenure and success.  In an era of the 18-month “stick” rate for tenure in the search industry, onboarding should be the cornerstone of your recruitment process.  If your search consultant's process does not mesh with onboarding principles, it may be time to look for one that does.

Talent is an organization’s most valuable asset.  It is a big component of the company’s net worth. When you hire a search firm, be engaged.  Set standards for performance and ask the consultants to share the risk.  To learn more, contact John Self at JohnGSelf Associates, Incorporated

 © John G. Self, 2010

 John G. Self is President of JohnGSelf Associates, Incorporated, a Dallas executive search and talent acquisition advisory firm.  The Firm’s client base currently extends from Hawaii across North America and Canada.  Mr. Self is highly regarded for his keen insight and for his record of identifying and recruiting exceptional leaders.  His success among executive recruiters is four times better than the national average.

He is a highly rated speaker on leadership, career management and executive search. 

You can contact Mr. Self at 214.573.5095 or via email.

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