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Hospital executives, Dan and Barbara, had something personal in common even though they did not know each other and lived 750 miles apart.

Within 48 hours of one another they were terminated through no fault of their own by their hospitals which were now part of the same large health system. Both shared something else — they were stunned.  They did not see it coming.   Both were well liked by employees and physicians, they had solid records of accomplishment, above average annual performance reviews and were respected in their communities.  But in the end, in a wave of post merger changes, none of that seemed to matter.

They were victims of what some are calling Phase I Realignment in the post healthcare reform economy. Some analysts predict that it probably will get worse before the industry, like it has done so many times in the past, flips from the latest popular strategy and pursues another approach. ( In the interest of fairness, there is a logical argument to be made that this time, the market conditions spurring this wave of consolidation and realignments, are radically different.)

Long criticized by business analysts and assorted politicos for soarings costs, sketchy quality of care and inefficient operational models, health systems and hospitals are reacting to healthcare reform by scrambling to build scale locally, regionally, and in come isolated cases, nationally.  As they look at strategic options for survival, size and aggregation of financial resources seem to matter.  The loss of talented executives like Dan and Barbara at the local level apparently is the price of progress to serve the greater good. 

Now out of work, albeit with reasonable severance packages to ease the transition trauma, Dan and Barbara face another reality — fewer executive level hospital operational jobs and diminished access in most markets.  As independent hospitals are swallowed by larger health systems,  in some cases market competitors, there are fewer job entry portals, dramatically so if you want to work in an acute care setting. 

With these market consolidations come interesting career management strategy challenges. 

Barbara’s husband is a successful local business owner.  He cannot simply follow his wife to a new town and start over. Dan has more flexibility — his wife’s career is transferable — but pulling up roots in a community where they have lived for more than 15 years, where they raised their family, will be traumatic.

As I talk to candidates in transition across the country, I am struck by the coincidence and similarity of Dan’s and Barbara’s stories and, regrettably, I am finding their plights are increasingly common.  As with Barbara, a common thread emerges from displaced executives who do not have the flexibility of relocating; what options do they have?

I can always consult.

I think I will do interim work.

In the 1990s, when companies across America were resizing and displacing thousands of executives, several authors, including recovering business consultant, Tom Peters (“In Search of Excellence”,  A Brand Called You, etc.) and Daniel Pink, began talking about the “Free Agent Nation,” the phenomena to describe those executives who were realigned or consolidated out of their jobs and began pursuing independent consulting careers. They made it all sound so romantic, so liberating. 

The problem was, and continues to be, that many displaced executives do not fully grasp the reality of what it means  to be successful in this line of work, to earn an income sufficient to maintain some semblance of  the lifestyle they had when they were employed. The fact is that joining the free agent nation requires a great deal of work — a massive dedication of time, effort, and, most importantly, emotional commitment. 

Once you start down that free agent nation path, you essentially become an entrepreneur, and there is nothing easy about that career choice.

So, if you are someone like Dan or Barbara, and you want to consult or work as an interim executive, consider these realities:

  • Dogged Determination – There is a constant among the most successful entrepreneurs — they are doggedly determined and passionately obsessed — to create a business solution to meet a need/solve a problem. 
  • Value Proposition – You must understand your value proposition — why would anyone want to hire you to consult or fill a leadership based on an  interim basis?  When an opportunity presents itself that is not the time to sort out this critical concept. You have to be clear, concise in communicating your experience, and, most importantly, your success in doing what the potential client is asking you to do.  If you struggled with this as a candidate, being a consultant will only be more challenging.
  • Business development — Looking for contracts/engagements requires a massive amount of time and effort.  If you do not already have a large network of relevant contacts, or if you lack experience in networking, recognizing this requirement for success is a good place to stop and reconsider your options.
  • Rejection Is Real and Frequent – Long-time outplacement consultant Craig Honaman, FACHE, CRC, liked to tell candidates that it only takes one YES when you are looking for a job to alleviate the pain of every NO.  In the free agent world, you are almost always looking for the next assignment and that can produce a lot of rejection.

While technically I am not a free agent since I run a search firm with multiple associates in different cities across the country, I identify with the challenges executives face when they decide to strike out on their own.  There absolutely is a sense of romance and adventure, the opportunity to build something that is uniquely your own.  But there are also many days when you question your sanity as you balance your various financial obligations while looking for work, or waiting to be paid.

The key is to be realistic financially and emotionally.  Do you have the resources and emotional commitment to see it through? The difference between success and failure can be your ability to ignore the pain of enormous stress and doubt.

I would not have it any other way.  For me, a guy who was a dedicated employee addicted to a bi-weekly payroll check,  I can hardly believe I have been out on my own for more than 20 years, but my hair also turned prematurely gray.