Selling yourself in a tough health care market. (The Evolving Role of the Physician Executive).

WHEN RETAINED SEARCH people meet, one of their favorite topics is not the perfect candidate that got away, but the hordes of candidates they sort through who have skills but no smarts, are visibly damaged goods, or who have other fundamental personality defects that divert attention from their technical and managerial skills. Career Strategies, Inc. in Wilmette, Illinois, recently ran a series of focus groups composed of health care recruiters and researchers (the people who actually find specific candidates) to find out what makes one candidate attractive and another, with identical--or even better--paper credentials, anathema.

The recruiters we learned the most from are the ones who screen the most candidates. Their experience is based on a sample of hundreds, not the ten or 20 that many hospital and HMO CEOs have seen. Here are the top items on their checklists.

What are recruiters looking for?

1. Articulated focus

Are you a recognizable brand? This is a currently favored buzzword. It means that anyone who interviews a candidate should know what he or she stands for within a few minutes. Think BMW, "the ultimate driving machine." Other automobiles may be faster or better constructed or more reliable, but most car buyers remember that BMW has declared itself "the ultimate." Nothing is more off-putting for a recruiter than a candidate who can't describe his or her skills in a few words and state what he or she most wants to do next. Health care has its full share of such people, many of them physician executives.

This isn't just a philosophical issue, it's practical. Because of the ferocious labor shortage--an unemployment rate hovering around 4 percent means everyone not on life support is working--recruiters must work harder to recruit candidates. Each search takes longer. For them, time is money. A recruiter forced to tease out of a candidate what he or she can--and wants to--do is wasting both. For many recruiters, lack of focus is a greater turnoff than lack of people skills. A hospital CEO will skin a recruiter who presents someone who exudes even a whiff of soft focus. For example, a candidate said, "I've been a medical director twice and I want a bigger job. I guess that's vice president of medical affairs." He guesses?

One recruiter told of meeting with a physician executive who, eight years after leaving practice with a clinic he'd help found, was still wondering if management "is for me." This physician is unemployable as a manager, except in the least desirable and most desperate of organizations. Who needs someone who can't make a decision, stick to it, or reverse one that was a mistake?

2. Documented results

You got results in previous jobs. Can you blame hospital and managed care CEOs for wanting to see proof of that, especially when they believe financial disaster lurks at every turn? Recruiters tell us that many candidates for senior medical management positions do not include measurable results on their resumes or even talk about them in an interview. Most resumes read like bulleted job description entries, not as a series of accomplishments. Scope of responsibility always matters but results count more. There are two kinds of highly desirable results: Money made and money saved. Even a noble failure is better than no results at all. Too many physician resumes are longer on duties than results; longer on esoteric articles written than people persuaded. Recruiters can't and won't wade through the verbiage looking for a meaningful result and hence a saleable nugget. They move on to the next resume.

3. Competitive intelligence

Our panel told us that another flaw that will doom a candidate in this market is a lack of knowledge about his or her organization's competitors. A medical director who can't talk about all the players in his or her health care market is too insular for consideration. That doesn't mean bad-mouthing the competition, but being able to rank order them for quality, viability, and patient satisfaction. Candidates often stumble when ranking their own organization on those qualities.

4. Professional growth

In the early 90s at the height of downsizing, Allstate Insurance laid off thousands of long-term employees. That gave rise to what is known as the "Allstate Syndrome." Recruiters would ask former Allstaters, "You say you have ten years experience. Is that ten years of different kinds of experience, or one year's experience repeated nine times?" Recruiters want physicians to answer the same question--preferably without being asked.

Anyone who recruits in health care knows how much systemic change has taken place. They want to see an executive who can adapt success fully to different realities, as well as changing them. Nothing demonstrates mental toughness and agility as well as success under different assumptions and conditions. Even if you've had the same job title for more than five years, your resume must show how the job morphed over that period, and how those experiences have contributed to your growth. If you've been with the same organization for several years, sort your duties and successes in two to three year groupings. Don't say, "1990-1999 Medical Director" unless you want the recruiter to assume you reprised yourself for nine years.

Get over any bitterness about changes in health care reimbursement and the good old days--or sublimate it. Nothing kills a candidate as quickly and effectively as dwelling on the past at the expense of the present and future. Even if the recruiter leads you in that direction--for example, "Give me your assessment of what's happened in health care"--don't follow unless you can discuss positive ways to lead within the current industry climate. One recruiter described a telephone interview with a 50-something physician who could not stop talking about how much medicine had changed--for the worse. He never got an interview with the client.

5. Good references

Peers, competitors, and subordinates respect your work and judgement and they say so without hesitation. They may mention that they didn't particularly like you, but you were effective. Recruiters will check with all three groups, even if nothing you do or say raises a red flag. Even if your resume shrieks "Platinum," they adhere to the journalistic motto, "If your mother says she loves you, check it Out." You won't get to select who in each group will be asked for information, nor given a chance to rebut. As one recruiter said, "One negative response from someone you worked with years ago won't kill you, but several people who hesitate before answering is invariably fatal. Those are the ones the candidate gratuitously wounded-and they have long memories."

Subordinates matter at least as much as former bosses, even more, if the hiring organization has high turnover. Exit interviews, once a formality, are now scrutinized carefully for comments on how someone was managed. A medical executive who claims he or she "can't get good help" won't get commiseration on the tight job market, but will be axed from the short list.

6. Appearance and social skills

Is your appearance role and situation appropriate? John Molloy, author of the classic, Dress for Success has not been superceded as a dress guru. Conservative, not trendy, clothing is still favored by recruiters and their clients. Pay attention to the little things that can undermine your overall appearance. For instance, has the Salvation Army refused to accept your briefcase as a donation because nobody could be that needy?

Don't forget your car. A recruiter told us of an impressive candidate who, when he and the recruiter left for lunch, opened the car door on a mobile disaster. The back seat and floor were covered with old papers, pharmaceutical samples (not the best advertisement for medical management), and sports equipment. The inside smelled like rancid gym shoes. He was judged too eccentric for further consideration.

Small talk is like a good rally at tennis. When someone asks if you had trouble finding the office the answer is not, "No." It cuts off the questioner's response. Much better is, "No, because your secretary told me to look for a Gothic church and two parks. Her directions were terrific." The questioner can then comment on the church, parks, secretary, or introduce a new subject. Small talk is a big Issue when a recruiter is trying to gauge fit and adaptability. Even Glint Eastwood isn't monosyllabic all the time.

If you're under 40, both appearance and conversational skills are especially important. Younger workers have been convicted of lacking people skills while wearing too many earrings. Recruiters tell us that 30-something candidates appear to think that conversational skills and good grooming are superficial or phony. Far worse, they adhere to the axiom that if you have nothing to say, say nothing. Middle-aged interviewers find this disconcerting at best, positively maddening at worst.

7. Responsive and timely

The fact that you think you wouldn't be interested in a move right now does not excuse you from returning a call or email. Recruiters have extraordinarily long memories and they keep detailed notes. In fact, not one of our focus group participants failed to mention unreturned calls and emails as major turnoffs. Senior managers always say they're too busy doing the job they've got to worry about a next one. That plays with recruiters as shortsighted and rude.

It's important to say no at the right time in the right way. It's no felony not to want a job, however, wasting a recruiter's time is. Candidates who refuse too quickly, before listening to a recruiter's entire pitch, can't expect to be called again. Recruiters aren't just interested in your reaction to a specific job, they're evaluating you as a candidate for other positions. What does it say about your management savvy--or your congeniality--if you break in on the recruiter, two minutes into his pitch, with your decision?

Even if you ultimately decline to interview for the position, always ask how you can help the recruiter. Offer honest referrals to recruiters when asked. It's easy to work an agenda by providing the names of your enemies as potential candidates. It's also not a new strategy. Recruiters can practically smell this sort of skullduggery when they check on the people you've referred. They also are quick to pick up that a subordinate you tout is really someone you'd like to fire but can't or don't have the courage to do so.

8. Technical skills

Speaking of answering email, if you don't have an email address, it's a clear indication that you're not computer competent. which is a major problem for otherwise excellent candidates. As recently as 1997, a computer illiterate senior manager in health care would have been assigned a secretary as a matter of course. Now, with secretaries among the scarcest of employees, he or she will be expected to use a computer for all but the most complex document.

Conclusion

A universal complaint among recruiters is "Candidates think we work for them, not the client who pays the bill." Candidates who believe recruiters exist to help them sort career priorities or provide counseling are a major annoyance. Keep your ego caged. Recruiters don't wear gloves. They're pirates and swashbucklers, looking to swell their bottom lines. That's why they're in search--it's a low-threshold, high reward business. They have only one allegiance--to the client who writes the check. Dealing with thin-skinned physicians who don't think they need to justify their records is merely an occupational hazard, best dealt with by eliminating such people as candidates.

The beginning of all wisdom is understanding that recruiters believe there is always a better, more agreeable candidate out there if they had the time to do a thorough search. Expecting a recruiter to treat you differently, for example, more deferentially than he or she would a candidate for a marketing. nursing, or planning job, isn't realistic. Money is made by moving the right people through the process as quickly as possible. If you demand obeisance you'll have to network into your next job.

FIGURE 1 THE GOOD CANDIDATE CHECKLIST

What makes a physician executive an attractive candidate? Consider the following qualities that recruiters are looking for, as they search through hordes of r sum s for top candidates:

* Articulated focus can you quickly articulate who you are and what type of position you are looking for? A hospital CEO will skin a recruiter who presents someone who exudes even a whiff of soft focus.

* Documented results can you show measurable results from your previous positions? Recruiters can t and won t wade through r sum verbiage looking for a meaningful result and hence a saleable nugget.

* Competitive intelligence do you know about your organization s competitors? A medical director who can t talk about all the players in his or her health care market is too insular for consideration.

* Professional growth can you show how your job has changed and how those experiences have contributed to your growth, even if you ve had the same job title for more then five years? Recruiters want to see an executive who can adapt successfully to different realities, as well as change then.

* Good references do your peers, competitors, and subordinates respect your work and judgment? Recruiters will check with all three groups, even if nothing you do or say raises a red flag.

* Appearance and social skills is your appearance role and situation appropriate? Conservative, not trendy, clothing is still favored by recruiters and their clients. Pay attention to the little things that can undermine your overall appearance.

* Responsive and timely are you returning a call or email, even if you think you wouldn t be interested in a move right now? Recruiters have extraordinarily long memories. Unreturned calls and emails are major turnoffs.

* Technical skills are you computer competent? If you don t have an email address, it s a clear indication that you re not computer literate, which is a major problem for otherwise excellent candidates.

Marilyn Moats Kennedy

Reference

(1.) Molloy, J. Dress for Success. New York, New York: Peter H. Wyden/Publisher. 1988.

Marilyn Moats Kennedy is Managing Partner of Career Strategies, Inc. in Wilmette, Illinois, a long-time member of the American College of Physician Executives' faculty, and a prolific author, writing the bi-monthly "In the Trenches" column for this Journal amongst other assignments. She can be reached by calling 847/251-1661 or via email at [e-mail].