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TYLER, Texas  — Do you want a career or do you want a job?

That is a question that I frequently ask when early and mid careerists call me to help find them a job.   If you are just looking for a job – meaningful work that pays the bills and allows you to pursue other priorities – then you have a lot more flexibility than those who are pursing a career.

The term career implies that you have a specific set of goals with a specific job attached to it such as Chief Executive Officer or some similar senior leadership position.  It can also mean the pursuit of a more traditional profession like medicine, law, architecture, or public accounting.  Today I want to focus on the career aspect.

People pursuing a career, particularly those chasing a senior corporate title, have a lot less room for a mistake when making a decision on their next advancement.

While the healthcare industry added jobs in April after several months of declines or no growth, the longer-term outlook for executive level employment remains guarded.  This forecast is based on the belief that the industry will probably contract as patient care moves into more specialized settings like lower cost outpatient centers, smaller specialized hospitals, and expansion in the types of patient care services provided in a home setting.

[Tweet “Gone are the days when hospitals could absorb the majority of graduating students.”]
Gone are the days when hospitals could easily absorb the vast majority of students graduating with a master’s in healthcare management.

We are already seeing a rapid growth in the intensity that employers are using to evaluate potential administrative and senior leadership candidates.  They want people who have an iron clad record of consistently delivering on relevant, quantifiable performance targets, with no gaps in employment or even the “we agreed to disagree” resignation stories.

In the best of times, hiring the wrong leader is very painful and expensive.  In this new era of reform and deficit reduction that will certainly shrink payments to hospitals and drive more intense competition, governing boards and senior leaders have no appetite for hiring mistakes or taking a chance.

[Tweet “Ask a lot of questions and do not take anything for granted.”]
So, here is my advice to candidates who are ready to take the next step forward in their careers: be careful.  Ask a lot of questions and do not take anything for granted.  If you have anything less than a deep understanding of a prospective employer’s operating culture, their finances, medical staff relationships and political environment, take a deep breath and step back.  You cannot afford a mistake.

Here are basic questions for candidates to consider in the hiring process:

  1. What is the organization’s culture?
  2. What is the organization’s competitive position in the market?
  3. Is the organization financially stable?  Are they positioned for the impact of the Affordable Care Act and the inevitable reduction in Medicare rates as a result of deficit reduction?
  4. What is the turnover rate?  If it is high, then why?
  5. Does the organization have a history of supporting career advancement?
  6. Is there a sense of mutual respect between the physicians and senior executives?