Working with a net. (Networking).

* Networking

* Good Networkers

* Networking Best Practices

* The Networker's Tool Kit

* Mentoring

* Harnessing Connections

IT WAS UH-OH TIME. His wife was on the shortlist of the shortlist- one of two overseas candidates (among four in all) invited to fly to Australia to inter view for a coveted academic Job. If the opportunity actually panned out, Robert H. Hodge, Jr., MD, CPE, FACPE, reflected in panic, What am I going to do?"

Quickly he began to network. From Virginia he sent an email to an Australian colleague he'd met through the American College of Physician Executives' International Forum some years before. He did the same to an Australian he'd worked with previously as a consultant to the Kellogg Foundation. And he contacted a friend of a friend in the National University's Department of Computer Science.

"All three began to pay off...," he recalls, though in the end, his wife Sandra lost out to another applicant by a single vote.

Still, the exercise was instructive, heartening... and replicable. Soon afterwards. Sandra did receive a faculty appointment at the University of Missouri. And again it meant that Hodge had to try to scare up a compatible slot-which, once again, triggered some serious networking. An email to a member of the College from the University-picked blindly from the ACPE directory-led to a further exchange of electronic correspondence, a telephone conversation, and a contact recommendation, an email to a dean who set up a meeting at which a helpful staff member suggested Hodge stroll down the hall to talk to another faculty member... who within a year had indeed orchestrated an appointment for Hodge as a clinical professor in medical informatics and telemedicine at the University's Health Sciences Center in Columbia, where he happily works today.

What is networking?

"Networking is critical, it's crucial!" declares Mark A. Doyne, MD, FACPE, Vice President of Medical Affairs at Curative Health Services, a disease management organization based in Richardson, Texas. it's one of those skill-sets that physicians, as they evolve into management and executive positions, need to develop and operationalize. The entire business community understands its importance. It's not necessarily intuitive to physicians, though--I know that when I was a physician in practice, I didn't really think network."

Whether or not it's done consciously, however, networking is neither an arcane practice nor a foreign concept to any remotely attuned contemporary American. All it really boils down to, according to physician recruiter George E. Linney, Jr., MD, CPE, FACPE, of Tyler & Company, in Charlotte, North Carolina, is "making connections."

A network, then, is just a web of relationships woven over the years-"family, friends, colleagues, associates, peers, professionals in the field...," a list informally ticked off by Jennifer Grebenschikoff of the Physician Executive Management Center, in Tampa. Florida. But an exemplary network is knitted together intentionally more than haphazardly-assembled out of many disparate threads of smaller and greater mutual interests, attractions, associations, most of them purposefully curried and cultivated, and none allowed to unravel through neglect.

"...Your attorney, your CPA...," Grebenschikoff continues. "...People in the community who share some kind of interest with you and in you. People who did residency with you, or were in the military with you. People you look forward to seeing at a meeting.... People in any area of your life. They're all part of your network."

Although they will be included in it, your family and your closest friends do not represent ideal models of the network relationship, points out Marilyn Moats Kennedy, Principal of Career Strategies in Chicago. Most of the people who make up a network-at least in a professional context-"are not going to be your buddies," she notes. "Think of it as an alumni association."

So a certain superficiality may prevail across much of a network. But that's okay-and it's not synonymous with insincerity.

"You identify some point of commonality with another person and then, if it matters to you, you nurture that," explains Linney. "How? By continuing to touch base with that person. But only if you sense there is some ongoing shared interest. There's no point in working too hard on relationships that don't click."

Rich veins

Networking is probably associated most often with job-hunting, acknowledges recruiter J. Larry Tyler, President of Tyler & Company, headquartered in Atlanta. As in Hodge's experience, it's a process of harnessing networks to networks--your own to those of others, to elicit opportunities and to make connections that would otherwise be unknown or unavailable: a logarithmic progression that spreads outward like cracks in safety-glass from the point of impact.

And in fact, notes Grebenschikoff, no more than 30 percent of the physician executive positions open at any given time are formally listed with an executive search firm. The rest are being recruited for by the organizations on their own," she says. "That means I'm not likely to know about them."

But the rich veins in networking run too deep and too wide to be mined only on the relatively infrequent occasions when one is prospecting for employment, suggests Tyler. "Typically, I'd look at It more from the perspective of finding information," he says. "You use your network to locate places to sell your goods and services, you use it to gather the information necessary to do your job... and to live your life! Finding a job is just a subset."

"A network is an informational tool," echoes Kennedy. "Networking is how you do any benchmarking, how you find a mentor, how you verify whether something is a fact or not. The classic ugly networking stories involve people who didn't network--who didn't, for example, check references on a prospective boss. Any number of people have gone into an organization that turned out to be very shaky--startups especially. And the only way you can turn up information about an iffy company or a bad boss is by networking. If I wanted to know about a physician, for example, I'd find nurses to ask. Especially now that there's a nursing shortage, they have little to lose by speaking honestly."

But don't forget that networking is "a sword that cuts two ways," stresses Doyne. "Like any relationship, if you only holler when you need help or are in dire straits, it's not good enough. I've developed a cadre of colleagues, advisors, peers in the physician executive world, and people in other fields of endeavor and in different industries whom I can turn to for advice in strategic planning, finance, how to evaluate a risk situation.... And I've developed a group of mentors, people I can trust, who know me and my strengths and weaknesses, and who will speak honestly to me--even sometimes telling me things I don't want to hear.

"But the conversation runs both ways," he reiterates. "You start to receive calls. People seek you out as a mentor. They ask for your counsel. And the network grows exponentially. It becomes a critical resource. A resource--especially now with email--that's always at your fignertips."

Born to network

As an only child growing up in Augusta, Georgia, recalls Larry Tyler, my parents would take me out to this cafeteria where my mother would immediately begin talking to everybody. She'd ask the waitresses what was going on in their lives, she'd chat with the people at the tables around us... and pretty soon she'd know everything there was to know about everybody who was there. I was embarrassed as hell. But I learned how networking works at an early age. I may not have liked it, but I absorbed it. So later, when I took my wife out on our first date, she said she felt like she was on an interview. She wasn't sure she liked me, she told me afterwards, because of that. But, you know, I didn't mean to make her uncomfortable. I was just trying to find our commonalities."

Tyler, indeed, is "the best networker there is!" exclaims Linney of his boss. Not only does Tyler regularly conduct workshops on that critical skill for the ACPE, but he sees it as the very essence of what he does as a recruiter. By talking to lots of people, he says, by emulating his mother and "by networking real well, we're able to fill our assignments."

But not everybody finds the undertaking quite so natural or comfortable.

"Networking is as fun for him and as easy as breathing," says ACPE Director of Professional Development Barbara J. Linney of her gregarious husband. "But I'm an introvert. It's hard for me. So I have to make myself do it."

Networking may be an especially unnatural exercise for the average physician, say many observers. It was likely to have played a negligible part in their choice of a first job after clinical training; thereafter, the hospital lounge and the local medical society constituted a convenient and mostly sufficient networking galaxy.

"Referral is an integral form of networking when you're in practice," adds Andy P. Morley, Jr., MD, Vice President of Medical Operations at Promina Managed Care in Atlanta. "But when you move into a full-time management role as a physician executive, you may be one of only four or five people who're doing that kind of thing in a whole city. Even in Atlanta, there are no more than ten of us, and finding ways to talk to one another is difficult. There's a kind of a void. So one of the keys is that you have to go make your network instead of finding one ready-made for you on the clinical practice side. You've got to invent your own network."

Unfortunately, suggests George Linney, "doctors come at networking from the standpoint of being very bright, knowing a lot of information, but wanting to be self-sufficient. And doctors aren't really used to exchanging information. Oh, they may receive it okay. but they don't know how to give it back. And networking is based on asking people for help."

Which sticks in the craw of the typical physician, concurs Grebenschikoff. "Physicians tend not to want to ask for favors," she says. "Most of them are uncomfortable when it comes time to turn around and ask for the same favors they've done before gladly for others. So while the rest of the professional world networks constantly, physician executives often don't, Although," she adds, "the more senior they are, the better they get at it."

A labile world

Good networkers--most especially those for whom it is not second nature--pursue the project systematically, say the experts.

That means they set up a schedule for keeping the embers of connection from guttering out, they assiduously compile and refresh a database (cyberspeak for what used to consist of a well-thumbed and heavily interlineated address book), and they pointedly show up at forums where old acquaintances can be burnished and new ones-most of all new ones--soldered. They follow networking best practices and they arm themselves with the essential instruments of the networking trade. [Please see sidebars on pages 60 and 62]

"Maintaining a network is like watering the plants or feeding the dog," summarizes George Linney. "You also have to do it even when you don't need anything. It gets old--and people start picking up on it--when the only time you talk to them is when you want something from them."

"The main reason for attending meetings is to build a network," asserts Kennedy. "But to do it well," she seconds Linney, "you have to have things that you can offer rather than just being a sponge. It's implicit in the relationship that if the other person needs you, you'll be there for them as well."

And make no mistake, a physician executive can anticipate no insufficiency of occasions for seeking and returning favors.

"Physician executives are not unlike other executives in health care," observes Grebenschikoff. "If you're advancing in your career, you re not going to be staying in one place for many, many years. If you can keep the same job as vice president of medical affairs for three, four, five years, you re doing very, very well."

"The health care world is extremely labile," nods Doyne. "It's a very explosive situation. People are being replaced voluntarily and involuntarily every day. You never know when you're going to get blindsided. But when it starts raining, the network is there for you--if you've nurtured it and built on it.

"Probably all my roles as a physician executive have come as a result of my network," he muses. "But, you know, the best part is that I've had so much fun developing the friendships."

RELATED ARTICLE: NETWORKING BEST PRACTICES

Here are some tips from experts on how to be an effective networker.

"When you go to a meeting, look at the registration list ahead of time and get familiar with who else is coming. Pick out the people you know who might be able to introduce you to others you U1 like to meet. This also helps you when you do encounter someone there for the first time."

Barbara J. Linney

"The tendency I have at a meeting would be to just spend time with the people I already know. So I remind myself that this is my chance to get to know a lot of new and interesting people. When you talk to someone, it's rare that you won't find some kind of common ground. But net working just for the sake of networking is not the way to go. If I meet you and then I don't call you for ten years, it's not worthwhile. Look for ways to keep in touch."

--Robert H. Hodge, Jr., MD, CPE, FACPE

"If you 're interested in finding another job, never respond to a box ad. It could be your own employer. Ask the people you talk to to maintain your confidence. A good approach is to invite a contact to lunch or breakfast. Chat about what you've done. Tell the person you're hoping for advice or suggestions. Always pay for the meal. And always send a thank you note afterwards. You can enclose a resume along with it. And it would be a good idea to take one along with you, in case it comes up in the conversation."

--Jennifer Grebenschikoff

"If you're not out there talking to people, you won't know what's really going on in the industry which parts of the country are doing well, and so on. And read the trade journals. Read The Physician Executive, Modern Healthcare, and similar publications- and read them with a different level of concentration [than you might expend if only skimming pro formal."

--Barbara J. Linney

"I've dropped letters to people I know when I've read they've been promoted or received some honor or award, as noted in the health care magazines. The focus was on congratulating them- but I did throw in a sentence about, 'If you ever have needs.... 'It's been suggested that a lot of people know me from my previous lives, and it's a good idea to remind them of what I'm doing now."

--Goorge E. Linney, Jr., MD. CPE, FACPE

"Be sensitive when building a network not to be too pushy Docs in the beginning aren't usually pushy enough, but still.... If you talk to somebody and you sense that things just aren't clicking, let it rest for while. You've also got to be aware of when it's an inappropriate time to talk to someone who might otherwise like to talk to you. About a year ago I saw a friend who's the CEO of a large hospital in the Midwest, and I wanted to remind him that I'd gone into the executive recruiting business and that I'd like to be considered if his organization had any executive search needs. I went up to him as he was walking into an anteroom and I started to say my piece, and he waved me off. 'Well, I wish I could talk to you now, 'he said, 'but I've got to get ready for my presentation.' And I realized he was just about to go on stage as the main speaker. 'What a dumb thing to do, 'I thought to myself. About six months later, though, at another meeting, we played golf together and went out to dinner and it was okay"

-- George E. Linney, Jr., MD, CPE, FACPE

"Email promotes networking. It's less intrusive than calling on the telephone, and the person is more likely to get your message. And you don't end up playing telephone tag."

--Robert H. Hodge, Jr., MD, CPE, FACPE

"I don't do this, but some people do, especially those for whom networking is difficult, Make up a list of people you want to communicate with and do it on a schedule. I know a physician who was living in southwest Virginia and who made himself add at least five new names to his network every month- people who might be able to help him make inroads into the hospital management sector. He did that over a period of 18 months. By the end of that time, he'd landed a job at a hospital in Denver-as a result of a contact he'd made 12 months earlier When the opening came up, it had clicked that maybe my friend would be interested."

--George E. Linney, Jr., MD, CPE, FACPE

"It's fascinating to me the number of times I've heard someone say, 'If only I'd known he was looking! We had something he'd have been great for in our organization!"'

--Jennifer Grabenschikoff

"Maintain a certain visibility- by writing, publishing, speaking, being on panels, presenting at meetings, involving yourself in community roles."

--Mark A. Doyne MD, FACPE

"One of the first things I'd do is go to professional or physician specialty chat-rooms on the Internet. [The ACPE, for example, runs email-based CyberForums at www.acpe.org.]"

--Merliyn Moats Kennedy

"Please.' 'Thank you.' 'Can you help me?' 'I really appreciate this. Those are some of the most common words and phrases you hear from net workers."

--J. Larry Tyler

THE NETWORKER'S TOOL KIT

These, according to the experts, are the essential tools in the effective networker's armamentarium:

1 A telephone And a rudimentary grasp of the protocols that allow one to negotiate secretarial firewalls and address people appropriately once you do reach them.

2 An answering machine hooked to the telephone, "so people can return your calls and leave messages," explains Larry Tyler.

3 A business card. "Don't leave home without them!" stresses Tyler. "And always make sure they include both your office and your home numbers-and probably your email address."

4 A pencil or pen. "Always have something to write with," advises Tyler. When you exchange business cards with a person you've just met, he counsels, note on the back of the card you've received some mnemonic details about the conversation, especially anything you've just agreed to do: send a resume, call in three days, or whatever.

5 A system for keeping up with your expanding network. These days it is most likely to be a computer and a "contact management software program, such as ACE, GoldMine, or Outlook. "But you can just as well do it manually," allows Tyler.

Though not essential, a very handy additional implement is a small "personal digital assistant" like a PalmPilot or a Psion instrument, notes Tyler. "They're very effective when used with a computer." (I-lodge swears by his PalmPilot, as a "secondary source" to his desktop system, which contains 600 names and addresses.)

But, of course, no gear can compensate for commitment to creating the network in the first place. "You've got to have the proper attitude," declares Tyler.

David O. Weber is a health care journalist living in Mendocino County, California. He can be reached by calling 70 7/937-2158 or via email at [e-mail].