I got one right

June 6, 2017analysis, CEO, Cognitive Skill, Decision Makinganalysis, CEO, Cognitive Skill, Decision Making, intellect, reasoning, Thinkinginterimcfo

Throughout my blog, I have argued time and again that the development and practice of cognitive ability is one of the key enablers or detractors of personal and organizational performance. I have encouraged my readers to focus on improving their cognitive skills as a means of empowering improved decision making capabilities.

When I was in undergraduate business school years ago, we were required to subscribe to and read the Wall Street Journal on a daily basis. That assignment started a discipline that has endured through my career. One of the reasons that I read the Wall Street Journal daily is that its healthcare industry coverage is as good as any. In addition, The Wall Street Journal is intellectually stimulating on many levels. For example, one of the things that has been shown to improve cognitive ability is vocabulary study. Rarely a day goes by that I do not see at least one word in the journal that I cannot define. I look these words up and record their definition. When I find myself with nothing to do, I get my list out. More often than not, these words are found on the Journal’s editorial pages that are written by some of the smartest people alive.

My article on career development has been very popular. I am honored and humbled by the number of people following my work that are genuinely interested in developing their careers and advancing in organizations. The comments, feedback and suggestions this article stimulated have been inspiring to me and motivate me to find suggestions and recommendations that will be helpful to my readers.

Many of us know and are motivated by the stimulation that comes from affirmation. In my article on career advancement, I argue for the development of cognitive ability as a means of building a foundation from which you may advance your career. One of the things that fascinates me about universities and the people that work there is that regardless of the subject, how arcane or trivial it may seem to be, there is a professor at some university somewhere that is an expert on the subject. We are so blessed and our society and life is so enriched to have these geniuses among us.

An article that appeared in the Wall Street Journal on June 5, 2017 is a very good example of what I’m talking about. This article confirms my theory that the development of cognitive ability is a critical success factor when it comes to roles and responsibilities requiring the incumbent to be able to do their own thinking. I had no idea that for many years this very characteristic has been under study. Not only that, there is a ranking of the degree to which various university programs are or are not successful in developing cognitive skills among their students. It is very sad and some may argue disingenuous that these data are not readily available to people considering one academic program over another.

The article title is: Exclusive Test Data: Many Colleges Fail to Improve Critical-Thinking Skills

So I’m vindicated. The admonition of this is that all of us can benefit from focus on continuous cognitive ability improvement. So what are you waiting for? How much more evidence do you need to be convinced that among the highest and best uses of your time is investment in yourself?

Please feel free to contact me to discuss any questions or observations you might have about these blogs or interim executive services in general. As the only practicing Interim Executive that has done a dissertation on Interim Executive Services in healthcare in the US, I might have an idea or two that might be valuable to you. I can also help with career transitions or career planning.

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If you would like to discuss any of this content or ask questions, I may be reached at ras2@me.com. I look forward to engaging in productive discussion with anyone that is a practicing interim executive or a decision maker with experience engaging interim executives in healthcare.

Best of luck – Ray Snead

Examples of what not to do – simple mistakes you have seen that others could avoid. AKA – How many ways can you get yourself into trouble?

May 28, 2017CEO, Consulting, Employment, Error, Failure, finance, Information Systems, Leadership, Management, Project, Receivablesanalysis, finance, job, leadership, managementinterimcfo

One of the items of constructive feedback I have received is that some of my articles are too long. The subject of this article resulted in an article over 2,000 words long. I have reminisced with friends in the consulting business that have suggested that we collaborate on a book on this topic based on the experiences we have had. As a result, this article will be posted in multiple editions.

A very highly regarded friend of mine recommended that I address mistakes that might be beneficial to others. Nasreddin said something to the effect that, ‘good judgment comes from the experience we get from exercising bad judgment.’ Given the benefit of this insight, I will address some of the things that I have seen as the cause of extreme angst in one healthcare organization after another. An exhaustive listing is beyond the scope of any article. However, I welcome tips and stories from my readers addressing vivid memories of things that would be beneficial for others to know, especially those that do not have the experience of some of us.

Blind trust of systems

This is one of the most basic managerial errors and it is seen over and over. People ‘assume’ that a system will or will not do something without proving the assumption only to be surprised when their blind faith is proven wrong in a spectacular faux-pas. Rather than assuming that people understand the meaning of the word ‘assume’, I will define it by dissection. All to often, people engage in assumptions leading to flawed decisions that make an ASS/out of U/and ME. I wish I could remember how many times I have witnessed flawed assumptions wreaking havoc around me. Sometimes, these errors result in terminations of the people involved. Mark Twain and Ronald Regan said that, “It is not what you know that will get you, it is what you are absolutely certain of that is just not right.”

Once upon a time when I had reason to doubt the controls in the hospital’s accounts payable system right after a new state of the art, super whiz-bang application had been implemented, I was assured by my Controller that there were safeguards in the system that he said would guarantee that there was no scenario under which an automated check for more than $25,000 could be produced and signed with my facsimile. I had set this limit to insure that I had the chance to personally review large disbursements and sign them manually. About a week later, it came to my attention that instead of keying a construction draw request of less than $25K, the A/P clerk keyed the remaining balance of over $275K to a contractor that the hospital was engaged in an active dispute with. What do you think happened when this transaction went through the system without interruption and out to the contractor? If you ass/u/me that he brought the check back, you would be sorely mistaken. I am sure others can provide similar nightmare stories.

There are thousands of ways to be trapped by our own systems. The more complex the systems, the greater the number of interfaces with other systems and the higher the volume of transactions, the greater the potential for error and the larger the error will have to become before it is discovered by normal control and balancing processes.

Hiring mistakes

Another HUGE area of learning in the school of hard knocks is hiring decisions. Jack Welsh said something to the effect of, “Getting the right people into the right jobs is a lot more important than developing a strategy.” As an interim executive I have observed that one of the more common areas that gets organizations into trouble is hiring decisions that result in people being put into roles where they cannot succeed. Some organizations and hiring decision makers are highly motivated to put the next person in line into a role whether they are qualified or not. I have been criticized for bringing people from outside of town into the organization to fill crucial roles. My response is that if properly qualified local applicants were available, I would hire locally to save travel money if for no other reason. I have counseled Boards and written on the subject of organizational performance being nothing more complicated than the collective caliber of the team on the field. One of my mentors taught me by example the potential and value of getting the right people into the right places in an organization and the difference they can make.

Getting the right people is as important if not more important than avoiding hiring the wrong people by making mistakes in the vetting process.

AR valuation

I have seen so many executives brought down by incorrect valuations of their accounts receivable that I have lost count. So many in fact, that I was inspired to address one of my blog articles to CEOs that all too often become one of the first victims of this error. The article asks the question, ‘have you been caught looking?’ One of the biggest risks on a hospital’s financial statements is the valuation of revenue and accounts receivable and for every understatement, there are multiples of over-statements of receivable and revenue value. In fact, I have not seen an undervaluation recorded although I have been in arguments with outside auditors about under and over valuations of revenue and A/R. It is a lot easier to convince an audit partner to not book an undervaluation than it is an over valuation. The executive that wishes to avoid becoming a victim of this trap needs to take the advice of my article on the topic to heart.

AR reclassifications

A reclassification of AR is potentially more dangerous and harder to catch than a simple error in calculating realizable value. For example, consider an organization that holds self pay balances after insurance in the same bucket as the insurance. This is considerably more common than many managers appreciate. Suppose a commercial receivable is valued at 70% of the underlying charges and self pay receivables are valued at 5%. When an amount like $5 million is reclassified from insurance to self pay to clean up a backlog after the insurance balances have been satisfied, the adjustment to the value of receivables will be 65% (70% – 5%) or $3.25 million. There are other reasons for balances to accumulate in the wrong buckets on the receivable system leading to reclassification adjustments. The receivables are not wrong, they are just valued incorrectly. This kind of error is enough to knock an enormous dent into or potentially wipe out the operating income of any enterprise. There are rarely adequate cushions or reserves in realizable value calculations to absorb a shock like this.

Summary

As can be seen, a text-book could easily be written on the topic of what not to do. There are plenty of texts that are written on what to do, they are just all too regularly ignored. Some leaders seem to not have the ability to connect academic learning and practice. These are but a few examples of things that I have seen go wrong in healthcare organization’s business operations. This discussion is a good example of the value of experience. Experienced executives operating on evidence based practice have a far better potential to avoid these pitfalls and others. Sometimes the value of an executive in an organization is more related to what they know than what they do. Once a patient in an outage accosted a surgeon over his fee. The patient took the position that the fee bore no relationship to the time spent on the procedure. The surgeon replied that 5% of his fee was for the cutting and the other 95% was for knowing where to cut and what not to cut.

My plan is to publish another article on this topic with more examples of what not to do. If you have any stories to contribute, I would love to hear them.

I would like to thank Dr. Christy Lemak, Dean of the Health Administration program at the University of Alabama at Birmingham for inspiring this article. I am looking forward to seeing my grade.

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Should I pursue professional credentialing?

April 24, 2017Association, CEO, Certification, Employment, Job, Leadership, Management, Personal Development, UncategorizedCEO, CEO turnover, Certification, employment, healthcare leadershipinterimcfo

I need to start this article with a disclaimer. I am HIGHLY BIASED in favor of professional credentialing. If this is offensive to you, stop reading this now. I am fairly well credentialed. I have a Masters of Business Administration degree and a Doctorate of Science in Healthcare Administration. I hold Fellowship certifications from both the Healthcare Financial Management Association (HFMA) and the American College of Healthcare Executives (ACHE). I hold HFMA certifications in Managed Care and Patient Financial Services (PFS). I am in the first class to be certified by HFMA in managed care and I was the national co-valedictorian in my HFMA PFS exam class. I served a sentence on HFMA’s Board of Examiners (BOE) including a year as Chairman of the BOE. The BOE is responsible for HFMA’s professional certification program. Other than this, I have not done much to improve myself professionally or promote professional certification.

Lest this come across as self aggrandizing, you should know that I had a rough time in high school but ended up being the first in my family to earn a bachelor’s degree and that undergraduate degree was bestowed by The University of Virginia’s McIntire School of Commerce. One of the highlights of my service to the healthcare profession is my service on HFMA’s BOE. A number of changes to the HFMA certification process occurred during my service on the Board and as the Chairman of the BOE that I am very proud of. Changes that were focused on making the certification process more objective and making the preparation process more efficient.

You’re damn right I think credentialing is important.

More than anything else, I think a professional credential makes a statement about you. I discuss this in my article about getting ahead. Holding professional credentials makes a statement that you have shown willingness to go beyond the minimum required by a job to be recognized by your peers in your discipline as being one of the best among them and an example for others seeking career advancement and improvement.

Professional certifications usually require a combination of education, experience and ability to demonstrate mastery of a discipline. The effort required to obtain a credential is useful in that in the process of achieving the recognition, it is impossible to not learn something or possibly a lot. This knowledge is helpful in career development and can differentiate you from your peers in a competitive job or search situation. Among your peers, those with professional certifications are typically held in higher esteem.

For some credentials and some disciplines, certifications are minimum requirements for certain roles. There was a time when holding an ACHE Fellowship was practically a minimum requirement for becoming a hospital CEO. That is not as true today because of the shortage of FACHEs and the effects of some head-hunters focused on making their own jobs easier by convincing Boards of Directors that requiring professional certification will unnecessarily restrict the pool of candidates. My question of a Board making a decision like this is why would they want to expand their net to catch applicants that did not feel that getting certification in their discipline was important? Ironically in hospitals, these Boards preside over medical staffs that increasingly require Board Certification of their members. My question is if they support requiring Board Certification of their physicians, why would they intentionally establish a lower threshold for the executives operating the organization? If the demand was higher for certified leaders, it could result in an remuneration differential and lead to more executives seeking certification. If I was advising a Board or a hiring executive, I would and have required headhunters to build a very strong case for recommending consideration of a non-certified executive when certified executives are available.

If you are an executive that is interested in career advancement, my advice is that credentialing is one of the first things you should consider. The type of credentialing you pursue can vary depending upon your current or desired role. In nursing for example, a wide variety of credentials are available. Many nurses carry several credentials.

We have all heard the adage that if something was simple or easy, everyone would have it. This principle certainly applies to credentialing. Credentialing can be expensive, time consuming and difficult. Credentials require a combination of minimum education, in-role experience, examinations, service under the tutelage of another certified leader and the like. Each discipline has a process for determining the requirements for one of their members to be recognized as the best among them. Some are more rigorous than others. An argument can be made that the more onerous the process, the higher the value of the credential and the greater the degree to which a credentialed executive is set off from his peers. In the case of HFMA, the credential is a Fellowship and it is earned by less than 10% of the members. If you are a HFMA member, start paying attention to the certified status of your peers and look at their career advancement success compared to the 90%+ of uncertified members. It should not surprise you to discover that the type of people that pursue professional certification are the same type of people that tend to advance their careers faster than others. Is it the credential? To a degree, I would argue that the answer is yes.

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What is a blind reference?

February 25, 2017CEO, Employment, Interviewing, Job, Leadership, Management, Mentorship, Personal Development, Severance, Termination, Transition, TurnoverCEO turnover, employment, healthcare leadership, hire, interim, job, recruit, reference, severanceinterimcfo

Some people naively think that the only reference checking that is done is with the references given by a candidate or a head hunter. Executives recruiting for talent will peruse your CV looking for places where you might have common acquaintances. They will also look for places that some of their friends and professional contacts might have insights. When these links are found which is most of the time for an experienced recruiter or hiring executive, you are about to become the victim of a blind reference.

A ‘blind reference’ is an investigation into your past by a hiring executive that you know nothing about.

I do not put a lot of faith in references provided by a candidate although I have had candidates give me references that were not very complimentary of them. If you are going to give a reference, at least have an idea about what they are likely to say about you. No one that has any sense is going to intentionally give a bad reference on a candidate to a stranger. I also disregard reference letters. No one is going to write a letter that states the candidate is bad. On occasion, I will write a reference letter for someone as a personal favor but I aways counsel them that reference letters in my opinion are a total waste of time. The only time I pay any attention to a reference letter is if I know the author.

Because of political correctness and the cold legal realities associated with references these days, the best you are going to get from formal references in most cases is that the candidate was hired on one date and departed on another date. The most you are likely to learn is that the candidate actually did work for the firm you are contacting for the stated period of time. They will rarely tell you anything more because references are subjective by nature in most cases. Subjective references that cause a candidate to be ruled out of a search can become a liability for the person that gave the reference. This is one of the reasons that blind reference checking has grown in my opinion.

If I get a reference call on a candidate being evaluated by someone I do not know, I refer the call to HR where I know what they are going to be told. Even if the reference call comes from a friend, I know the candidate and I know them to be bad, usually instead of giving a bad reference, I will refer my friend to HR where they will get the standard, canned response. The hiring manager gets the message. If a friend encounters me refusing to give a reference, they always get the message.

The more frequent call that I get is from a decision maker that is checking references that are not on the candidate’s list. These are the calls that are dangerous for candidates because they are blind to the candidate; hence a blind reference call. The candidate will never know in most cases they were vetted through a blind source. This is one of the many reasons why it is so important to keep up your networking and to not burn bridges unnecessarily. If you left a place under questionable circumstances, you need to have a good explanatory story and you need to be forthcoming and transparent. Of course a blind reference is not necessarily a bad thing. Under the right conditions, it can propel you to the front of the line. I received a blind reference call on a candidate I happened to be considering at the same time. I told the blind reference caller that they could dispense with their questions because my reference will be very simple, “If you do not hire her, I will.” I had worked with this candidate before and she is outstanding. She was going to end up with a gig regardless of how the reference checking worked out in this case.

When I get a blind call from someone I know and trust, they are going to learn the whole story. The reason is that I know I can call them to have the favor returned at some point in the future. If the candidate departed under less than ideal circumstances or told a story that I know to not be true, I will give the reference to HR as stated above. This usually surprises the decision maker that hoped to get something from me. The fact that I refuse to provide a reference for someone that the decision maker knows I know well usually tells them enough, especially when I put off multiple requests for help. About the third time I refuse to provide any information, the recruiting executive gets the message. If you are going to engage in this activity, you have to be absolutely certain that your confidence will be protected. This is the main reason that I resist giving references to head hunters unless I know them personally because it is hard to be certain your confidentiality will be protected.

When you are looking for a job, who will the hiring decision maker call? What will they be told by people you used to work around? Time after time, I have received blind reference calls. Often, these calls are about someone that has done little if anything to endear themselves to me or to even keep in touch. People like this generally do not return calls, ask of an acquaintance while offering nothing of value to i.e., they do not engage in networking, they do not accept meetings or referrals, they do not attend or participate in industry related networking or continuing education activities such as ACHE or HFMA. I wonder what these people expect I am going to say about them? And of course, all of this is above and beyond anything I might know about their acumen, experience or capabilities. I would rather not receive these calls in the first place but I do not control who calls me.

I do not know what it is about some people. In one case, I reached out to an executive that I thought might benefit from my insight about handling executive turnover in his organization. He humored me then never called me back in spite of the fact that I specifically requested a call regarding a wealth of information that I volunteered. I never heard from him and I do not expect to hear from him because his failure to take my advice was at least partially responsible for his own firing a couple of months later. A few weeks ago, I got a blind reference call. The guy was seeking employment with a consulting firm and I knew the hiring executive very well. What do you think happened?

This kind of thing does not have to happen to you. If you are smart, you will get serious about networking and building as many positive relationships as you can. Many of these relationships come from active participation in associations, alliances and industry peer groups. You should volunteer your time to give yourself exposure to people that you might need for a job some day and in the process help them develop a positive impression of you.

There is a saying that there are three kinds of people; Those that make things happen, those that watch things happen and those that wonder what happened. You never know when someone is going to make a call to someone that you might not even know; about you – a blind reference. When that occurs, what will the results of that call be? If you or someone you know is having difficulty getting a job and their qualifications appear competitive, they may be the victim of blind reference checking which puts them in the category of wondering what happened.

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Just a nurse?

December 24, 2016CEO, Employment, Job, Leadership, Management, nursing, Personal Development, thanksgiving, Valuefox news, leadership, nurse, nursing, politicsinterimcfo

Merry Christmas. This article is my Christmas gift to my readers, especially nurses whether they read my blog or not. I thank you for your support and wish all of you the very best for this Christmas season and a safe and prosperous new year.

My wife sent me an article that ran in Fox news about an Australian nurse that fought back on Facebook after having her fill of hearing, “just a nurse.”

One of the saddest aspects of our society in my opinion is the general lack of regard that people have for hospitals. It is especially demoralizing when community leaders are actively engaged in destroying their community hospital and in the process disrespecting the doctors, nurses, volunteers, leadership and hard-working employees who would do anything for them at any time, no questions asked. It makes you wonder whether the people who engage in this destruction even care about the capability of the hospital should they or one of their loved ones be stricken with an accident or illness. I tell audiences regularly that it is not hard to see that people do not care about the hospital . . . . until they need it. The same people who persecute voluntary trustees and administrative representatives of their community hospital expect nothing but the best that medicine has to offer when they or one of their loved ones needs the hospital’s services. Some of these hypocrites will quietly seek healthcare elsewhere while doing nothing constructive to help their community hosptial. Sometimes I wonder if the people in the towns where these activities occur realistically believe that they can escape an involuntary visit to their community hospital when they are the victim of an accident, a heart attack or some other unanticipated serious illness?

When the people who engage in activities of this ilk intentionally denigrate their hospital, they are disrespecting all of the employees, physicians and volunteers of the hospital by inference regardless of what they say. Just like the disgusting, duplicative politicians that commit the young people in the military to life endangering missions then withhold resources and/or engage in open criticism of the military. This disingenuous behavior is too routine in our society when we witness the spectacle of politicians holding hands and praying together before they send the military overseas only to then undermine and denigrate military leadership and increase the number of body bags coming home by their subsequent lack of support.

I view a hospital like an aircraft carrier. On a carrier, EVERY person aboard the ship has a job that can be directly traced to the support of a relatively small number of airplanes and their pilots. The ratio is over 6,000 to about 100. In a hospital, the primary reason for every person in the organization is to support the nursing function, more specifically, bedside nurses. The services delivered in hospitals are for the most part ordered by physicians but they are delivered by nurses. It is the nurse that is in the building with the patient 24/7/365. It is the nurse that will place themselves between a patient and any source of danger or threat. It is the nurse that is the first responder to the patient’s every need. It is the nurse that carries our their responsibilities with dignity and pride even when they are disparaged or abused by physicians and other authority figures in a hospital. It is the nurse that is the voice of assurance when a patient is afraid. It is the nurse that is left to pick up the pieces when a tragedy occurs. It is the nurse that carries out the final preparations following death.

Nurses control resource utilization and therefore the cost of providing healthcare. It would seem that executives that are interested in getting more out of nursing would see to it that nurses have what they need to do their job. In my experience, most of the time, no one has to tell nurses what to do. They know what to do and they will do it gladly if we will facilitate their efforts and get out of their way. Those of us in healthcare administration should be ever vigilant to remove barriers, policies and procedures that frustrate the efforts of our nurses to give their patients our collective best. Nurses influence patient satisfaction and patient outcomes. One of the greatest sins in society in my opinion is activities of any kind in a hospital that undermine nursing, particularity when these activities are carried out by authority figures.

You do not have to teach or train a nurse to be compassionate or focused on error free work. In fact nurses operate at far higher levels of performance than the rest of us usually appreciate. Most of us would not make it very long if we had to perform at the level of our nurses. Nurses understand the grave consequences of errors in their work. All too frequently, a nurse that is involved in an all too common human error becomes the second victim of a bad outcome. That these people can function at all under this stress tells the rest of us how incredible our nurses are.

I have thoroughly enjoyed my relationships with nurses over the years. The type of people who gravitate to nursing are special. Most of them are motivated to be in a position to do things to help other people in their time of need. They do not allow those of us that are ‘bad patients’ to detract from their focus to give us their best. Their attitude is always positive and uplifting even when we are in the mist of having our worst day(s) and showing it liberally.

Most hospitals recognize their nurses by providing badging that clearly indicates that they are nurses. One of my personal crusades is to make sure that EVERY nurse in the organization whether they are a bedside nurse or not PROUDLY display their RN identification so that no one will mistake these giants of humanity for any one of the rest of us regardless of their role.

What would our world be without nurses? What would our world be without the type of people that gravitate to nursing? What are we doing as leaders that is making life more difficult for our nurses? Are we creating environments more or less conducive to patient safety?

The next time an opportunity presents itself, do not miss taking the time to thank every nurse you meet for their service to the hospital, its patients and your community.

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Thanksgiving 2016

November 20, 2016Personal Development, thanksgivingfriends, season, thanks, thanksgivinginterimcfo

As hard as it is to believe, it is Thanksgiving again already. Thanksgiving is a time for all of us to stop running like we are crazy and reflect upon what we have to be thankful for. Most of us are blessed beyond anything we deserve with health, family, wellbeing, a career and a lifestyle. Most of my generation is blessed with a much higher standard of living than we grew up in. In my case, I am so blessed that I would not know where to start to give proper thanksgiving for all that I have to be thankful for.

I am thankful for each and every one of you, my blog followers. I am thankful for every person that has intervened throughout the course of my life to save me from myself or to mentor me so that I might be better prepared to serve healthcare organizations at their time of need. Many of you have played critical roles by providing opportunities that have helped me to grow my skill and relevance to organizations in transition. Many of you have taken chances on me to provide opportunities that I likely did not deserve to demonstrate that I might make a difference. I am eternally grateful to everyone that has played a formative role in helping me become the person that I am today. I sincerely hope that I have not been too much of a disappointment to some of you.

I am eternally grateful for the unbelievable people I have had the privilege of working with. The incredible demonstrations of integrity, drive and knowledge around me have inspired me to embark on a never-ending odyssey of self-improvement. I wish I was able to personally thank each and every one of you but time does not allow and I would be certain to overlook someone.

Recently, a CEO of a hospital I had served told me that the place was better for my intervention. He went on to say that people in the town that never knew I was there owed me a debt of gratitude for the difference my service had made in that hospital and community. Like so many people like us, this is what we live for; the opportunity to make a difference. To help an organization and the people that make it up be better for the patients and families we serve. We are so blessed to work in healthcare where our work improves the abilities of the organizations we serve to save lives and heal people.

Each and everyone of us can always find ways to be better. This is a heavy burden for those of us serving in the healthcare industry. In our case, people that do not know us are entrusting their very lives to our ability to insure that the organizations we serve delivers the very best that is possible for them.

I owe my family, especially my wife, thanks for putting up with me . . . through years of education while working. For getting moved several times. For suffering with me through terminations and transitions. For encouraging me and believing in me when no one else believed in me including myself.

I am thankful that I live in the United States. In spite of the malaise that characterizes our country and the political divisiveness we suffer under, we still live in the best country on earth. Not deterred by the fact that over the past eight years, we have seen the standard of living begin to fall as opportunities for the young, especially those in the middle class evaporate or are exported over seas; we can remain thankful and resolved to each do our part to fix this mess for our children and grandchildren. Now we have a historic opportunity to reverse some of the blight that has overwhelmed our country.

We all need to remember and be thankful for those that sacrificed so much to give us what we have in spite of the thankfully shrinking contingent of consistently incompetent, self-serving, dishonest and sorry politicians that we elected. This is one thing we can thank the current administration for. There has never been such a comprehensive sea-change of leadership at every level in our country inspired by disgust at what Washington has become. Remember, it was around this time in 1941 that the Japanese fleet sailed for Pearl Harbor.

Last but not least, I wish to especially thank those in my inner circle. Those that report to me directly or work closely with me who collectively have seen to it that I do not fail. They consistently refuse to let me quit or get down on myself. Not only that, they will not allow me to get discouraged in spite of the daunting tasks I face. They will not allow me to become demoralized and they continue to sacrifice much of themselves for the cause of the hospital we serve to insure that failure does not occur on our watch. Thanks to all of you.

Every year, I try to make some calls during Thanksgiving week to thank some of the people that have meant so much to me. I encourage you to do the same. Life is so delicate, precious and short. Among my regrets are things that I wish I had said to some people about how much they had meant to me or my family before it was too late. Do not let this happen to you.

Here is a thanksgiving toast to you and yours: Here is to health, money & love and the time to enjoy them – John D. McDonald

THANKS to each of you for being such a positive part of my life. I wish the very best for you and yours for Thanksgiving and the upcoming Christmas season. I appreciate each and every one of you.

Ray Snead

Where is Mark Richt?

October 23, 2016CEO, Employment, Football, SportsBoard, CEO, CEO turnover, employment, healthcare, interim, job, richt, UGA Footballinterimcfo

A lot of people do not understand executive succession events. It is common for a leader to be liked inside and outside the organization. The performance of the leader is seen differently based upon the perspective of the viewer. While many may see a leader as ‘nice’ and ‘trying hard’ others see him as ineffective. In several of my articles, I make reference to the fact that as you progress in leadership, you are evaluated more on the results of what you do than the effort expended in leadership. Some times, personal or organizational limitations inhibit the potential of a leader to be effective regardless of how hard he tries. Ultimately, the people responsible for the leader conclude that in order for the organization to reach its perceived potential, a leadership change is necessary. It is at this point that executive turnover begins and it is almost always followed by collateral turnover as lower level leaders are replaced in an effort to improve the ability of the organization to better meet its challenges or mission.

In Georgia, we have an excellent example of this phenomena. When someone asks me what happened to someone or how the organization could do something so harsh to such a nice guy, I ask them, “Where is Mark Richt?” In November of 2015, the University of Georgia announced that Mark Richt was leaving. Many wonder why. This gives me an opportunity to launch a Socratic dialog. My questions usually go something like this:

Would anyone argue with the following premises?

That Mark Richt was not a nice guy?

That he compiled a record at Georgia and in the NCAA that places him among the icons of sport leadership?

That he did not understand the game of football?

That he did not want to win?

That he did not live an exemplary Christian life?

That he intervened in the lives of dozens if not hundreds of young people to set their lives on a better course?

And in spite of all of this, he is gone. However painful the transition must have been for him, at least it was a homecoming of sorts as he has returned to his alma mater in Florida.

The reason for the transition is that the people responsible for Mark’s employment concluded that the program was not going to reach its expected potential under his leadership. Those of us familiar with SEC football know that this means that nothing much matters in GA if you cannot beat Alabama and Florida consistently.

People are inclined to blame a lot of things for a situation like this. Things like recruiting, the players, the coaches, facilities, funding, the play book, play calling and on and on. Sometimes a coach like a business leader is handicapped by unexpected loss of talent due to behavioral issues like those pointed out in another of my articles, injuries, transfers or other losses. The reason is irrelevant. The leader of an organization or part of an organization is accountable for the results achieved or lack thereof and a responsibility that cannot be abdicated rests upon his shoulders.

Sometimes, leadership turnover induced in an organization makes things worse. We will see as the season progresses if the Georgia team has achieved improvement. As is the case in situations like this, it may take some time (several seasons) before the final analysis can be done. As I have said before, if you are a leader, you have to lead; from the front. You cannot wait for someone to tell you what to do. In order to be effective, you must take initiative and frequently risk if you wish to keep yourself ‘off the radar.’ This is unless you have reached the limits of your capability and are falling victim to the Peter Principle. If this is the case, you still have control of your destiny. You must continue to invest in yourself though study, professional credentialing, post-graduate education or other means of continually re-inventing yourself and maintaining your relevance to a constantly changing and increasingly challenging environment.

The current healthcare environment is difficult to say the least. As the industry transitions to value based payment, many of the rules and assumptions of the past are crumbling before our eyes. Individuals and organizations that are capable of adapting and prospering in this rapidly changing environment will do well while many others will fall by the wayside. Leadership is hard enough in a ‘stable’ environment if there is such a thing. It is infinitely more difficult in an environment where the organization is striving to improve itself while it reacts to external environmental forces.

What is the outcome of your self assessment? Are you up to the challenges? Do you understand the nature of coming heightened demand to make your area better? If so, are you up to the challenges and opportunities that are being presented?

One of my personal challenges is that I am ever cognizant of the difference between what I believe are my capabilities those of my team of leaders and what I believe the environment is demanding. I will never be satisfied that we are accomplishing as much as our collective potential should deliver. As a result, I spend a great deal of time in continuous study and research in an effort to improve my ability to understand and properly respond to challenges, opportunities and risks that come my way every day. I feel the burden of leaders reporting to me, the staff of the organization, the patients, the medical staff and the hope of the community that we will ‘get it right’ for them. I find the exhilaration of this dynamic environment stimulating and I am up to the challenge. My hope for you is that through these articles and your development of you own capability you will be inspired to emerge as one of the strongest leaders in your organization.

As the healthcare environment continues to become more challenging, organizations and their leadership teams are being shaken out. This is what is causing a lot of the consolidation we are seeing in the healthcare industry. Leaders, systems and processes that worked in the past are failing in this tougher environment. Some of the problem is government induced problems that are difficult if not impossible for community hospitals to overcome. An example is the cumulative effects of government healthcare policy on rural hospitals that are systematically being forced out of business. In spite of these handicaps, some organizations do better in a given environment than others. There is a dearth of leadership in healthcare just like there is in professional sports, business and other endeavors. One of the causes of the inordinately high turnover in healthcare administration is a continuing effort on the part of hospital Boards and executive leadership to improve the caliber of talent and this effort is one of the reasons that good people are being turned out of organizations at an alarming rate. One of the few benefits of this activity is that it is creating growing demand for Interim Executive Services.

This is original work. This material is copyrighted by me with reproduction prohibited without prior permission. I note and provide links to supporting documentation for non-original material.

What is the value proposition of an Interim Executive?

October 2, 2016CEO, Consulting, Interim, Job, Leadership, Management, MentorshipCEO, CEO turnover, employment, executive, healthcare, interim, management, recruit, temporary, turnoverinterimcfo

Interim Executive Services as defined in my ‘About‘ page is not as common in the US as it is in Europe. On the continent, in order to practice as an interim executive, a person needs to have a certification similar to a CPA in the US. In the US, it is still the wild west when it comes to interim executives. A few years back, a private enterprise in NC attempted to establish a credential for interim executives but the effort failed so now it is a buyer beware market. There are firms providing interim services but in my experience these firms do very little in terms of either training or providing oversight for their interims. The interims are placed and they are usually on their own from that point. This raises the question of the value proposition of an interim executive because the proposed pricing is usually higher than the hourly rate for the employee being replaced.

In my experience dealing with buyers of interim services, the first and often most heavily weighed consideration is the cost of the interim resource. The less sophisticated the decision maker, the more likely that they will be motivated primarily if not exclusively by cost. This is because they do not get or choose to ignore the value proposition. This has happened to me time after time. Each time, I held my ground and demanded a fair premium for my services. In each case, I told my client that if they did not find value in my services, they could terminate me without cause or notice. Once they had a chance to experience what a sophisticated interim executive could provide, the cost issue was not raised again. A decision maker that seizes an opportunity to buy interim services at a small or no premium should be worried about what they will be getting for their money.

I am aware of interim firms that prey on executives in transition that are desperate for income. Some of these interims will take any job at any price. The interim firm then sells their services based on price alone and is successful getting a markup of 30% to 50% while providing a price sensitive decision maker just what they paid for.

What would rationalize a premium for a sophisticated interim executive? There are many considerations that a decision maker should contemplate in addition or in lieu of rate. I am making repetitive use of the adjective ‘sophisticated’ when referring to interim executives. There are differences in the sophistication of interim executives and the decision makers that engage them. These differences are discussed in an earlier article.

The criteria below while useful in understanding the value proposition of a sophisticated interim executive may be equally if not more valuable in evaluating potential interim resources for fit in your organization.

I would advise against hiring the first interim you see unless you have a recommendation from a source that you highly trust. When I worked with Tatum, they made it a habit to present at least two resources on each project so that the decision maker would have the ability to see more than one alternative and make their own choice instead of letting the interim firm sell them on whoever happened to be currently sitting on their bench with nothing better to be doing at the time.

Experience – One thing worth paying a premium for is experience. The typical interim executive is a late career individual with a lot of experience, usually in a number of organizations. The depth and breadth of this experience allows them to assimilate quickly an organization and to begin creating value almost immediately. This is particularly true if the interim has on-point experience, something you should always look for.

In addition to career experience, it is worth paying a premium for an interim executive with multiple interim engagements on their CV. The approach to a position as an interim is radically different from what one would take as an employee. It is worth paying a premium for an experienced interim unless you already have another interim in the organization that can serve as a mentor.

Credentials – In addition to being highly experienced, sophisticated interims tend to carry above average credentials. Things like advanced degrees, CPA certifications, ACHE, HFMA and/or fellowships. These credentials may or may not specifically make one person better than another but the probability that a credentialed executive is going to have a higher level of cognitive capability and an innate drive toward personal excellence is a pretty safe bet. Another consideration is that no one requires executives to seek advanced education and professional credentialing. In a situation where everything else is equal, I will always favor a credentialed individual because the very fact that they have obtained a credential is proof of their drive to go beyond the minimum required to get by. In my experience, credentialed executives are always superior for this reason alone. As most of us that are credentialed know, you do actually learn something in the credentialing process that might come in handy once in a while.

Expertise – Knowing what you are doing should count for something. I have seen more than one decision maker hire the first resource they could find that had a heart beat only to make the situation infinitely worse when the interim executive failed. Most decision makers I have met do not know how to supervise or manage an interim executive. For example, I would argue that most CEOs do not have the ability to manage a CFO from a technical or risk management standpoint. I discuss this phenomenon in an earlier article. The risk for the decision maker is that if the interim fails, the decision maker will usually be held accountable. The interim will go on to the next gig while the decision maker that may not have been considering relocating finds himself hanging paper from home.

Mentorship – Sophisticated interims are invaluable in the potential they present to mentor rising executives in an organization. A sophisticated interim executive that knows how to mentor properly can help turn younger leaders into rising stars. In addition, interim engagements frequently lead to demand for additional interim resources that were not anticipated at the beginning of an engagement. In this situation, an interim that has the capability to manage and/or mentor other interims can bring a very high value to an organization. I have engaged a number of interims while serving as an interim myself. I can say from experience that I believe I have delivered substantial value by making sure that the other interims were doing what they are supposed to be doing.

Judgment – You have probably heard the one liner that says, “Good judgment comes from experience that we get by exercising bad judgment.” I would argue that having the ability to bring above average experience and judgment to bear on a problem is worth paying for. Experienced executives, especially interim executives can be expected to have better judgment than a decision maker might be accustomed to.

Stability – A transition situation is unstable by definition. My practice has shown me that the only thing you can be certain of in a transitory situation is that you cannot be certain of anything. Some people have difficulty dealing with unstable, unpredictable situations. After or arguably before a decision maker initiates a transition, they should be thinking ahead about their next steps and high among them should be an effort to stabilize the situation so that a business interruption or a bad outcome may be avoided.

Morphing deals – Some people need predictability and stability in order to function effectively. They are unnerved by constantly changing circumstances and seize up. An experienced interim executive knows that as a project progresses, things will happen and changes will become necessary that were not initially expected. The project morphs from one set of circumstances to another. It is worth paying for experience that can not only help stabilize a situation but experience that can adapt to unforeseen challenges.

Easy to sever – I have seen interim engagements fail. There is no way that I know of to accurately predict in advance if the interim executive will be what was expected or whether or not they will be effective in your organization. In the event that the engagement is not working, you should have the ability to have the interim replaced immediately without cause or reason. I discuss this in my article about contracting. If the interim deal is not working, it is highly unlikely that it will improve. I have had to terminate an interim before the end of their second week in an organization. In the event that something like this occurs, the sooner you act, the less the potential for damage. The other side of this is that the issue may not be anything worse than a bad fit. I am happy to be the easiest person in the organization to get rid of but if I am expected to bear this risk, part the premium I receive justifies me taking this risk.

Interim services firms will endeavor to mitigate this risk by asking for minimum engagement time periods. My advice would be to pay the premium and refuse to accept a minimum term as explained in my contracting article.

Velocity – In my article about contracting, I talk about the importance of velocity as it relates to interim engagements. Frequently, decision makers procrastinate about making a decision but once they make up their minds, they want the resource TOMORROW. Providing this kind of flexibility is worth paying a premium for especially if the resource you want has been waiting for you to make a decision. If you want a resource to sit around waiting for you make a decision and be at you beck and call at any time, you need to be prepared to pay a premium for this luxury.

Rapid acclimation – When I was at Tatum, the firm’s mantra was ‘Velocity.’ The connotation is that the firm focused on rapid response. What I have learned from the stages of an interim engagement is that once a decision maker decides to bring an interim executive in, they want them tomorrow. Part of the premium a decision maker pays is to get an interim executive to get to their site quickly, Sophisticated interim executives also know how to assess a situation quickly. This skill and experience allows them to become productive much faster than would be expected of an employee. Decision makers tend to vacillate and procrastinate about a decision to bring in interim resources. They should not be unhappy about paying a premium for a resource that can help them compensate for the time it took to get the interim on their site.

No benefits – An interim deal is simple from the perspective that it usually only involves the professional fee and out of pocket expenses. Unsophisticated decision makers will compare the salary rate of the departed employee with the billing rate of the interim and conclude that the interim is expensive without taking into consideration that the employee had benefit cost somewhere in the range of 25% of their compensation. Not having an interim executive on the organization’s benefit plan is clean and can be a cost saving aspect of the engagement.

Living and travel burden – If you don’t think an interim executive deserves a premium, try living in a hotel and traveling every week. Not only does this create an expense that substantially adds to the cost of an interim engagement, it is very hard on the interim executive. The longer the engagement lasts, the harder this becomes on the interim. It is too easy for decision makers to forget the interim executive as they are going home a warm meal and the privilege of going to bed with their spouse while the interim is separated from their family, eating out and going to sleep in a cold bed. This aspect of interim executive consulting by itself warrants a premium. I accept that the burden of travel goes with Interim work but I wonder if the price my family and marriage have paid for me to do this work has been worth any amount of money. I have lost my sensitively about what I ask for my services primarily be causes of the burden that the interim lifestyle places on the consultant. I discuss this in detail in my article about becoming a an interim executive.

While I could take the position that it is not a problem of mine, I deeply resent the cost associated with being an interim executive. Travel, food, temporary lodging and other costs associated with an interim executive is a significant proportion of the total cost of an interim resource. It drives me crazy to pay these costs or incur them on behalf of a client. This is one of the strongest reasons for making sure that you are getting your money’s worth from any interim you engage.

Hired independently or via a firm – My experience is showing me that there is a growing population of ‘free agent’ interim executives. Firms that place interims will take somewhere in the range of 30% – 50% of the total professional fee for their overhead and profit. In addition, because of what I would describe as oppressive government overreach, most if not all firms now require their interims to work on a W-2 instead of a 1099 or K-1. This can result in the interim losing tax benefit in the best case and paying tax on out-of-pocket expenses in the worst case. While free agent interims can be harder to find because you have to know how to network to find them, they can be less expensive because they are not taking a hair cut in a direct deal. In my experience, a free-lance interim is likely to be much better than interims that come from firms for a variety of reasons that are beyond the scope of this article.

Summary – I could go on but I trust that as a decision maker or an interim for that matter, you can see that there is plenty of justification for a premium for interim executive services. The premiums I have seen run 50% or more over the base salary of the executive being replaced. If you are a decision maker, you should not be afraid of paying a premium to get superior skills and resources brought to bear quickly on complex or dangerous business problems and or transitions. Quibbling over rate can slow down the process of getting the right resource and can prevent you from getting the best possible skill in place. One of the most profound value propositions of an interim executive is their ability to raise the probability that the decision maker that hired them will not also become a victim of the transitions that created the need for the interim in the first place. In my experience, decision makers routinely discount this aspect of an interim engagement’s value that is in my opinion one of the strongest reasons for paying a premium for the right interim.

If you are an interim executive, you should not ever sell yourself short. I took a haircut on a deal that was only supposed to last 3 months to mitigate on behalf of the firm something that I had nothing to do with. After three months, the firm would not get my rate corrected and the engagement ended up lasting thirteen months. I will not work with that firm again because they have demonstrated in more than one case involving me that they cannot be trusted. As an aside, from my perspective in this case, the firm detracted significantly from its value to me while adding insignificantly to the client’s value. If you have experience as an interim, you know that one certainty is that you are probably going into a situation that will turn out to be significantly different from what was described and invariably more challenging. You also know that there is a very high probability that you are going to be in the organization much longer than the decision maker assumes at the onset. In my experience once you have proven your value, decision makers will take considerably more time getting you out than they took getting you in. I have helped decision makers over the cost hump by reminding them that hiring me is a no risk proposition. They can send me packing the day that they decide that the engagement is not working or that I am failing to produce more value than they expected. I am happy to take this risk as long as I am being appropriately compensated. I have yet to be sent packing. In every case, I have remained much longer than initially expected or planned. Some interim firms prey on unsophisticated executives in transition by buying them at or below what they were receiving as an employee and reselling them at a market consulting rate. If you allow yourself to be prostituted in this manner it is your own fault.

In closing, I believe there is substantial justification for paying a premium for interim executive services. I postulate that the time usually lost by decision makers that struggle with the decision to bring an interim in can quickly create costs and/or losses that far exceed any premium. As I said in an earlier article, if you are a decision maker, make a decision.

This is original work. This material is copyrighted by me with reproduction prohibited without prior permission. I note and provide links to supporting documentation for non-original material.

So you want to become an interim executive?

June 20, 2016CEO, Consulting, Employment, Firm, Interim, Personal DevelopmentCEO, interiminterimcfo

I get requests about Interim Executive Services from people that are starting to look at interim consulting as a means to make a living and/or make a difference.

My first response to this question from someone is why?

What is their perception of interim executive services? What about it do they find attractive? What is their level of understanding of what is involved?

Collectively, these questions address the level of sophistication of an interim executive as described by Goss and Bridson.

Unless the person is legitimately interested in becoming a sophisticated interim executive, I am done talking with them.

The reason is that an unsophisticated interim has the potential to cause more problems than they solve and they will be conflicted in the organization(s) they serve. I believe an organization that is interested in securing interim assistance deserves a sophisticated interim even if they do not know any better themselves. If the interim is not serious about their role as an interim and what they are really looking for is a job or to disrupt a search, I have no further interest in wasting time on them.

So what is being an interim about anyway? First the bad part.

You will be working long (12 + hour days) while living in a hotel in a strange town. It can get very lonely. You will be working in a stressed or distressed organization that is unstable because of prior and coming managerial transitions. A lot of people in the organization will resent your presence. This resentment has several sources. Frequently, there is remorse for the departed executive. It is common for people to feel like their previous leader did not deserve to be terminated or that they got a bad deal. These concerns are generally valid. I rarely follow ‘bad’ executives. I follow people that are no longer in the organization due to politics, the performance of their area of responsibility or the fact that they became collateral damage to other potentially unrelated turnover. Sometimes people I follow have left the organization because the executive lost credibility. In other cases, it was determined that either the organization or their area of responsibility is not meeting its mission and that things were unlikely to improve. I discuss this phenomena in an earlier blog. Sometimes a need is created when a successful executive takes advantage of a career opportunity and decides on their own to move on. Another reason for resentment is that in addition to employees seeing you ‘taking’ their prior leader’s job, they sometimes see you getting paid what they believe to be premium pay for providing your services.

In addition to the resentment, there is a trust issue. People are naturally cautious about trusting someone they do not know. In a transition, there is plenty of paranoia about what you have been told, your goals and how people around you might be affected by your role in the organization. They know you are very closely connected to the Board and/or the front office and they fear your knowledge about the future direction of the role you are filling or the organization.

The lifestyle that goes along with interim executive services can be brutal. Your life devolves into a two dimensional existence that consists only of work and sleep. You lose touch with friends and activities back home until eventually they are no longer a part of your life. Having a ‘routine’ disappears as you lose the ability to maintain exercise, a social life and healthy eating activities. After a usual schedule of four ten to twelve hour days, you get to go through the only remaining legal form of torture; air travel – twice per week. The expense, the hassle, the strip searches, the time and frustration of travel further eats into your time until you have little if any personal time left. Hobbies and extracurricular activities become memories. Living in a hotel and eating out every day becomes an old drag quickly. Anyone that has done this knows how fast the ‘glamor’ of being a consultant wears off. It even takes a lot of time to begin to figure your way around the town.

You are in the organization but you are not really part of it. You do not share any of the culture and history and there is usually no expectation that you will be around long enough to develop meaningful relationships. Remember the ‘Replacements’ segment from the TV series, ‘A Band of Brothers?’ If not, you should look it up. You are rarely included in social activities in or out of the organization. As a result, you feel isolated and alone. Initially, no one expects you to be around very long so they make no effort to get to know you. The distance that others in the organization establish, particularly other executives is palpable.

Under good conditions, you are drinking daily from a firehose, particularly in the earlier stages of an engagement. You do not know anyone, you do not know where anything is, you do not know who controls what and as you proceed through your engagement, it is common to identify issues that need attention at a rate that far exceeds your ability to address them. People are cordial either because it is the right thing to do or they feel it helps their personal cause without going out of their way to be particularly helpful most of the time.

I could go on and on about this but hopefully you are beginning to get the point about the challenges of being relatively unwelcome in a strange organization in a strange town where the organization is being roiled by the effects of what is usually an unexpected turnover event or multiple turnover events. I served an organization that had released nine senior executives at the same time including the CEO and most of his direct reports. The managers left were shell shocked and some of them had survivor’s remorse. They could not function because they could not understand why they were left and some of their best friends and associates were gone. Most of these people eventually left the organization.

Given all of this, the obvious question is why on earth would anyone that had not lost their mind would want to have anything to do with this kind of work?

I believe there are two primary answers. The first is that there will never be a better opportunity in that organization for an interim executive executive to have a transformational impact that can literally alter the course of the organization. The second reason is that the work has the potential to be exhilarating from the intellectual challenges it presents while being more lucrative financially than traditional employment.

A turnover event starts when the organization or its Board concludes that the organization of a part of it is on the wrong track and the existing leader is not meeting the organization’s needs. When the body of evidence that the situation is unlikely to improve reaches critical mass, the turnover and succession processes start. An interim coming into a situation like this finds that unlike an employment situation where you have to fight politics, bureaucracy and undermining peers to get anything done, the organization is hungry for fresh ideas, new blood and the injection of energy into an area that was perceived to be falling behind. It is common to enjoy considerably more latitude than your predecessor to make what would have previously been considered radical recommendations to get the organization moving in the right direction. Leadership and governance are actually interested in what you have to say and are considerably more likely to act on reasoned recommendations. Of course, the burden of responsibility that comes with being such an advisor is sobering because you are expected to ‘get it right’ 100% of the time. This is not an easy burden to bear.

Another reason for performing interim executive services is what I call empowerment. Employees at every level sub-optimize routinely because they engage in self preservation. They guard their jobs and roles at any cost. When you have nothing to lose by being fired and you have absolutely no fear of being fired, you enjoy a sense of liberation and empowerment that can only be appreciated by experiencing the phenomena. Because you have no ‘job’ to protect, you can say and do things no employee would ever consider. You can challenge the organization, its leadership and governance to do hard things if they are the right course of action for the organization even if making the recommendations puts your own role at risk. The only objective I have as an interim executive is to get the best result possible for the organization regardless of how I am affected. If I get run out of town for that, I will leave happy with knowledge that whether they agreed or not, they will at least be making informed decisions. I recently told a community leader that my biggest concern if I got run out of town would be whether or not I could stay out of work long enough to have a decent vacation. There is no shortage of organizations needing competent, professional Interim Executive leadership services. So far, I have not been run out of a town and I have said and done things in Board rooms that have resulted in shock, awe and horror. I have pressed organizational leaders and Board members to do the hard work necessary to make their organization better.

The upside of this is that I have left every organization I have served a better place and I have continuing excellent relationships with Board members and CEOs of every organization I have served. This is another of the many benefits of interim services; the residual impact of your transformational leadership in an organization will last for years after you are gone. The courage and determination you demonstrated in your efforts to achieve better results for the organization will inspire many that follow you. This probably will come across as cliche’ but the US is a great county. My wife and I have been blessed to serve healthcare organizations in many states. Every part of the country has a unique culture and climate. It is interesting to learn how certain concentrations of ethnic groups came to be located as they are around the country. You cannot learn nearly as much about an area passing through as you can by living in the community for several months at a time. These aspects of Interim Executive services can be extremely rewarding. Decision makers in distressed organizations are generally anxious to get help. I frequently encounter staff that have been frustrated by the fact that they were let down by their leadership and as soon as you establish credibility, they engage you in as much Mentorship as they can absorb.

In the past year, I have received two of the most rewarding telephone calls of my life. One came from the Chairman of the Finance Committee of a hospital system that had just been upgraded by a rating agency. The first call he made was to me to thank me for my intervention years earlier. In his opinion, the results of my run in that organization laid the groundwork for the improvement in performance that led to a rating upgrade years later. The second call was with a CEO who told me that the people in the community served by his hospital owed me a debt of gratitude for my service in spite of the fact that there were only a very few members of the community that had any knowledge that I had ever been there.

You might say, all of this sounds good but what about the people that came before? I make it a habit to resist criticism of my predecessor(s) or the decisions they made. In fact, I told one Board that as far as I could tell, the guy they got rid of was better technically than me. As I said before, in nearly every case, they are good people and I do not know why they did what they did. I was not there at the time previous decisions were made and I am not privy to the information they had or the pressures they were under when they made the decisions that sent them on a path toward transition. I do know from personal experience how brutally agonizing it is to go through a transition, especially if it is the first transition for that departing leader.

The most common primary concern of departing leaders have expressed to me is that their successor will ‘trash’ them. I have had this happen to me and I know how it feels, especially when the criticism is coming from someone that does not know me. As a result, I have made it my habit to reach out to my predecessor and offer any assistance that I could during and following their transition. These people are not happy and initially some of them have not been particularly happy about dealing with their involuntary successor. I am very proud to say that in most every case, each of these executives have gone on to much bigger and better things and I maintain friendly, cordial realationships with them.

I have been instrumental in replacing myself in several organizations including casting the deciding vote. I am happy to say that in each of these situations, my successor is still in place and the organizations are better for my Interim Executive intervention. I was blessed and honored to have the opportunity to serve in a variety of cultures, climates and communities.

So if you are looking at a career move, you can handle the lifestyle and you wish to make a difference while earning above average income, you might be suited for Interim Executive Services. Obviously, this work is not well suited for people trying to raise families. I will conclude by stating that if you are married, the unqualified support of your spouse is a necessity for success as an Interim Executive. I will write an article in the future on how to qualify yourself for one of these roles.

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This is original work. This material is copyrighted by me with reproduction prohibited without prior permission. I note and provide links to supporting documentation for non-original material.

There is nothing that I can do for you.

May 22, 2016CEO, Consulting, Employment, Job, Leadership, Management, Personal Development, TransitionCEO, employment, healthcare leadership, strategyinterimcfo

Responding to my blog article entitled, “Why do CEO’s get fired . . . ” Bill Eikost, a long time aquaintance of mine in a comment raised the following question:

“In one facility, the hospital had contracted with a large consulting practice to come in and do an assessment of the organization. As I understand it, when they made their presentation, which included some tough decisions be made, the board objected to it not being in the best interest of the organization or the community. Why have them come in in the first place then? The CEO supported the idea of the change but was met with resistance from his board. In almost all cases, I would bet the board wins. As a result, many of the senior leadership left and they brought in or promoted new leadership to continue the course. ”

I have been mocked for having epiphanies. People tell me they are tired of hearing some of the stories I use to make a point or illustrate a concept.

Recently, I have been dealing with some vexing problems related to matters beyond my control and entrenched, recalcitrant culture. It was during a personal low point of frustration, depression and demoralization about these matters that I had yet another of my epiphanies.

Heart surgeons regularly carry out miraculous interventions that result in people that would otherwise be dead walking from the hospital under their own power healing of their afflictions. One of the more difficult aspects of being a cardiovascular surgeon is case selection. CV surgeons and their practices are continuously evaluated by all sorts of local and national statistics. One of these statistics is mortality. What percentage of patients treated by this physician ended up dying? Talk about a Hobson’s choice! On one hand, the physician is motivated to do everything within his power to give the patient the best possible chance of survival. On the other hand, there are times when the probability of a surgical intervention being successful is nominal. A surgeon that is too aggressive taking high risk cases will have an above average mortality rate and be branded a bad doctor. Can you imagine what it must be like to look another human being in the eye and tell them, “There is nothing I can do for you.” The surgeon knows that putting the patient through a procedure would be unlikely to be successful but he also knows that he is in many cases effectively issuing that patient a death sentence. I could not do this and I have respect for these surgeons that I cannot articulate. I do not think I could do this and live with myself. The next time you see one of them, thank them for their service.

Getting back to my epiphany, some of the things needed to ease the stress on the organization were going to require some community leaders and Board members to step up to challenges and take on controversy they did not sign up for. Sometimes the easiest thing to do is nothing and if this were to occur, I was finished. I had reached the point where if this was to be the case, there was nothing more I could do for my organization (patient). In the middle of the night I awoke in a cold sweat when this realization dawned upon me. Suddenly, I had insight into what it must feel like for a surgeon to tell a patient they cannot be helped. If the resolve in the organization and the Board to take on the hard work was not there, I was done. It would make no sense to continue to play along burning up time and resources on a hopeless cause.

All of us have heard the admonition, “Do not go to the doctor unless you intend to do what he tells you to do.” Compliance in medicine is a huge problem. If I was at this point, I could easily log some more time but effectively it was over.

I have seen this phenomena before but I did not see it in this light. I have seen several organizations go through this process. In one case, an organization that had never had what I would describe as a professional materials manager expressed resolve to recruit one. An outstanding incumbent was recruited following a long, arduous retained search. And of course, less than six months into his run as he would say, “the defecation hit the rotary oscillator.” Seemingly over night, the organization that said it wanted a materials manager changed its mind when the realization of what actually having a materials manager really meant starting dawning. Sadly, the new executive’s tenure ended up being very short, his career and his family were disrupted and the organization went back to doing things as they had before. This was the first but certainly not the only time I have seen this happen.

Time for another digression. About the materials manager referenced above. His case is fairly typical. Sometimes the fit is not right but that does not mean the person is bad. While no one would recommend anyone going though a situation like the one described, the manager emerged from this trauma a better person for the experience, stronger, wiser and with a clearer vision about evaluating opportunities. He has gone on to have a distinguished career and currently holds one of the largest material management jobs in the entire healthcare industry and thank heavens, the two of us are still on speaking terms.

A lot of people say they want a lot of things until they fully realize what is involved or what the ‘desired’ change implies. For example, I described what it takes to obtain an advanced role in an organization in a previous blog article. A lot of people say they want the lifestyle and income that comes with higher level jobs until they find out how long and hard the road is to get there. Unfortunately, I do not know of any way to assess in advance the point at which resistance will be encountered or how it will be addressed.

In my recent personal case, I have seen support I would not have believed possible come to bear in an effort to achieve the favorable change for the hospital and the community that is there for the taking. You never know what people are going to do until the chips are down and the hard questions are on the table.

Kevin Rutherford, a trucker, radio commentator, author and producer of a trucking website ends his shows with the admonition to, “Do the hard work and master the journey.” I like to say that you will never find the walls unless you are willing to push the limits.

Success is not measured by how long you last in an organization. It is not measured by how good you are at ‘staying off the radar’ when the organization is seeking to improve itself. It is not measured in how adept you are at keeping your job. Success in my opinion is defined by the degree to which you demonstrate selfless leadership to take your area of responsibility to the next level. I have posed the pertinent questions before. Are you and your area an example of the best of their type in the industry? Are you an example of what others should aspire to become? Are you and your area an example of best practice? Is your expertise sought out by peers striving to improve themselves? Do you know what data is used to make these determinations? Do you compare favorably with all of the statistics available to evaluate your leadership? Are you taking initiative or are you waiting for someone to come along and tell you what to do?

An honest self-assessment is very difficult but in my experience, no one that was ‘left behind’ should not have seen it coming.

This is original work. This material is copyrighted by me with reproduction prohibited without prior permission. I note and provide links to supporting documentation for non-original material.

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