Are you ready for the next “War for Talent in Healthcare?”

Frankly, no.

I have little patience for superficial and inane slogans in general, and no patience for this slogan in particular. (An actual headline for a webinar, in case you’re wondering). In the context of healthcare, there is a jarring dissonance between the term “war” (violence, carnage, and death) and the term “healthcare” (care, compassion, and hope). Such thoughtless and lazy use of concepts marks a thoughtless and lazy mind. Unfortunately, I see it all the time. It just ain’t pretty.

Looking beyond healthcare to Talent Acquisition as a whole, I find this term is increasingly anachronistic and reflective of a tired philosophy, one that pits “us” against “them” in a “battle for supremacy”. Yep, it’s easy to use the terms. Yet false and misleading. And potentially destructive. No one benefits for long from a hostile mindset or a continuous escalation of competition.

A different and more progressive philosophy acknowledges competition but doesn’t attempt to destroy its competitor. In healthcare this philosophy allows for collaboration between talent teams within different companies as everyone seeks solutions for the shortages in nursing, rehab, and other critical skill areas. And this philosophy is not new, just overlooked. Maybe if we give it a new, hip name that will help raise its image. Let’s call it “open networking.”

Now that I’ve coined the term, tell me, what does it mean to you?

Two teams in particular were the focus of the show: a huge team from Carnegie Mellon that actually had the funding and the headcount to run two heavily customized Humvees in the challenge, and a small team from Stanford that used a mostly stock Volkswagen.

The Stanford team won. Let’s get that out of the way, because I want to talk about how their philosophical approach differed and why it matters.

The differences were apparent throughout the show, but the epitomizer (alert: new term!) came on the night before the challenge. Each team received a CD with GPS coordinates for the course. The Stanford team downloaded the information into their vehicle and went to bed; the Carnegie Mellon team devoted a small army to dissecting and studying every detail of the data then painstakingly inputting very specific instructions to account for every twist, turn, hill, or bump.

I couldn’t help it: I thought about labor costs and efficiency. And the military. I’ve seen command centers before and this is exactly what CM’s tent looked like that night.

The CM approach reflected a philosophy of control: everything had the potential for failure; every contingency had to be accounted for; every variable controlled. From the hardware to the software to any externalities, every potential failure had to be mitigated and redundancies implemented. This necessitated swapping out and modifying a large percentage of the vehicles’ hardware and the design and construction of complex optics, as well as the creation and constant alteration of lines of software code. The result was a lot of people creating a lot of complexity.

By contrast, the Stanford team used mostly off-the-shelf components, including mass-produced laser range finders and a vehicle that was outfitted for disabled drivers. They decided to rely on parts that had been proven to work already and instead focused their energy on solving for the single unproven variable: the software. Their philosophy was one of acceptance: they chose to believe that components produced by others were of sufficiently good design and quality that they didn’t need to be considered as possible point of failure. And this philosophy allowed the Stanford team to produce a superior result utilizing a much simpler process.

Just for fun, I’ve guesstimated the labor cost difference for the two teams. This is totally pulled out of my…well, here are the numbers:

• Carnegie Mellon
• Headcount: 25
• Average salary: $50,000 (they get off cheap because many seemed to be students)
• Total cost for 25 FTEs: $1.25 million

• Standford
• Headcount: 7
• Average salary: $90,000 (many of them seemed to be teachers/researchers)
• Total costs for 7 FTEs: $630,000

We humans seem to be drawn to the complex like moths to a flame. I know I find complexity fascinating. (Which means I might also have control issues, but that is a different post). But, fascinating as it is, it’s often the least best (and most expensive) way to get things done.

I hope you’ll join me and contribute as I return to this investigative journey. And I hope you’ll contribute your astute observations and ideas when you feel compelled to do so. Onward, brave souls!

Although I have to admit that I’ve been ignoring my own advice recently—much to my own detriment (tired eyes, grumpy demeanor, depressed immune system), but I did it to myself and I did it because I thought I was capable of doing it. And I suppose I am…if I’m willing to sacrifice my ability to be efficient, effective, and fully-rested. Because after about the 5th hour of staring at the LCD screen I begin to enter a state of reduced cognitive function—i.e. I start to drool. Try as I might (and concentrate as I may), I simply cannot focus on an activity for more than a few seconds. And forget any kind of creative thinking: that ability is lost after about two hours.

I’ve come to realize two things (never mind that countless studies have already proved these things; apparently I have to experience my own stupidity firsthand to come to any conclusions):

1. I can’t really be effective for more than about 5 hours a day
2. I start to lose focus (and consciousness) after about 30 minutes of concerted concentrating

Recently I’ve been working about 12 hours a day. Call me insane. I completely agree with you. And for all that time spent carpal tunneling I’ve probably only added about two hours of actual productive time to my day.

Two hours.

In other words, it’s a bloody waste of time.

So why does corporate America still cling to the idea that the more hours we work the more productive we are? Why do they accept with open arms the evidence that a brighter workspace boosts productivity but reject, prima facie, the evidence that a 5-hour workday makes the most business sense? Are they really as dumb as I am?

Yep.

Maybe it’s not just the corporate types. Maybe it’s the employees on the ground who fear all the ramifications of a 5-hour workday: less pay, fewer benefits, the possibility of having to pick up a THIRD job. Hell, some of them would do it just because they like to work. Of course, they’re insane.

The first company to adopt a 5-hour workday as their 1.0 FTE will revolutionize the economy. They will probably also go out of business. But the seed will be sown. And a whole host of ancillary benefits will ensue, not the least of which will be a social awakening. Studies (yes, more studies) have shown that people who work fewer hours, or who work jobs with flexible hours, are more involved in their communities, giving a whole lot more of themselves than the full-timers. In this case our country is analogous to our home: if we weren’t so wiped out when we got home we’d clean the place up a little more. At least fold the pile of clothes on the couch. Yes, work wife, I’m looking at YOU.

• Firefox 3 (helper)
  • I love Firefox for its ease of use and customizability
  • Two great add-ons are Ad Block Plus and Tab Mix Plus (you’ll have to use the dev-build on FF3, but I’ve had no issues at all)
• Apple Mail (helper/stealer)
  • If I didn’t have MailTags this app wouldn’t be nearly so helpful, but with this add on installed, I can use Mail to manage projects very nicely
  • I’ve subscribed to too many digests right now and they’re overflowing my inboxes
• iCal (helper/stealer)
  • I interface with Google Calendar using Spanning Sync, which is bulletproof, so I have access to my calendar no matter where I am
  • I love the ability to create multiple, contextual calendars and subscribe to my Project Management webcals
  • I’m bummed that it struggles with invitations; having to retype them through the Mail Tags function wastes time
• NetNewsWire (STEALER)
  • I downloaded this to be a helper, then subscribed to a bazillion news feeds and personal blogs; now I just READ ALL DAY
  • If I could manage to manage my curiosity, this app would be great, since I get  RSS updates from my Project Management site
• On The Job (helper, could be improved, but that is apparently on the way!)
  • The current version is a nice little time tracker, but it does have it’s shortcomings so I’m excited to see the improvements
• Things (HELPER)
  • The BEST task manager I’ve used, bar none
  • The wireless sync between the iPhone app and the desktop app is MAGIC
• Quicksilver (HELPER)
  • I am one with my movements and therefore unconscious of them
  • I use this helper for about 50% of my desktop movements

These apps make my laptop infinitely more usable, which makes me moderately more productive. I think I might have to ditch NNW, though, if I ever want to get any real work done…

What combination of apps helps you be your most productive? Which one(s) suck the day away?

In laying the groundwork for the new Employee Referral Program, I mentioned the reward structure, which we had used at another facility in the same company and which works thus:

• 5% x FTE of the position’s annual base salary is paid to the employee

For instance, if I refer a full-time RN and the base salary for that position is $65k, then I make $3,250. If I refer a full-time CNA and the base is $26k, I make $1,300.

I got immediate pushback on two fronts:

1. “We need CNAs more than RNs right now”
2. “I think this goes against our core value of equity—we are all equally important”

The first objection is reasonable and solvable: let’s create a promotional period where we double the CNA referral reward.

The second argument I call bullshit on. When it comes to compensation, we are not all equal, and for very good reasons. Think about it, if we were then the logical inference we can make is that we should all be paid equally, that a housekeeper should make the same as a unit manager. Right?

Of course not, because the jobs simply aren’t the same. One is far more important to the success of the business than the other. The unit manager who was making the argument said, “We all know how difficult it can be with a housekeeper missing.” Difficult, yes, but the unit stays open when the housekeeper is missing; everyone else still works; the residents can remain. Without an RN, however, the unit closes. No other employees work and no residents get care. And the facility loses buckets of money. This is why RN staffing agencies exist in such numbers; it costs far less to staff a unit with an agency RN than to shut it down altogether. Housekeeping not so much.

Further, this kind of equivocating devalues higher-level staff, who had to actively pursue higher education to attain their current competencies, and on who the facility places a much greater weight of responsibility.

I’m not arguing that support positions are not important, because they are, or that we don’t underpay support staff, because we do. Issues surrounding fair compensation need to be addressed. But it’s a red herring to argue that a program which offers differing rewards based on the level of the position creates inequality. Inequality does not follow from differences in compensation for different levels of skill, competence, and responsibility.

Bottom line: we have to provide incentives that are comensurate with the level of the position. Some positions, and the people who staff them, are simply more important.

It’s a pretty simple equation: respect = collaboration. And without collaboration success is nigh impossible. But with all their talk of respect, compassion, egalitarianism, etc. in the workspace, many companies still struggle to walk the talk. And they fail as a result. Which is hilarious (and ironic, and contradictory–I LOVE $5 words), because a lack of tolerance for failure in the process or, especially, in the person, creates conditions for failure. If we don’t respect failure then we usually don’t respect the one who failed. And then fingers get pointed while nothing changes.

The problem is this: Failure is okay (in fact, it’s absolutely fundamental to suceess), as long as we learn from it, but repeating failures is–as a gritty, old-school talent director told me–the definition of insanity.

The problem is twofold:

1. It indicates a lack of leadership. Respect is fostered by leaders who set the example and who are not afraid to discipline (gasp! not that!) staff who don’t play nicely in the sandbox. Think Zach DeLaRocha and RATM. They worked magic for a while but there was no one to keep Zach’s ego in check. The result? A dead band, a dead solo career, and Chris Cornell nailing the lid shut with his vocal hammer of death.
2. Secondary to and resultant from poor leadership is a wholly inadequate selection process that ends in the choice of the wrong candidate: we’re looking for the Beatles but we end up with the Butthole Surfers. Totally wrong. Disturbingly wrong. Without the right team–one whose members can practice the core value of respect and thus collaborate–consistent, continuous, disheartening failures will be the hallmark of the team.

“And once again I’d like to present the Dysfunction Award to the Butthole Surfers! They managed to accomplish NOTHING last quarter. Which made the rest if us look like geniuses. Give ‘em a hand!”

Haha?

Anyway…

The solution can be driven by process change, by leadership change, or by a simultaneous movement of both, but it must be holistically driven (that is to say actively accepted and developed by employees across the workspace spectrum, from janitor to CEO), it must have simple, achievable, yet agressive goals, it must be well-planned and structured, and, perhaps most importantly, it must respect failure. Without the acceptance of fallibilty in the procees or the person, respect is impossible. And since the whole point of this post is that we need to select for respect and respectfully manage, well, then just stop reading.

• you made on Word (or even In Design for the fancy people) and had printed at Kinkos?

OR

• you sent to an ad agency for professional-level ad copy?

What I’ve seen and heard from employees is this:

• Don’t waste money trying to impress us with slick campaigns; just show us the money and the respect
• If you DO produce a slick campaign we’re going to wonder a) how much money you spent, and b) why you’re so concerned about APPEARANCE

What it boils down to is authenticity. As long as you produce quality collateral that gets employees’ attention, and as long as you’re representing what employees know to be the TRUTH about the company, you’re golden. In fact, collateral produced in-house will almost always ring truer and generate a better response than flashy ad-copy produced by a mega ad firm—and that LOOKS like all the other collateral produced by a mega ad firm.

Of course, you CAN make a mess of your collateral, but then so can an ad firm. So an even better idea is to have your employees help you create the brand. Then they’re invested in it, you’ve conducted a simultaneous focus group, and you can be pretty sure the finished product will go a long way toward representing you in an authentic and effective way.

This raises another question: do you think your CANDIDATES really notice the difference between a nicely designed position profile that

• you made on Word (or even In Design for the fancy people) and had printed at Kinkos?

OR

• you sent to an ad agency for professional-level ad copy?

But that…is the subject of the next post.

This makes me think of the “old school” recruiters I know. The ones who strongly resemble used car salesman.

“I’m not kidding you, this is the BEST job you’ll EVER have. Seriously. And between you and me, I’ve got two other candidates who are more qualified than you in the pipe. But I like you and I want to see you get the job.”

Seriously, who falls for that? Almost everyone. It’s the same reason you bought the 1985 Ford Fiesta with the peeling paint and the brakes that grind a little. Old school recruiters know how to trigger the fear response like nobody’s business. They are masters of manipulating all our negative responses.

And they generate a LOT of hires. Which is great. Except for the fact that they don’t necessarily generate the RIGHT hires. I have to wonder (because I don’t KNOW) what the retention rate is for hires generated by the OG crowd. I’m betting it’s crap.

After about a month my friend said to hell with the job and with Arkansas and he moved home. He’s now digging himself out of about $10,000 of debt from the moves and feeling very bitter. Plus, he is now acting like a virus, spreading his vitriol among his friends and acquaintances. So not only did the company’s retention rate take a hit, its word-of-mouth reputation did, too.

Companies, especially small ones, cannot afford this kind of negative advertising. Today, any serious job hunter will google the company. And they will find rants like my friend’s. And they will look for a different company.

Next blog: The importance of honesty in recruiting or: if the buyer wants a Cadillac, don’t sell them a Ford Fiesta.