Category Archives: Personal Development

Further rumination on success

The Wall Street Journal’s lead editorial on June 23 featured an article by Kay S. Hymowitz entitled, “Is there Anything Grit Can’t Do?” The article is about the work of Angela Lee Duckworth.  In my article about career advancement, I talked about hard work, paying a price and the perseverance necessary for career success.  Here we have another excellent example of a researcher that has dedicated their career to the study of a specific topic.  If you do not believe a researcher in academia can become the undisputed authority on a subject, check out Dr. Duckworth’s CV.  For those of you interested in further study of this topic, the list of grants, articles and presentations in Dr. Duckworth’s CV reads like the literature review in a dissertation.   In the case of Dr. Duckworth, her expertise flies in the face of a lot of conventional ‘wisdom’ and political correctness.

The ideology of indoctrination of children in too many failed government schools and universities for that matter vacillates between victim-hood and entitlement insuring the continuing institutionalization of mediocrity and poverty.  In my opinion, public education has deteriorated markedly over the past thirty years.  The US Department of Education was founded in 1979.  In federal fiscal 1980, the department’s  budget was $14 billion.  By FFY 2015, the bureaucracy’s budget had ballooned to $73.8 billion.  Studies have shown an inverse relationship between spending per student and outcomes yet the common proposed solution to every problem is more money.  I do not know anyone that thinks that public education is any better for this spectacular increase in investment.  I have heard Eric Von Hessler and others advocate for the elimination of the Department of Education in its entirety as a means of balancing the federal budget.  I think a lot of people would agree that education is better-managed locally and not from a central federal government bureaucracy.   Too few young people are being taught that the thing that has the greatest potential to make a positive difference in their life is drive or ‘grit’ as described by Dr. Duckworth and not the narrative of the NEA.  There are probably not very many people who have done a more thorough job than Dr. Duckworth understanding how to help children and adults succeed.

If you search Dr. Duckworth on YouTube, you will find a long list of videos.  These presentations are as inspiring as they are compelling.  A lot of Dr. Duckworth’s inspiration and early discovery came from teaching elementary school math.  She became fascinated almost to the point of obsession to understand why some of the smartest students as measured by IQ exhibited lackluster performance while others who did not have the gift of rote intelligence excelled.  Those of us fortunate enough to have parents that were members of the greatest generation of Americans know what grit is.  The greatest generation got their grit honestly from the great depression, WWII and the work involved in building our country into the success it has been.  I will never forget my son’s late scoutmaster, A.H. Friel, a WWII veteran saying, “We were not worried about whether or not we would die in the war.  Our biggest concern was that it was going to be over before we could get into the fight.”   Mr. Friel’s service included a stint on the USS Indianapolis just before its fateful mission.  Contrast Mr. Friel with the current ‘run, hide and tell’ advice citizens are getting from western governments about responding to the threat of terrorism.  Many of us that grew up in these homes learned a ‘git ‘er done’, ‘suck it up’, no griping no whining demeanor.  When those of us that are products of the 60’s and 70’s got to college, we encountered a fiercely competitive environment that extended into our early careers.  Many of us have driven ourselves to the edge in relentless effort to succeed.  This phenomena inspired one of my favorite songs; Luckenbach.  Willie and Waylon lament that, “This successful life we’re livin’ got us feuding like the Hatfields and McCoys.”  They go on to sing, “We’ve been so busy keepin’ up with the Jones, got a four car garage and we’re still building on.  Maybe it’s time we got back to the basics of love.”  One of the most memorable days in my life was spent in Luckenbach, TX.  I highly recommend you put it on your bucket list.  The inspiration of the song and the ‘town’ led me to start my article on success by posing a question; what does success mean to you?

People that know me know I like motor racing.  Two of racing’s biggest stars are Dale Earnhardt senior of NASCAR and John Force of NHRA.  Both of these men rose from very difficult childhoods.  They grew up in poverty.  They are not well educated.  Yet they became titans in their respective sports and grew massive racing enterprises.  Why?  A lot of people would say grit or drive or in the case of Force, brute force.  They have a refuse to lose, ambitious, opportunistic demeanor that dominates their personality and their performance on and off the track.  This is in spite of vicious wrecks that in the cases of other drivers permanently altered their competitive drive.  An example is Earnhardt’s 1996 wreck in Talladega that was eerily similar to and actually more destructive than the 2001 wreck in Daytona that killed him.  Force has said, “I’ve been on fire from here to Australia” and “I saw Elvis about 1,000 feet down a drag strip one day.”  I have heard a number of professional athletes say that they were not born with their talent or gifted.  Many of them attribute their success to willingness to work much harder than the people around them and to take chances others would not take.  That and a vision of success.  I heard John Smoltz say that when he was nine years old, he was pitching in the World Series in his mind.  There was never a shred of doubt in his mind that he would pitch a decisive game in a World Series.  By the time he became a World Series pitcher according to his account, the reason he was so calm and focused was that he had played the game in his head over 1,000 times.  Napolean Hill said, “Whatever the mind can conceive and believe, it can achieve.”  Les Brown said, “To be successful, you must be willing to do the things today others won’t do in order to have the things tomorrow others won’t have.”

So to sum this up, if you are not happy with how things are with you, you might want to reconsider Pogo; “We have met the enemy and he is us.”  The demons standing between where you are and where you want to be might be mostly between your ears.  All of us can cite examples of people we know and work around that are examples of what I am talking about here.  As I said before, success is not always best measured by career accomplishment.  However you measure success, if you want to increase yours, one of the best strategies might be to resolve to turn up your grit.  My hope for that you have the courage to click some of the links in this article and that you are as blessed and inspired as I have been by what the people I have referenced are saying and doing.

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.

The easiest way to keep abreast of this blog is to become a follower.  You will be notified of all updates as they occur.  To become a follower, just click the “Following” link that usually appears as a bubble near the bottom this web page.

There is a comment section at the bottom of each blog page.  Please provide input and feedback that will help me to improve the quality of this work.

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.

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.

 

 

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Should I pursue professional credentialing?

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.

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.
The easiest way to keep abreast of this blog is to become a follower.  You will be notified of all updates as they occur.  To become a follower, just click the “Following” link that usually appears as a bubble near the bottom this web page.
There is a comment section at the bottom of each blog page.  Please provide input and feedback that will help me to improve the quality of this work.
This is original work.  This material is copyrighted by me with reproduction prohibited without prior permission and attribution.  I note and  provide links to supporting documentation for non-original material.
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.

What is a blind reference?

Some people naively think that the only reference checking that is done is with the references given by a candidate or to a head hunter.   Executives recruiting for talent will peruse your CV looking for places where you and they 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 usually 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 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 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.

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.

The easiest way to keep abreast of this blog is to become a follower.  You will be notified of all updates as they occur.  To become a follower, just click the “Following” link that usually appears as a bubble near the bottom this web page.

There is a comment section at the bottom of each blog page.  Please provide input and feedback that will help me to improve the quality of this work.

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.

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.

Just a nurse?

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.

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.

The easiest way to keep abreast of this blog is to become a follower.  You will be notified of all updates as they occur.  To become a follower, just click the “Following” link that usually appears as a bubble near the bottom this web page.

There is a comment section at the bottom of each blog page.  Please provide input and feedback that will help me to improve the quality of this work.

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.

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.

Thanksgiving 2016

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

So you want to become an interim executive?

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.

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.

The easiest way to keep abreast of this blog is to become a follower.  You will be notified of all updates as they occur.  To become a follower, just click the “Following” link in the menu bar at the top of this web page.

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.

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.

There is nothing that I can do for you.

 

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.

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.
The easiest way to keep abreast of this blog is to become a follower.  You will be notified of all updates as they occur.  To become a follower, just click the “Following” link in the menu bar at the top of this web page.
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.

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.

 

 

How do I get ahead?

A frequent question I get is how do I advance my career?  How do I get ahead in the organization?  This is a question I asked myself a lot earlier in my career.

The first question to ask is what does it mean to you to ‘get ahead?’  Success is not always best measured by career accomplishment.  I have learned that life is full of trade-offs.  If you wish to advance your professional career, you are going to have to pay a price.  The price is measured in short-term sacrifice for longer term goals, moving to where the opportunities are, pursuing advanced education and professional credentialing among others.  These ‘prices’ are higher than many people are willing or able to pay.  The effect is that they get trapped in roles where they can not realize or achieve their full potential.

When I was coming along, I was always looking up and ahead.  I was the first in my family to earn a college degree.  My parents did not understand college but they did recognize that people with college educations did better.  In college I was exposed to people that had achieved much personal and professional success.  I was inspired to replicate what these people had done so that I could enjoy the niceties of life that they had earned.  When I started working, it seemed to me that given the chance, I  could do better than the people ahead of me in the organization.  I set myself to learning what they had done to become qualified for their roles and I started closing the gaps of experience, expertise, knowledge and credentialing.  Before long, I was given consideration and started achieving my goals of reaching advanced roles in healthcare administration.

One of the things that occurred to me along this road is that the key thing organizations select and reward leaders for is cognitive skills.  Decision making in my opinion is one of the most if not the most valuable skills a leader can develop.  The better you are equipped to make decisions, the more responsibility the organization will bestow upon you.  The larger the responsibility, the more substantial the risks and rewards associated with the decisions you are called upon to make.  These risks and rewards are ultimately reflected in the remuneration for which you are eligible.

In my practice as an Interim Executive, I learned that the primary factor differentiating organizations that were doing well from those that ended up with challenges and transitions is less than optimal decision making.  Show me an organization with challenges, operational difficulties and unacceptable financial results and I will show you leadership that has compiled a poor record as a result of questionable decision making.

As I have reflected upon this phenomenon, it has occurred to me that as we progress through our career and through increasingly responsible roles, the nature of our work changes.  This has led to the development of my ‘Model of Career Progression.’

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Early on in our career, the amount of ‘work’ we do is how we are measured.  The work is usually measured in volume and it frequently requires a high level of technical skill but not much cognitive skill.  For example, what field on what page do I access to find certain information?  How many ‘activities’ can I complete in one day?  I once had a senior leader ask me if I had reviewed certain accounting journal entries.  I told him that I did not know what drawer the journal entries were stored in.  I did not know where the journal entry pad was and I could not remember whether the debits went by the door or the window.  What an outrageously stupid question!  I have not reviewed journal entries since I was a Controller over thirty years ago.  I am not paid to review journal entries, I am paid to assure that the organization’s financial statements are timely, materially accurate and that they fairly state the financial position and operating results of the organization.  Can you see the difference?

As you advance in an organization, technical skill becomes less important and decision making skill becomes much more important.  At higher levels of responsibility, you become more of a generalist because you are not evaluated based on how much ‘work’ you do.  You are evaluated based on the results of your leadership, particularly as it relates to the outcomes of your decision making regardless of how much time and effort you expend in the process.

In my opinion, the development of cognitive ability is what will launch or limit your ability to advance in an organization.  How do you develop cognitive ability?  All of us are limited at some level by our basic intellect but I do not think that is what constrains most people.  The reason is that people like Earl Nightingale and others have said that most of us rarely use more than 10% of our mental capacity so I am not buying the theory that people are not ‘smart enough’ to do higher level cognitive work.  The way you develop your skills is to invest in yourself by seeking advanced education and professional credentialing in your area of expertise or interest.  Continuous self study helps you to cement your position when given opportunities to function at higher levels.  Experience in multiple situations is also helpful.  You do not necessarily have to leave the organization to gain this experience.  I have counseled numerous young people to seek opportunities in other ares of the organization to learn as much as they can about how the enterprise functions and to see where their areas of greatest interest or gifts lie.

There has never been a time in healthcare that more and better leadership is desparately needed.  There are plenty of opportunities available for those who wish to advance their careers.  All you have to do if you are one of these people is to start investing in yourself.  I can assure you from my own personal experience that investment in yourself is the best investment you will ever make.  I don’t care how cliche the phrase is.  It has served me and a number of other very successful people I know extremely well.

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.
The easiest way to keep abreast of this blog is to become a follower.  You will be notified of all updates as they occur.  To become a follower, just click the “Following” link in the menu bar at the top of this web page.
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.

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.