Acing the 'chemistry' test

With the right boss, you can go far and learn much. The wrong boss could actually slow or even stall your executive career. When you interview for a job, you're also interviewing for a boss--and it's in your own interest to try to find the individual who is the best possible fit with your own management style. This is a matching process--not quite a courtship, but with some of the same characteristics. What can you do to ensure a good match with your new boss? (1) Do your homework; (2) Make your interview a dialog; (3) Use subtle strategies, too, such as watching for body language; (4) Ask the employer for references; and (5) Know yourself.     

The importance of building alliances

This may come as a surprise to Gen-Xers, but on-the-job allies are a political necessity. Information and support from workplace alliances are vital to doing your job. Your peers, boss, subordinates, and even enemies, can and should be in your network of allies. How do you build alliances? It's accomplished by cultivating relationships based on mutual benefit and interest. Information and favors are traded on a quid pro quo basis. Your peers, subordinates, and boss have different needs but they share some goals with you. Goals are the common denominator. Consider the following ways to cultivate your network of allies: Be a reliable news source; offer feedback; be congenial; share expertise; consult; strive to be a role model; don't demand credit; don't wait for recognition; articulate your needs; share a hot idea; save face for someone; and connect people who can help each other.     

How could I have gotten it wrong?

Can you avoid ending up in a career-denting job: Are there potential pitfalls to recognize on the search for a rewarding position? Finding oneself in an impossible job, working for a boss who brings out your worst qualities and deepest insecurities, or joining an organization that is doomed are nightmare scenarios. How do these judgment errors happen? We asked physicians who've been there and, unfortunately, done just that. What they learned might help the rest of us skip the experience.     

Congratulations ... you're fired!

Being fired as a physician executive is the dark side of burgeoning opportunities for health care leadership. The risk of termination is 20 to 40 times higher than for clinicians. Several approaches to calculating and predicting the probability of being fired are presented, based on a recent survey of American College of Physician Executives members and the author's professional observations. The survey identified several factors that are associated with a higher risk of being fired. These include structural conditions like organizational type and position, as well as factors ranging from being the first person in a new or unclear job to working for an entity with two or more years of significant financial losses. Persistent conflict with a boss or board member--concerning personal style or organizational strategy--is another commonly present danger signal. Additional predictive variables include recent termination or departure of a boss, recent merger, and widespread organizational downsizing or re-engineering. This article suggests strategies to better predict high-risk situations, to prevent termination, and to increase the likelihood of your professional and personal well-being when termination becomes inevitable.     

Fired? Here's an exit strategy

Who gets fired in a boom job market? People are fired more often for things they failed to do than for mistakes they made. The new rules of engagement are: There is no probationary period; resistance to technology is a quick ticket out; a lack of emotional commitment to the role you're hired to play is usually fatal; personality defects that keep others from producing are not tolerated. The most common reason for being fired, however, is lack of fit. Whether you're laid off or fired, don't ask for explanations. The fact is, the people with the power to get rid of you don't want you to stay. What matters is maximizing what they'll do for you on departure. To get the most favorable terms with the least financial and ego damage, here's a game plan: (1) Get a favorable reference--in writing--from your boss; (2) gather work samples and good performance appraisals you've received; (3) negotiate for as much severance pay as possible; (4) negotiate for outplacement assistance; (5) gather contact names from co-workers; and (6) leave in style.     

How to make the pitch for a part-time workload

Are you planning on moving from full-time to part-time hours? You'll need a game plan to negotiate what you want, including establishing a timeline and agreeing on productivity expectations. If you can agree on a reasonable timeframe that doesn't inconvenience anyone or endanger important results or relationships, you have a high probability of getting your boss' okay. If you and the boss can't agree on what you must produce, don't consider part-time work unless you thrive on combat. Once you negotiate your new schedule, consider the issue of managing co-worker resentment. Here are the best hints for keeping co-worker envy and resentment at a manageable level: Don't be secretive; keep a low profile; attend all office frolics; and ask for a trial period.     

Falling from the top: the fired physician executive

Today's health care market is volatile, and the job of a physician executive is becoming more risky. Recognizing signs of trouble and taking immediate action is essential. Ten early warning signs that you could be fired are: (1) Net profits dip unexpectedly; (2) investment income can't cover operating losses; (3) bond rating is downgraded; (4) revenues are not rising as fast as costs; (5) senior executives leave the team; (6) wage increases don't improve nursing vacancy rate; (7) unions begin whisper campaign; (8) medical staff elect an SOB; (9) hospital is slapped with a costly lawsuit; and (10) recruiters call to check on your status. Physician executives are quickly learning what it takes to overcome tough challenges and prevent premature job termination: Communication; no-surprise performance; continuous monitoring of key indicators; openness and plain talk; and no-more-business-as-usual attitude. What can you do to make your job loss as painless as possible? (1) Negotiate a contract upfront; (2) don't lose your temper; (3) ask for your wish list quickly; (4) be reluctant to sue your former employer; (5) tell your family as soon as possible; (6) take only a brief vacation; (7) consider a temporary assignment; (8) be prepared to be re-employed by your former employer; and (9) keep a positive attitude.     

Are you obsolete?

Are you vulnerable, regardless of length of service at your organization and your unique skill sets? There are ways to test vulnerability and assemble some hard evidence that your management role makes a difference. You need to conduct a self-test for obsolescence. Ask yourself the following questions: Are your skills state-of-the-art? As a manager, how do you compare with others doing the same, or similar, job at competing organizations? Is your role essential? Where does your job fall into the big picture? Can you be replaced easily? If a thorough examination of your skills and your role convinces you that your contribution returns more to the organization than your salary, can you prove it? Consider these strategies: (1) Put together a portfolio, (2) ensure your boss' support, (3) advertise your successes, and (4) cultivate recruiters. The best reason to analyze your value to the organization is that if you are laid off, getting another comparable job--or a better one--will be far less of a hassle.     

How to survive a new CEO

A new CEO means everyone in the organization is now a new hire--an unknown entity that must prove he or she can and will enthusiastically, tirelessly support the CEO's agenda. Those who want to stay on the payroll must avoid a business-as-usual attitude and demonstrate that they share the CEO's dedication to change. If you're in a staff job, it's important to show you're essential to the new regime, quickly and convincingly. Some important steps to consider as you plan for the transition include: Do your home-work; anticipate the CEO's needs; be supportive and nonpolitical; be realistic with your direct reports; and appear poised to leave willingly and quietly--and you may not have to.     

Managing up: dynamic following in an organizational setting

Learn how working with an executive coach can help ease a rocky relationship with your boss or co-workers.     

Becoming a company person.

Physicians face a management challenge in adjusting to being part of a larger organization. By nature, physicians are not "company people." For physician executives, whose instincts can still lean toward being ferociously independent and individualistic--therein lies the struggle. Here are a few suggestions to help physician executives make the adjustments that are required of a "company person": (1) Be in the right place; (2) abandon critical/negative thinking; (3) focus on the issues; (4) maintain solidarity; and (5) make your boss look good.     

Joe's First Bank

Joe Spoke has had a highly successful career in banking. Joe will leave his present job as CEO of a county region of a bank chain within 60 days because of disagreements with his new boss. The case explores several career options for Joe. One option is to take a job as one of three executive vice presidents of a local bank. A second option is to take a job that will involve relocation. A third option is to start a new bank in his county. The case explores the option of starting a new bank in detail. Projected financial statements are included for analysis by the students. This revised version was published online in July 2006 with corrections to the Cover Date.     

Can you take your soul to work?

David White in The Heart Aroused: Poetry and the Preservation of Soul in Corporate America explores ways for professionals to take their souls to work, instead of checking them at the door. "We simply spend too much time and have too much psychic and emotional energy invested in the workplace for us to declare it a spiritual desert bereft of life-giving water." Several ideas are presented to help physician executives preserve their souls in an increasingly corporatized U.S. health care system: (1) Figure out what you are meant to do as your life's calling; (2) know what you think and want; (3) share some of what you think at work, while being careful to not lose your job unless you choose to; (4) be a trustworthy listener and find one; (5) get yourself outside; (6) pay attention to your physical space; and (7) develop some new hobbies or refresh old ones. "One of the disciplines of building a rich soul life seems to be the simple act, on a daily basis, of remembering what is most important to us."     

When it's time to say goodbye

You've landed the perfect job, but now you must face your current employer and deliver the news that you're leaving the organization. While an exciting time, this can also certainly be a stressful one. Here are some strategies and ideas for saying goodbye to an employer that may be useful in guiding your actions. From being ready for counter-offers to downright hostility, you need to be prepared to deal with various scenarios. No matter how you have steeled yourself to go into the boss's office to share your news, you cannot predict with total accuracy just what his or her response will be. There will always be surprises, although usually things are never as bad as your imagined worst-case scenario. However, when you are ready to make your plans known, one simple rule is always required: You must have total commitment to your new position.     

High expectations mirror high stakes for physician executives

Because the stakes in health care are high, physician executives are challenged to meet high expectations set by their CEOs and boards. These may be unrealistic--for example, demanding that physician executives possess expertise in finance or strategic planning. Job stresses for physician executives are specific to the role, but are not unlike those faced by other senior executives. It's a fact that professionals leave jobs for any number of reasons; sometimes, not through their own choice or fault. Thus, every time a physician executive leaves a job, it should not be characterized as "being fired," and not every job-leaving should be taken as a failure. Accept that you may make mistakes while doing the best job you can. Rely on your own value system and integrity to see you through.     

Why acting managers rarely survive

Can acting managers win the job? Or are the scales tipped so far in the outside candidates' favor that it's not worth venturing into this shaky territory? If you want to be your former boss' successor, take note of the cautionary tales offered here. From power and control issues to strategies for protecting yourself if the unmentionable happens--you lose the position to some outsider--insights are offered on why you should think twice about accepting the acting manager job.     

Delegation can make (or break) your career

Delegation is not a soft skill. Physician executives who do not delegate well and strategically cannot expect to achieve the top jobs now or in the future. It's not enough to have great communications skills to convey your vision. You won't achieve that vision alone; you must have a great team to bring that vision to fruition. However, you can't delegate your first and most important step--self-assessment. To maximize your strengths and minimize your weaknesses, you'll need a clear view of what makes you tick. Then start thinking about your executive role in these terms: Conceptualize work mandates as projects; choose people who are better than you for your team; and try to work yourself out of a job. By learning to delegate, physician executives can make their own careers (as well as those on their team) richer and more fulfilled.     

Thriving in change

The turbulent state of health care and the rapid changes that show no sign of abating point to many career-related challenges for physician executives. How can you predict the impact of these changes on your career? What measures can be taken to prevent any negative impact of change? And how can you prevail when dealt a negative blow like job loss? The signs that foreshadow the unraveling of a physician executive's career are described. The warning signs are: Not keeping up with change, losing your influence; getting negative feedback; turning your "concerns" into complaints; the economy working against you; and being blindsided because we think leaders operate logically. Being proactive puts more control in your hands and leaves less to chance. You can prevent being blindsided if you: develop your people skills; get comfortable and involved with e-business; stay abreast of health care trends; pick up the pace; and develop "You, Inc." There is a final component to prevailing over adverse circumstances--find your work-related passion and apply it to your career.     

Controlled burn! Physician executives must be ready to handle job burnout, career stress

Job burnout for workers in any career can be frightening. It's truly debilitating to think that your job and career are worthless, that your future isn't bright. There are, however, some steps you can take to recognize, avoid or overcome the stress and anxiety that leads to job burnout.