Korn Ferry: Leaning Forward To Recruit Health Leaders

Academic health care centers combine a focus on service and education with a culture that values tradition and precedent. The emphasis on tradition, however, can leave these institutions mired in inefficiencies. Consider, for example, the process by which these organizations recruit their top leaders, whether the executive search is led internally or by a specialized outside search firm. In more traditional academic centers, high value is placed on a deliberate and inclusive search, which typically occurs too slowly to meet such organizations’ needs. Instead, opportunity exists for executive search processes in academic health centers to apply new approaches that may lead to significant efficiency gains without sacrificing favorable outcomes.

CURRENT HIRING TRENDS.

The Association of American Medical Colleges (AAMC) in 2011 surveyed the CEOs of major United States teaching hospitals, finding that 75% of respondents had filled at least one executive-level position in the previous two years (Mallon et al. 2011); the average number of new executive appointments among hiring hospitals was 2.54. A similar survey of medical school deans (Mallon and Corrice 2009) found that the schools averaged 4.1 new chair or center director appointments in a two-year period. These surveys also found that for major teaching hospitals, leadership searches took seven months on average and that the average search for department chairs and major center directors in medical schools took almost a year; some searches took almost four years. These long pursuits not only drained resources but also resulted in lost opportunities for the institutions, which had to delay launches of executive-led strategies while waiting to fill key positions.

A typical hiring process at these institutions consists of multiple stages (Alexander 2003):

• In-house preparation: Forming a search committee, selecting a chair, creating a position description, drafting advertisement language, and developing a search timetable (Alexander 2002)
• Candidate sourcing: Developing a list of potential candidates through direct contact, referrals, and advertising
• Candidate screening: Establishing which candidates meet the criteria for the post and deciding which qualified candidates will participate in first-round interviews
• Candidate interviews: First- and second-round interviews of qualified candidates requiring scheduling of transportation, hotel arrangements, interview timelines, etc.
• Reference checking: Contacting candidate references
• Offer and negotiation: Closing the deal and determining the selected candidate’s compensation and benefits

The AAMC surveys showed that 74% of teaching hospitals used external search firms, while 12% tapped in-house human resources professionals. For leadership posts in teaching hospitals, the search committees included 10 members on average; 8% of these committees had 20 or more members. The survey authors speculate that committee members often are appointed for symbolic and representational reasons rather than because they offer specific competencies to assist the search. External executive search firms were retained for only 26% of clinical department chair openings, probably because of potential costs and a tradition of hiring faculty in peer-driven processes. It is worth noting, however, that external firms’ searches were done three months faster than in-house searches for medical school clinical chairs.

Several hiring challenges in academic health care institutions emerged in the surveys. The research showed that for teaching hospitals, proper fit between candidates and the organization was the most challenging hiring aspect. CEOs said they struggled to find candidates who were highly qualified and who understood academic medical centers’ unique needs. Respondents also specified a need to develop better succession strategies for internal leadership hiring, saying that they would ease both the issues of cultural fit and the complexity of the transition period.

For medical schools, the survey found the top hiring challenge to be development of solid candidate pools. Respondents said it was tough to find candidates with the proper background, skills, and abilities; the lack of diversity in the candidate pool was disappointing. Leaders at teaching hospitals and medical school deans also said that finding candidates with the appropriate fit was a challenge.

This information offers insight into challenges and opportunities in hiring academic health care leaders.

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