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Every year, hundreds of hospitals recruit a new CEO. And every year, a surprisingly high number of the successful candidates fail to survive two years. Even more disturbing, many who do survive are marginal performers – they are not good enough to take the hospital to the next level of performance but they are not bad enough to be immediately fired.

RecruiterThe politics and the fallout of failing to hire the right candidate can devastate an organization.

So, why do so many boards struggle with this their most important responsibility?

Most lack the knowledge of, and experience with, a gold-plated recruitment process. They sometimes worry about the costs and do not fully realize the critical importance of comprehensive due diligence, a quality recruitment process, in-depth candidate screening, and rigorous vetting methods. More often than not they believe that hiring a nationally known firm will ensure success. That is no guarantee of anything. So what factors should boards bear in mind?

Here are five important questions they should consider:

  1. How much time will the search firm spend learning your organization – values, culture, how you do business as well as the concerns of your medical staff? Hint, this cannot be accomplished in a day or a day and a half. Moreover, it is shocking how little many search consultants actually know about their clients. Most will rely on their cookie cutter approach when what most hospitals need is a customized solution. Do not let this important engagement become just another transaction.
  2. Who will do the work? Will the consultant who conducted the due diligence visit be the one making key decisions regarding which candidates to present? For most search firms, the answer is no. This is one reason so many searches produce mediocre results. Think cookie cutter.
  3. Will the partner responsible for the search meet the candidates face-to-face before recommending them to the board? Do not work with a recruiter who relies on videoconferencing interviews. That one dimensional format is not ideally suited for making such an important decision. Candidates who have experienced that type of screening often say they never personally met the search consultant and complain that the search process was more about convenience with little emphasis on transparency.
  4. Will the search firm conduct an independent background investigation before recommending a candidate? Many firms, including some of the so-called industry leaders, do not provide that level of service unless the client makes a specific request. Checking three references does not constitute an in-depth vetting process.
  5. All search firms tout their experience and recruitment process as being the best. No surprise there.   So then the important question to ask is, if it is so good, will they share more of the risk for recommending candidate who does not work out? Hint, a one-year placement guarantee is the industry standard. The problem with that is that research shows that most of the issues that lead to termination arise in the 12 to 18 month range. One highly regarded national firm reported that 40 percent of their placements had left within 18 t 24 months. One year is not a good standard for shared risk. You should ask more questions about the scope and depth of their screening process if they are reluctant to share the risk with you.