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Hiring in the 21st Century … It’s a Whole New BallgameHiring in the 21st Century … It’s a Whole New Ballgame
“We got to think differently.” - Brad Pitt, as Oakland A’s General Manager Billy Beane, in Moneyball
I’m a longtime baseball fan. And so when they came out with a movie based on one of my favorite books – Moneyball – I was eager to go see it. I wasn’t disappointed; I thought Brad Pitt did a terrific job playing the A’s general manager, Billy Beane.
But I have to admit, I had forgotten one important thing since reading the book a few years ago: Moneyball isn’t so much about baseball as it is about change.
In the case of the 2002 Oakland A’s, who had the lowest salary budget in baseball that year and, therefore, an inability to buy their way to success, change meant finding a different way to assess, recruit, and utilize baseball players and their skills. It nearly worked for the A’s that year, and it fundamentally and permanently changed the game of baseball.
As I watched the movie, I was reminded of how entrenched the healthcare industry can be in doing things a certain way. Not in the same way as major league baseball, necessarily, but certainly to a similar degree.
The impact of this touches every aspect of our business, not the least of which relates to executive recruiting and hiring. Thanks to rapidly rising costs, ongoing changes in rules and regulations, and widespread dissatisfaction among stakeholders of all types, the profile of the “ideal” healthcare executive has necessarily evolved.
What worked in the past won’t work anymore; as Billy Beane observes, “We got to think differently.” Here then, are three areas in which healthcare leaders will need to excel:
1. Matrix Management
As recently as ten years ago, some of the most successful executives in our industry were “top-down managers” – decision-makers who used a command and control approach in running their respective organizations or divisions. They sat at the top of a pyramid-shaped organizational structure and had both authority over, and responsibility for, everything below them.
Those days are coming to an end. Industry changes have caused organizations to rethink the way they deliver care and reevaluate their relationships with other institutions. Funding is limited at federal and state levels; access to capital makes it difficult for hospitals to invest in IT and infrastructure; economies of scale are needed in order to drive down costs as well as to exert leverage over payors and vendors.
Externally, this has resulted in hospitals banding together (not always by choice) as part of larger systems. And whether that means affiliations, partnerships, joint-ownership of assets and staff, or some other hybrid combination, the notion of a stand-alone institution is disappearing.
Internally, changes are taking place as well. For example, in an effort to provide better, more efficient care, many hospitals are organizing by service line, rather than by department as they had in the past. As a practical matter, that means that those in charge of a particular program – cardiology, for example – need to work across many areas (OR, ICU, telemetry, radiology, rehab, etc.), most of which they do not directly manage or employ.
For executives, these fundamental changes mean that accountability no longer resides with one person or within one department. To put it another way, the ability to lead through influence – not authority – is the new coin of the realm. Those who succeed are skilled at influencing competing agendas—enabling them to be effective in this fluid, less structured environment.
From a hiring perspective, careful interviewing has become more important than ever before. It’s no longer simply a question of reviewing resumes and finding someone with a specific number of years in a certain leadership role or a pedigree from a well-respected organization. Finding those with a strong team orientation (people who favor the use of “we” over “I”) and who thrive on ambiguity is more important than ever.
2. Technology
The matrix organization is necessarily more dependent on technology. Decisions need to be made quickly, and key players are often spread across departments, job functions, physical locations, and even organizations. Those who can’t (or won’t) use the latest technology to bring people and information together in real time will be at a distinct disadvantage.
In the past, of course, executives tended to use less technology as they moved up the ladder, turning over routine tasks to others who did the note taking, scheduling, typing, etc. But this is about much more than administrative duties – technology is at the heart of 21st century healthcare and leaders need to be comfortable defining, interpreting, and acting upon data using the latest tools.
Consider something as straightforward as reporting, a function which until recently was entirely retrospective and largely viewed in paper format. A hospital CEO would view census data from the previous month, for example, and make adjustments accordingly going forward. Today, this information is relayed via a real time dashboard, and that same CEO is likely to find himself/herself huddling daily with staff to make decisions.
The impact of technology reaches beyond the hospital walls as well. We live in a 24/7 world now and leaders must have an orientation that matches up with this reality. Here, as well, the hiring process must screen for those individuals who are facile with technology; owning a laptop or cell phone is simply not enough. Senior executives need to be comfortable with PowerPoint, Excel, texting, blogging, smart phones, and other tools that will help them communicate their vision and respond quickly to the dynamics of the marketplace.
We ask candidates as a matter of course now to describe how they use technology in their work and in their lives. Successful healthcare organizations of the future need executives who are not simply aware of technology, but living it every day.
3. Transparency
The lack of absolute control and authority at the top leads to a need for more transparency – both inside and outside of the organization.
The executive who makes all the decisions can afford to hoard all the information. But as the matrix organization takes hold and complex interdependencies become the norm, everyone needs to understand how the pieces fit together and what their role in success is. It’s no longer possible to manage entirely from one central point.
Outside the organization, transparency has become a requirement as well. Consumers are more educated (they routinely shop for doctors on the Internet and make selections based on outcomes); the media has infinitely more information; board members, community leaders and other external stakeholders can see into your operation with more speed, more clarity, and more depth than ever before.
Today’s top leaders are astute regarding these changes, and they’ve learned to organize around them. We know of a CEO, for example, who recently took the helm at a mid-sized community hospital. His predecessor had an old-school style and ran a top-down, closed shop.
The new CEO, in refreshing contrast, has taken an entirely different approach. He blogs, he runs “town hall meetings” with staff and the community, and he goes out of his way to share information – good and bad – across and outside of the organization. He’s thrown open the doors of the institution, working from the understanding that there’s no hiding anymore.
A New World
There was a time in the not-so-distant past when success in healthcare was simply tied to keeping your expenses down and managing your division effectively. It was a slow-moving, closed system; those, who could (to use a baseball metaphor) find the right players, put them in the right positions, and manage from above, were the winners.
Going forward, it’s a whole new ballgame. back to top |
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