As 2013 unfolds and the economy tentatively climbs its way into recovery, many business leaders are slow to place a “Help Wanted” sign in the shop window. Healthcare leaders are no exception. In fact, hospitals, health systems, and physician practices can be especially cautious about filling positions that have remained vacant for months or even years, mostly because along with this economic recovery, the next phases of the Affordable Healthcare Act loom, adding another layer of uncertainty to the near future.
The cath lab setting in particular remains challenging due to the complexity of care provided, the specific skill set required of staff and management, and the variability of volume, especially in the new era of appropriate use criteria (AUC). With profit margins for cath lab procedures projected to remain slim for the foreseeable future, hospital leaders cannot afford to leave this department without strong leadership, even for a brief time. This is one reason that interim leadership is so popular in this area.
As the number of people affected by heart disease continues to rise, the demand for cath lab personnel will increase in tandem. According to the Bureau of Labor Statistics, job opportunities for catheterization laboratory technologists are predicted to increase 24% between 2008 and 2018. But the cath lab isn’t the only area that requires strong, experienced leadership. Industry statistics reveal that a real and significant need exists for talent in clinical, operational, and leadership areas of the cardiovascular service line as well.
Corazon believes this trend of mismatched need and hiring growth will continue at least through the near future, as hospitals try to retain skilled clinical professionals as long as they can1 and postpone any long-term commitments to increasing the staff or leadership complement in particular areas. But, as volumes increase and greater demands are placed on healthcare professionals to cut costs, ensure quality, and meet the other standards of program excellence, strong leaders are essential for continued success and viability. All of these changes have made the market for interim managers, both from the personnel and the employer side, an appealing proposition.
Recent reports regarding the costs of a bad hire show the total impact on an organization going well into the six figures, in addition to the toll on the mismatched employee and his or her family. Hiring an interim manager significantly reduces this risk, with the benefits far outweighing the additional upfront costs. In addition to the well-known values of interim employees (such as experience, rapid availability, and a strong network of resources), there are many esoteric benefits that should also be considered. These include:
1. Understanding the potential employees’ cultural fit within the organization and the community. While many organizations pay thousands of dollars to conduct psychological and critical thinking testing on potential employees, little attention is paid to how they and their family will acclimate to the region where they will be employed. With over two-thirds of the nation’s public hospitals located in rural areas2, how an employee acclimates to regional specific beliefs and customs can be very important to their overall success and acceptance as a leader within a facility.
2. Increasing the depth and skillset of the current employee roster. Cath labs and nursing units have successfully used this technique with traveling staff for a number of years. Transitioning it to a management level affords an “on-the-job” training program for staff members who are interested in moving to the next step of their career, but who do not have a mentor to help them along the way. Many people incorrectly believe that a successful interim placement is one that ends in permanent employment. This skewed belief eliminates the large segment of the interim management pool who want to remain interim, yet have a great deal to offer an organization on a short term-basis, including grooming someone to permanently fill the position that they temporarily will hold.
3. Improving financial projections and forecasts. Interim staff is treated differently on financial reports, which can have a positive impact on an organization’s fiscal outlook. Commitment to full-time employees is a costly venture, beyond direct salary; there is payroll tax, paid time off (which should be reflected as debt), healthcare and other insurances, physical plant space and equipment, unemployment and any malpractice insurance, and more. Many of these costs transfer to a shorter-term operational expense when interim staff is considered.
There are some drawbacks to hiring an interim, though, and employers should be wary of the pitfalls, which include:
1. The perceived lack of investment in your organization. It is a special type of professional who can treat each interim assignment with the enthusiasm and commitment of a permanent employee. However, such a commitment is essential to a successful engagement, as staff will immediately identify and reject someone who is just there to ‘fill space.’ Finding the ideal interim candidate can be a daunting process, but there are many qualified and highly-skilled professionals who have chosen to use their experience and passion to bring real and positive benefits to organizations on an interim basis. Finding the right fit is the key.
2. Staff apprehension to commit to someone temporary. Admittedly, this is a tough situation. Staff are hesitant, and rightfully so, to commit to a leader who will not be with them for the long haul, or at least has perceived longevity. However, staff commitment to the interim leader, and his or her objectives, is essential to their success. One way around this apprehension is to commit to the interim leader beyond the permanent placement of an employee into a position. This demonstrates the organization’s support of the interim leader, which can often translate into staff support as well.
Despite these drawbacks, Corazon believes that an interim placement can be a worthwhile investment, depending on the particular situation of the organization as a whole. We have had many clients who have experienced great success with interim leadership, including those who have been able to permanently fill vacant positions with successful interim placements that turn into employment offers, as well as those who have used a set interim period as a training and mentorship program to enable the transition of talented clinical staff into successful leadership roles.
To help ensure a successful interim engagement, employers should carefully evaluate potential candidates, keeping in mind that the skillset required for a permanent position will not be exactly the same as what is needed in an interim. While questions regarding long-term successes are more than appropriate for the employed candidate, they are essentially meaningless in a position that is intended to have a much shorter duration.
Since many interim managers are hired to fill gaps brought on by the sudden departure of a key leader, those charged with filling the interim position would do well to question candidates about experience in calming staff and maintaining continuity during periods of change or upheaval. Understanding a candidate’s ability to navigate what could, in some cases, be very rough waters, can serve an organization well in difficult situations or when a less-than-positive response is expected.
As sometimes is the case, more than one position is vacated at the same time, either purposefully or by circumstance. Understanding how a potential interim leader would navigate these situations is essential. While permanent leaders may need to be focused on growth or change, interim leaders typically focus on keeping the course and quelling discord.
With all of the uncertainty facing the healthcare industry today, it will be the leaders open to new ideas and concepts, such as interim managers and staff, who will be the most successful. History demonstrates that organizations that prepare for and embrace change, while finding creative solutions to challenges such as staffing shortages, are the ones that remain successful for the long term.
Jim is a Vice President at Corazon, Inc., focusing on strategic program development for the heart, vascular, neuro, and orthopedics specialties, and offering consulting, recruitment, interim management, and physician practice & alignment services to clients across the country and in Canada. To learn more, visit www.corazoninc.com or call (412) 364-8200. To reach Jim, email email@example.com.
- Ernst and Young. ITEM Club Special Report on Business Investment, November 2012.
- Most Public Hospitals Are in Rural Areas. Agency for Healthcare Research and Quality (AHRQ). U.S. Department of Health and Human Services, 2010. Available online at http://www.ahrq.gov/news/nn/nn090910.htm. Accessed January 17, 2013.