focus paper eric schwab, facmpe august 21st 2015 · recruiters in your niche (n.d.) states that...
TRANSCRIPT
Navigating the job change process and pitfalls to avoid
Focus Paper
Eric Schwab, FACMPE
August 21st 2015
This paper is being submitted in partial fulfillment of the requirements of the Fellowship
in the American College of Medical Practice Executives.
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Introduction
Medical practice executives enjoy a challenging and rewarding career with many opportunities
for growth. Over the course of a medical practice executive’s career, they could be faced with
several difficult decisions regarding career advancement. The focus of this paper is to examine
the thought process and research that goes into making or not making a career changing decision.
This paper also identifies potential red flags in evaluating a new job opportunity.
The decision to make a job change can be exciting, overwhelming, and scary all at the same time.
This can be a long process with several steps in the decision making process. This paper will
discuss all phases of this process including factors that prompt an individual to consider a job
change opportunity, how the opportunity is presented to them (recruiting agency, networking,
etc.), the interview process, salary negotiation including possible counter offer situations with a
current employer, proper research of a potential future employer, and accepting or declining the
opportunity.
Once a decision is made, it is possible that a medical practice executive could be faced with the
fact they made the wrong choice. Pitfalls or red flags will be identified to help aid in one’s
decision making process. This will be further discussed through a case study highlighting one
medical practice executive’s experience in the process and the realization of a career mistake.
The research methodology used in this paper will include literature from several renowned
authors on success and career growth. In addition, multiple online articles focused on topics such
as changing careers, the right questions to ask in a job interview, evaluating a job offer, red flags
to look for in the job change process, and executive job search tips are referenced. A survey was
also conducted of 25 medical practice executives made up of 6 questions that asked them to
answer if they had been in a job change situation before and what factors led to their decision
making.
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Background
Navigating the job change process will affect every medical practice executive at some point in
their career. New graduates will be faced with multiple opportunities to start their career. More
seasoned practice executives will come across several opportunities over the course of their
career through networking, recruiting agencies, or other methods.
The job change process can have several impacts, many of which can be positive. The practice
executive may earn a higher compensation, be promoted to a larger role, have the opportunity to
focus on the aspects of their job they find the most fulfilling, love the most, or have a better
work/life balance. However, not all job changes are positive. The practice executive could burn a
bridge with a previous employer, realize the position wasn’t the right fit, not get along with his or
her new co-workers or supervisors, or have a worse work/life balance.
Stakeholders in this process include the medical practice executive, their current employer,
potential future employer, and family and friends of the medical practice executive who could be
impacted by the decision. Because of the potential impact on multiple stakeholders, the job
change process is important to research and evaluate thoroughly. Multiple factors affect decision
making and one must choose the decision that is perceived to have the least risk of having a
negative outcome. Avoiding pitfalls is crucial to prevent damage to any stakeholder.
Job Change Decision
The point where a practice executive decides to embark on a new career path can be an exciting
yet stressful time. Maxwell (2012) states “to reach your potential you must grow” (pg.1). A new
position can signify that growth. Many practice executives enjoy long careers with the same
organization. They are fulfilled by doing so as they love their job, the people they work with, and
their overall life balance. Other executives look for career growth opportunities via job changes.
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These opportunities can come in the form of a change in responsibility, a change in specialty, or
even a change in location.
How does a person know when the right time or right opportunity presents itself? It is certainly a
discussion that has many layers and every individual’s situation is different. Switching jobs or
careers can be a thrilling and a scary experience but the key is to take small conscious steps and
prepare yourself for a successful transition (Canfield & Switzer, 2005). A practice executive will
be well served by taking a cautious approach in evaluating a decision to change positions.
John Maxwell (2012) advises that every person develop a personal growth plan. A personal
growth plan can serve as a guide to aid in the decision of the right time is to pursue other
opportunities. A medical practice executive’s personal development plan should include
certification as a medical practice executive (CMPE) through the Medical Group Management
Association (MGMA). This certification can be further enhanced by obtaining a fellowship in the
American College of Medical Practice Executives (FACMPE). Achievement of these
designations can identify practice executives ready to move up in their profession.
In a survey conducted of 25 medical practice executives in May 2015, respondents were asked
questions about times they were faced with decisions to change jobs and the factors that led to
their decision. Fifty-five percent of respondents have considered changing jobs 3-5 times over the
course of their career and almost 50% of total respondents actually did change positions. About
60% found their next job through networking contacts, 20% through a recruiting agency, and
20% via online job postings. Overwhelmingly, higher compensation was the number one factor
that caused executives to both evaluate and eventually accept a new position.
At times, practice executives find that they must seek a new position. Their current employer
could be downsizing, an unfavorable relationship may develop with a new boss, or perhaps a
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spouse’s job forces a relocation. These factors can play a large role in decision making but can
also rush an executive to make an uninformed decision.
Job Search
Once a practice executive decides it is the right time for a job change, the search process begins.
As mentioned previously, survey results indicated most executives found their opportunities
through networking. Morgan (2015) advises that a job hunter can improve their odds of landing
their dream job by diversifying their search across all sources such as employee referrals and
networking, job search engines, job boards, company websites, and recruitment agencies. Social
media can also be a powerful tool. A website such as Linkedin allows an executive to start
networking with peers at desirable companies which can potentially open doors to opportunity
with that organization (Perman, 2009). The MGMA Career Center can also be an excellent
resource for additional advice on a job search as well as a job board from employers across the
country. An executive can utilize the MGMA Career Center to narrow down their search to a
state of preference as well as search for jobs with specific keywords.
Recruiters and recruitment agencies can aid practice executives in evaluating opportunities. In
addition, these resources allow the executive to ask candid questions about a potential new
employer interacting with that employer. The Wall Street Journal article titled How to Find
Recruiters in Your Niche (n.d.) states that “building relationships with recruiters may expose you
to career opportunities that you might not learn about otherwise”. This is due to organizations
preferring to contract with a recruiter to find a top quality candidate instead of eliciting responses
through an internet job posting. Recruiters are paid by the employer and offer an advantage to the
employer by doing the work of limiting the candidates to only those best suited for the position
(The Wall Street Journal, n.d.). When starting the job search, a practice executive could seek out
recruitment agencies that specialize in medical management recruiting and placement. A
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recruitment agency should be able to provide a history of successful placements with top
organizations, references, and a professional process (The Wall Street Journal, n.d.).
Interviews and Evaluation
The medical practice executive has now entered the portion of the job change process where
potential opportunities are identified with mutual interest by the executive and the employer. The
first step in this portion of the process is typically an interview. The interview can be conducted
via phone, video chat, or in person. This is a crucial time in the job change process. Not only is
the employer evaluating the candidate, the medical practice executive can use this opportunity to
evaluate the employer.
As previously mentioned, the survey of medical practice executives found that the majority of
respondents considered changing jobs in search of higher compensation. Compensation should
not be the only factor when considering an employment decision (Malugani, n.d.). A larger
paycheck doesn’t necessarily correspond with a positive work environment. Other factors to
consider are culture of the new organization, a collaborative environment with co-workers and
your boss, benefits offered, and if the candidate will be challenged and have the opportunity to
further grow and advance. A candidate must do their homework on a new employer, ask a lot of
questions, and make a comparison checklist (Malugani, n.d.).
The job interview can be the perfect opportunity to get a clear idea of some of these factors. It is
important to ask the right questions in an interview because, if done correctly, the questions can
confirm your qualifications as a candidate as well as determine if this organization is where you
want to work (Konop, 2014). Konop (2014) also provides several suggestions for questions that
should be asked at an initial interview to gain perspective on fit:
What skills and experience do I possess that make me an ideal candidate?
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What is the single largest problem facing your organization and would I be in a position
to solve this problem?
What have you enjoyed most about working here?
Can you tell me about the team I’ll be working with?
What constitutes success at this position?
The candidate should write the answers down for analysis after the interview. The candidate can
also ask themselves questions after the interview process. McMullen (2014) suggests important
questions that a candidate can ask themselves which include:
Does the offer meet most of my needs?
Are there opportunities to expand my skills and experience?
Do I know very clearly what is expected of me at this job?
Could I speak to a potential colleague in the department?
What is the financial health of this company?
A medical practice executive deep in the job change process needs to have these types of
questions answered in order to make an informed decision and reduce the risks. The executive
should make a clear list of their needs and rank them in order of importance. If a job only meets
your salary needs then perhaps the absence of other factors would ultimately make the job
undesirable. A person cannot grow if there is no one above them who is better (Maxwell, 2012).
Even if the position is at the top of the organization, is it challenging enough? Will you be able to
learn from others and expand your knowledge and experiences? For some, a limited growth
potential can be a deal breaker.
Expectations of the role should be clearly outlined. In the form of a job description as well as
other less tangible areas. Are late nights and weekends common? Will you still be able to get to
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your children’s ball game? Does the position title match the expectations? For example, while the
title may be Director of Operations, you may be expected to handle more human resources or
marketing related issues. Passion and a clear purpose are important determinants of success
(Canfield & Switzer, 2005). If you are not doing what you are truly passionate about it, this job
will ultimately be the wrong fit and not meet your expectations.
After the first interview stages are complete and mutual interest is identified, the medical practice
executive can also explore several other evaluations to avoid errors in their decision making. On-
site visits and speaking to potential colleagues in the organization are highly recommended
methods to truly gauge the culture of the organization (McMullen, 2014). These people will most
likely be honest and forthright when describing the corporate culture and expectations the
organization places on their management and executive team. This interaction can also provide
insight on employee satisfaction. If available, the turnover rate for the organization can be a
barometer for workplace satisfaction. If an organization is hesitant to allow this type of
interaction that could be a potential red flag that there is something to hide.
The financial health of the company is also extremely important. Is the company in financial ruin
and your position is expected to change that state? If so, the candidate should be informed of the
expectation. In the medical practice field, a private practice could be interested in hospital
acquisition in the future. This can certainly impact the decision because hospital systems may not
continue your position after acquisition. Depending on the level of position, it is not uncommon
to ask for financial statements from the organization before making your decision (McMullen,
2014).
Job Offer
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The next part of the job change process involves the offer. The job offer is of course dependent
upon the organization having selected the medical practice executive as their chosen candidate,
the candidate has evaluated all aspects of the position during the interview and evaluation stage,
and the executive feels they are willing to receive the offer and consider acceptance. Any
management position in the healthcare industry should have a written offer letter. If not, this is
something the candidate needs to ask for which should include elements such as the job title,
reporting structure, and compensation plan (Ryan, 2014).
When the offer comes, the medical practice executive should be well prepared with terms and
conditions they will accept already in mind. A great resource for this is the MGMA Management
Compensation Survey. The MGMA Management Compensation Survey can give salary ranges
by position, geographic location, specialty, and number of providers managed. This data will be
extremely valuable in negotiations as MGMA is a trusted industry resource.
There are also hidden costs to consider such as benefits, commute time, or a possible relocation
(Green, 2014). These hidden costs should be factored into salary or even a signing bonus. In the
instance of a relocation, costs can be extensive with moving your belongings and even selling a
current home. These are factors that can be negotiable but it certainly does not hurt to bring them
to the employer’s attention (Green, 2014).
Being a medical practice executive requires a high level of professionalism and responsibility.
That is why a notice period is highly important when considering a job offer. A medical practice
executive’s current employment will probably require a four week notice if not longer depending
on the level of responsibility. A new employer should be respectful of this time as it should speak
to the candidate’s professionalism and integrity. If a relocation is involved, there should also be a
considerable amount of time given for the candidate to finish their current responsibilities and
also have time to move. A move can involve the sale of a home, moving children between
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schools, and saying goodbye to friends and family. The candidate should really consider the
impact this can have on a successful transition. An organization without a sensitivity to this may
indicate a lack of compassion for their employees and their work/life balance.
Final acceptance or rejection of a job offer should be evaluated with much analysis as well as
discussion with peers and family members. A rejection should be handled professionally to avoid
burning bridges with any contacts that may reappear in the future. A rejection should also outline
some of the reasons the candidate felt the job would not be an ideal match. An acceptance can
certainly be a time for celebration. A new opportunity that is aligned with the candidate’s needs
and career growth plan is a great achievement.
Potential Red Flags and Pitfalls to Avoid
This paper has discussed elements of the job change process including identifying the need to
begin the process, the job search, the job interview and evaluation, and the job offer. Taking the
proper steps to navigating to the process will help to mitigate the risk of entering into an
unfavorable position with a new employer. Medical practice executives should be aware of the
potential red flags and pitfalls they could identify early in the process to help them avoid this
situation.
Avoiding common pitfalls can mean the difference between success and failure (Madell, 2015).
Many of these pitfalls can be identified during the evaluation and offer stages but it is important
to take some time and truly analyze the interactions with the potential employer. The excitement
of a new opportunity can blind the candidate to some of the red flags. One common pitfall is
desperation for a new position. This can be during a time of unemployment where almost any job
seems better than no job at all. Some jobs are better off not taking as accepting the wrong position
can set your career back even further (Tuggle, 2015).
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The timing of the job selection process can be an indicator of future working conditions. The
selection process for an executive position is likely to take six months or longer to find the right
candidate (Ryan, 2014). A rapid selection process is likely to be a red flag as it may indicate a
high turnover rate and a desperation to fill a position with any warm body. Even though the
process may be long, the candidate should also expect to hear regular updates from the potential
employer or recruitment firm. A lack of communication is certainly not a preference for a
motivated job seeker.
While it is an important question to ask in the interview process, the topic of whether or not your
position is replacing someone and why can be an indication of a pitfall. The candidate should be
wary of any hiring manager who badmouths someone who previously had the position (Millard,
2013). This is a red flag because most professional organizations would not share these feelings
with potential candidates.
If the offer is too good to be true, it most likely isn’t true (Tuggle, 2015). While that statement
may not be true in every circumstance, the candidate should be mindful of any behavior that
suggests the new role is perfect. Every job comes with its challengers and this can be a sign for
the practice executive to dig deeper in their research. The research should be the true indicator of
whether the candidate is a fit for this company’s corporate culture and give the candidate a better
idea on how the position will truly develop.
The job description and expectations should also be fairly consistent with every person the
practice executive may speak with during the recruitment process. If the hiring team is not
consistent with the information presented, it could signal either a lack of communication
internally or an insufficient job in defining the position and expectations (Tuggle, 2015). A
candidate may be set up for failure if the potential employer cannot define how success in the role
is measured.
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A high turnover rate is a giant red flag for the prospective candidate. The medical practice
executive should think twice before accepting an offer if a company appears to have a revolving
door of employees (Ryan, 2014). If possible, it may be wise to seek out past employees to find
out why they left. Employees not staying long with the company can be a sign of a bad boss or
toxic work environment (Ryan, 2014). This doesn’t necessarily have to be with management
positions only. The overall turnover rate will be a very useful piece of information for the
candidate.
A lack of transparency with any of these potential pitfalls serve as an immediate red flag for the
prospective candidate. Companies should be willing to talk about any major challenges and
should be forthright with where they stand financially (Tuggle, 2015). An executive level
position is certainly a position where there is justification for releasing this data.
Another important piece of advice for the medical practice executive is to trust your instincts. A
company should be willing to hear you out and at least meet in the middle in terms of
requirements for your new employment (Tuggle, 2015). If not, the candidate should be cautious
and continue searching for an employer that truly values this level of position. Never
underestimate the value of your own intuition (Canfield & Switzer, 2005). Your intuition acts as
your own personal alert system or red flag. If the job or situation doesn’t feel right, it may not be
(Canfield & Switzer, 2005).
Conclusion
The intent of this focus paper is to provide lessons and recommendations to practice executives
who feel they may be considering navigating the job change process in the future. Those who find
themselves in a position that is not ideal by changing jobs can also take lessons learned by others
to truly evaluate where they are, where they want to be, and how to get there.
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Navigating the job change process should start by identifying the individuals career goals, growth
potential, and overall job satisfaction before considering the idea of searching for a new position.
A true pro/con evaluation of their current role will be helpful in determining if leaving the current
employer is the truly worth the potential risk and reward.
If a practice executive decides to enter into a job search, they should be mindful of the potential
red flags addressed in this paper. A practice executive should leverage research on the correct
questions to ask during the recruiting and interview stages of the process to find the most
pertinent information when evaluating the opportunity. Once identified as a potential candidate
for the position, the practice executive can leverage the interest a new employer has in them by
asking for more specific information about the company and role including financials, turnover
rates, community perception, and other factors that can indicate a better sense of the company
culture.
Practicing an extensive evaluation can assist the executive throughout their career in finding the
right opportunity. Each experience can provide a learning moment that can be recalled and
assessed with future evaluations. Navigating the job change process and pitfalls to avoid can
certainly be an arduous task but the practice executive will reap the benefits of conducting the
proper research and using proper decision making tools.
Appendix A: Case Study
Statement of the Problem
The problem occurs when the medical practice executive makes a decision to leave his current employer
of two years and take a job opportunity that required a relocation to another state. Although extremely
satisfied with his current job, the organization experienced a reduction in work force and the practice
executive becomes fearful of job security. Under his current role, he is the Director of Operations for a
large multispecialty group that is hospital affiliated. Fearing that middle management is a target for cost
cutting, the practice executive begins to field interest from recruiting agencies.
An opportunity is presented that offers a higher salary in addition to the title of Chief Operating Officer
which indicates a promotion in role and responsibility. The setting will be quite different. The new
opportunity is a large but private practice and a specialty that the executive has no prior experience in.
The position is also located in another state around 300 miles from his current location.
The practice executive encounters one phone interview and one on-site visit before receiving a formal
employment offer. The practice executive accepts the offer and issues his formal resignation to his current
employer.
The current employer decides to counter the resignation with salary increase and additional responsibility
however the practice executive chooses to take the new opportunity. The two parties’ part ways amicably
after a 30 day notice period. After a short period of time at the new position, the practice executive
realizes he may have made the wrong decision. In many ways, he feels the position was misrepresented to
him and feels very uncomfortable with the physician leadership at the practice.
The work environment extends itself to the executive’s personal life as well. He and his family are not
happy with the situation and decide that it was time to end this new position and pursue other
opportunities. The practice executive is now faced with decisions that have a severe financial and career
impact.
Alternative Decisions Considered
There are several decision making processes involved in this case study. The first is to leave the current
employer for the new opportunity. The second decision involves staying with the new position or finding
another position so soon after a recent change.
A. Stay with current employer
Pros
Continue working in a position where he had established relationships, accomplishments, and
job satisfaction
Receive a salary increase and increased responsibility to remain with the company
Cons
Investigate ethical dilemma of using a counter offer against current offer
Risk losing job if workforce reductions continued
B. Continue to evaluate other opportunities
Pros
Possibly find a perfect fit instead of settling on first offer
Cons
Risk losing a job while conducting job search
Face uncertainty in the job market
C. Leave the new employer after a short time for another opportunity in the area
Pros
Avoid another relocation
Possibly find a job more suited to interests and skill set
Cons
Possible negative perception in job search due to the quick transition
Possible salary reduction given the current market
Contractual issues with breaking employment agreement in under 2 years
D. Investigate returning to previous employer
Pros
Resume work that was satisfying
Potential counter offer could still be available
Return home to family, friends, and familiar environment
Cons
Financial problems with the organization could still be present
Risk feeling a sense of failure by returning so soon after resignation
Endure another relocation
Contractual issues with breaking employment agreement in under 2 years
E. Continue at the new position for the remainder of the contract
Pros
Continue earning a highly competitive salary
Would avoid another relocation in the near future
Chief Operating Officer title could be valuable for future opportunities
Cons
Dissatisfaction with the position affected personal and professional life
Compromised ethics
Could waste valuable years of experience in a specialty that was not a good fit
Decision
Due to the ongoing issues between the practice executive and the new employer, the situation eventually
came to a point where the practice executive left the position. The practice executive chose to return his
previous employer. Ultimately, the culture of the new organization did not fit with the practice executive.
A high turnover rate was reported as the single biggest indicator that the practice executive could have
identified in the job search process that would have alerted him not to accept the position.
The practice executive was frequently placed in uncomfortable situations with the owning physician of
the group. Due to the perception of current staff and actions by the owning physician, the practice
executive’s authority and position were not respected. Suggestions for improvement to the practice were
frequently ignored and direction was usually given to handle tasks not appropriate for a Chief Operating
Officer position.
After a five month tenure, the practice executive decided to leave the new position and return to his
previous employer. Fortunately, the practice executive left on good terms with proper notice. After
evaluating the possible alternative, he found that the reductions in management brought on a change in
senior leadership that had turned the organization around in short order.
The decision to return to his previous employer was not an easy one. The practice executive had an
internal conflict of returning with perception as a failure. It is common for professionals to make a career
change and have immediate regrets (Smith, 2013). The practice executive realized the grass was not
greener on the either side and felt he may have rushed his decision based on an irrational impulse. Barrett-
Poindexter (2012) provides the following tips when reaching out a previous employer about returning to
the company:
Reach out to former colleagues to gauge interest and also any positive or negative changes since
departure
Prepare to explain the situation and why it did not work out
Leave pride out of the discussion
Focus on lessons learned and how to apply them moving forward
Be open to taking a step back in pay or responsibilities to ultimately move forward
After going through these types of analyses and interactions, the practice executive chose to return to his
previous employer. His previous position had not yet been filled and the counter offer remained in
negotiation. The practice executive relocated back to his home state and resumed duties. Although
painful, the experience truly helped the practice executive realize what type of work was most important
to him. Since returning to his previous position, the practice executive has led several initiatives and
achieved multiple goals. Experiencing this decision making process and feeling the impacts will now help
the practice executive in evaluating future opportunities in his career and avoid making the same mistakes
by doing proper cost/benefit analysis and research.
References
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offer-no-matter-what
Survey
A survey was conducted of 25 medical practice executives in May 2015. The following 6 questions were
asked in the survey:
1. How many times in your career have you considered taking another position at a new company?
2. How many times in your career have you actually taken another position with a new company?
3. If you did change jobs at any point in your career, what was the most common method of finding
the opportunity?
4. After a job change, have you ever been in a situation where you returned to a previous employer?
5. In order of importance to you, please rank the following criteria when evaluating a job
opportunity (Higher compensation, Better benefit package, Geographic location, Promotion to a
higher role, Scale of responsibility, People you will work for, Financial health of the
organization).
6. In order of importance to you, please rank the following factors you would consider for leaving a
position for another opportunity (Compensation, Benefit Package, Geographic Location, Lack of
upward mobility, People you work for, Financial health of the organization, Feeling un-
challenged).