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Last Wednesday I spoke to the Health Management and Policy grad students at the University of Michigan. We discussed how healthcare reform will change this industry. But the bigger threat is the budget crisis and the looming national debt/bond market upheaval, which could have abrupt, dramatic and painful consequences for our industry. Look at the disruptions and severe austerity measures in the euro zone. We are not far behind — three to five years, according to David Walker, deficit hawk and former Controller General of the GAO. These are different times that require new career strategies.

I challenge new graduates — and early careerists — to think of themselves as a brand and to manage that career brand with enormous caution and focus.

Our sovereign debt problem poses real challenges for career management, especially for new graduates and early careerists.  First among them is increasing pressure to perform, to deliver measurable value and do it with less, not more, resources. Reimbursement will only decline. The amount of money healthcare providers are paid today will probably be the most we will see for a DRG in our lifetime, save some minor adjustments for COL. Managed care companies will only follow CMS in lowering their payments.

These developments will also impact the elusive life balance battle that so many of us wage. There will be the inevitable system consolidation, hospital closures and job loss — in other words fewer entry level positions with more new graduates competing for the fellowships, internships or even entry level analyst positions. The first job is always the toughest to land, but even if it is not exactly "on point" with your ultimate career path, do it well to prepare yourself for the next step. You will not get any free passes in our “new normal” economy.

Along the way find a mentor –someone who will take the time to tell you things you do not necessarily want to hear when you ask for advice, but listen carefully. Someone who can spot your unrealized or undeveloped talents and then push you to improve will be a necessity for early careerists going forward.

Choose your jobs wisely. There are a host of bad leaders in this and all other industries, and they have the ability to wreck an up and coming career. A good leader is a work of art who will prepare you for the next level. A bad leader is a tragedy.

Start a career journal. Athletes and musicians improve their skills with continuous practice, but what type of practice can leaders use to improve their skills? Journaling. At the end of each week, spend some quiet time reviewing your performance and your decisions. Using regulated thought, replay in your mind the game film of your week’s decisions and interactions with colleagues, as leadership consultant Rand Stagen likes to say. Force yourself to think about what you could have done better — from analysis, the actual decision, to communicating the way forward. Record your feelings and observations. Ask yourself hard questions. This is not easy work. The journal is not for self-laudatory B.S. It is a record that you can revisit over and over, reminding yourself of important lessons learned.
Wrap all of this together and you begin to understand the importance of effective career brand management.

For early careerists who push themselves to get better, who deliver results and who effectively manage their brand, the healthcare delivery segment will provide incredible career opportunities. But just as the size and performance of athletes has improved substantially over the generations, so will the performance expectations for healthcare leaders.

These are troubling times, but there are abundant opportunities for those who want to make a difference.

© 2011 John Gregory Self

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