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HomePosts filed under talent management
Showing posts with label talent management. Show all posts
Showing posts with label talent management. Show all posts

Health IT - How Did Things Get So Bad? Look to Late 20th Century Recruiters and "The School of Hard Knocks" Leaders They Preferred

I have a long memory, unfortunately for health IT opportunists and hyper-enthusiasts.

After reading letters and reports such as:


One might ask the question:

"How did things get so bad?"

I believe one needs to look to the culture of medicine and to the culture of IT, specifically, the culture of IT recruiting in medicine by exclusive retained recruiters hired by hospitals to secure IT leadership (the predominant model used, with the contractual agreement that jobs will only be filled through the recruiter). 

The culture of medicine is one of demanding education and proof through repeated testing and licensure that some fundamental level of competence exists.  This cultire arose, in part, as a result of the Flexner Report of 1910 (http://www.medicinenet.com/script/main/art.asp?articlekey=8795) that called out abuses in medical education and practice where anyone from the "school of hard knocks" could call themself a physician and hang a shingle, with disastrous results:

... The Flexner Report triggered much-needed reforms in the standards, organization, and curriculum of North American medical schools. At the time of the Report, many medical schools were proprietary schools operated more for profit than for education. Flexner criticized these schools as a loose and lax apprenticeship system that lacked defined standards or goals beyond the generation of financial gain. In their stead Flexner proposed medical schools in the German tradition of strong biomedical sciences together with hands-on clinical training. The Flexner Report caused many medical schools to close down and most of the remaining schools were reformed to conform to the Flexnerian model.

The culture of health IT recruiting?  Perverse.

Having posted many times on the issue of "expertise not needed" relative to HIT, the mother of all statements on health IT talent management has to be this from the major HIT recruiters of the late 20th century.

From the article "Who's Growing CIOs?" in the journal “Healthcare Informatics", November 1, 1998, see http://www.healthcare-informatics.com/article/who-s-growing-cios?page=3:

... In seeking out CIO talent, recruiter Lion Goodman doesn’t think clinical experience yields IT people who have broad enough perspective. Physicians in particular make poor choices for CIOs, according to Goodman. "They don’t think of the business issues at hand because they’re consumed with patient care issues." ... Instead of healthcare organizations looking just outside their IT divisions to recruit IT management, Goodman advises, "Look for someone who has experience outside healthcare as well as inside healthcare," in particular people with IT experience from industries such as banking and manufacturing, which use more advanced information system technology.

When I first saw this in 1998, I was stunned by its abject stupidity and feared for the future implications.  My fears in 2015 are now realized, in spades.

Lion Goodman was an idiot, and a dangerous idiot at that in my opinion.  "Patient care issues" ARE the business of hospitals.

Experience in banking and manufacturing IT is not helpful because medicine is not a mercantile or banking activity.  Also, "advanced technology" was not the issue as today's usability, interoperability, crashes and other failures demonstrate.  Banking and manufacturing IT personnel understood the more critical issues of human factors engineering supporting healthcare provision like a fish understood nuclear physics.

More importantly, medicine is far different and in fact the IT culture in those environments is anathema to the flexibility and understanding of the poorly bounded, high tempo, high risk practice of medicine (see "Hiding in Plain Sight", Nemeth & Cook, http://www.researchgate.net/publication/7738740_Hiding_in_plain_sight_what_Koppel_et_al._tell_us_about_healthcare_IT, click on "full text" image on right).

That health IT is now nearly universally reviled by physicians and nurses and is harming and killing people and even bankrupting healthcare systems trying to fix 10,000 bugs (e.g., "In Fixing Those 9,553 EHR "Issues", Southern Arizona’s Largest Health Network is $28.5 Million In The Red", http://hcrenewal.blogspot.com/2014/06/in-fixing-those-9553-ehr-issues.html) is a predictable outcome of hiring patterns for today's health IT leaders that resulted from such a perverse and ignorant talent management ideology.

Even worse, in the same article from Goodman and another major IT recruiter of the day with whom I was very familiar is this gem:

I don't think a degree gets you anything," says healthcare recruiter Lion Goodman, president of the Goodman Group in San Rafael, California about CIO's and other healthcare MIS staffers. Healthcare MIS recruiter Betsy Hersher of Hersher Associates, Northbrook, Illinois, agreed, stating "There's nothing like the school of hard knocks."

Ms. Goodman and Ms. Hersher must have been transported to the late 20th century from the Dark Ages.

Oh wait ... even Medieval monks in monasteries believed in the value of scholarship.

These attitudes are completely alien to medicine, and for good reason.  The damage done to health IT by the hiring practices of the past is incalculable, but likely considerable.  I was shocked even then by the qualifications and abilities of the health IT leaders I encountered, most of whom I had to clean up after, one way or another in order to protect patients from their abject medical recklessness and ignorance (e.g., http://cci.drexel.edu/faculty/ssilverstein/cases/?loc=cases&sloc=clinical%20computing%20problems%20in%20ICU , and http://cci.drexel.edu/faculty/ssilverstein/cases/?loc=cases&sloc=Cardiology%20story as just two examples).

One wonders just how many "from the school of hard knocks" HIT leaders were pushed by these recruiters onto healthcare organizations, and the harm such leadership may have done to healthcare, healthcare IT, and to patients in the intervening years.

Such an ideology widened the pool of candidates and likely increased the recruiter's profits ... the ultimate in parasitism considering, in 2015, the waste of hundreds of billions of dollars on terrible technology, reviled by most users and causing harm, in part due to being designed and implemented by leaders from "the school of hard knocks."

-- SS
5:58 AM

Healthcare Talent Management: Seeking Unicorns Using Broken Software Not Very Good for Patients - or Stockholders

In the May 30, 2012 WSJ article "Software Raises Bar for Hiring" by David Wessel, the Wall Street Journal's economics editor (subtitled "Software Screening Rejects Job Seekers" in the web page header), and in a followup June 4, 2012 NPR piece "Employers: Qualified Workers Aren't in Jobs Pool" where Wessel is interviewed by Renee Montagne, an issue noted in past years here at HC Renewal is discussed.

The issue is poorly done and/or misapplied e-Recruiting software actually causing employers to be blinded to needed talent, and skilled members of the workforce laid off in the Great Recession to remain unemployed.

From the NPR interview (emphases mine):

... WESSEL: Well, there are basically two views about unemployment today. One is that the biggest problem is there just isn't enough demand out there, not enough spending so employers are reluctant to hire readily. And if that's right, then there are things the government might do to stimulate demand - either Congress, or the president or the Federal Reserve.

The other view is the biggest problem is, as you suggest, this mismatch between the skills that employers need and the ones that available workers have. And if this view is right, and the fiscal and monetary policy can't do much. So people on the second camp seize on these very loud complaints from employers that they just can't find the workers they need. And the real question is how can that be?

MONTAGNE: Well, offer us an answer or two.

WESSEL: Well, I talked to a business school professor at the University of Pennsylvania, Peter Cappelli, and he suggested a number of possibilities. One is that with so many unemployed workers, employers may simply be too picky. They're looking for the perfect worker. They won't settle for the merely capable. One person in the business calls this looking for a unicorn. A second possibility is they're just not willing to pay enough. A third is that they've lost interest in training and they're insisting on experienced workers, so they're turning away a whole lot of people who could do the job but just don't have experience. And then, in what I find most provocative possibility, they've become over reliant on the software that's used to screen applicants.

MONTAGNE: Now software, that's an interesting idea.

WESSEL: Right. A whole lot of people who have applied for jobs lately, know that the initial application often is done online. That's because software takes the employers criteria, which is often extraordinarily precise, and then screens the application. There's one company that Mr. Cappelli writes about in the new book that says he had 25,000 applicants for a standard engineering position, only the software in the HR department told him nobody was qualified.  [An absurdity on its face - ed.]

In another one, an HR executive, in an experiment, applied for a job in his own company and couldn't get through the software screening. And as you mentioned, I wrote a column about this and I got flooded with people with experiences like this who were just enormously frustrated with the software and how it was preventing them from getting to a human being to get an interview on a job that maybe they could do.


In other words, the combination of employers looking for the "perfect, prefab employee" - a unicorn - is complicated by the fact that employers, or more properly, Personnel Departments (now euphemistically referred to as "Human Resources" departments, a "resource" they cannot properly manage, it seems) are using broken software.  This creates the erroneous appearance of a talent vacuum.

I made quite similar observations at my blog posts of several years ago including at a post of Feb. 2008 "If pharma cannot get its basic IT right, what about the hard stuff?"  and a Sept. 2011 post "Merck to Cut Up to 13,000 (More) Jobs by 2015."  I had noted repeated, bizarre solicitations for positions that were way-off base (such as for "Application Services Associate" in the Feb. 2008 post, and for "SAP Security Analyst--Merck & Co.,Inc.-INF003774" as mentioned here) by the automated e-Recruiting systems of a number of pharmas and healthcare organizations to whom I had submitted an electronic CV.

At the latter post I observed:

... I thought the problems with bizarre eRecruiting solicitations that I wrote about in my Feb. 2008 post "If pharma cannot get its basic IT right, what about the hard stuff?" were over.

However, just yesterday I received an automated solicitation from this company regarding something related to import/export, an apparent profound mismatch to my background. It makes me wonder if the people with a sufficient understanding of computational linguistics who could fix the parser in the eRecruiting system were all laid off.

As I mentioned in the earlier post, mismatched outbounds probably correspond to internal blindness to inbounds (i.e., in properly parsing resumes). I wrote:
Could a poorly-tuned or malfunctioning eRecruiting parser, which probably works in both directions (i.e., alerts not just outside candidates but also people internal to Merck of incoming resumes it identifies as "interesting") adversely affect the "apparently available" talent pool across many disciplines?

I still get entirely inappropriate solicitations from time to time, such as for marketing or low-level IT support roles, from this company -- where I was once high-mid management and use their exact term for that role, "Director", terms such as "Medical Informatics", "Electronic Medical Records" and others directly in my CV -- and others.

e-Recruiting systems could function poorly for a number of reasons, including but not limited to:

  • Incompetence
  • Deliberate sabotage, making it seem talent is exceptionally hard to find, to increase the job security of HR personnel who are themselves being downsized due, in part, to automation;
  • Deliberate sabotage to facilitate more hiring of lower-paid employees such as non-citizens found through other means.
Any of these scenarios, of course, is not good for stockholders and the unemployed.

Finally, I actually tried to alert the head of HR of one company, Merck, to this problem.  In the aforementioned Feb. 2008 post I reproduced the email and further commented:

... I wrote to the VP of HR and an HR associate, both of whom I knew, in Dec 2006:

Sent: Monday, December 18, 2006 10:45 AM
To: Levine, Howard
Cc: Lewis, Drew B
Subject: Merck eRecruiting system malfunction
Dear Howard,

I maintain a resume on Merck's eRecruiting site. I rarely get alerts, but recently I received the automated alert below for " Multi-Channel Management Campaign Manager" as below.

It is a profound mismatch to any keyword or context in my background (I am an MD & information science specialist, formerly Director Published Information Resources & The Merck Index.)

The eRecruiting system is apparently broken. It is likely others are getting similarly mismatched results. Suggest repair.

I was thanked for my email, and instructions received on how to turn off auto-notification by their job site. This was something I already knew how to do, and obviously was not a helpful or meaningful suggestion vis-a-vis "doing business."

Nothing more was received, and considering I continue to get frivolous solicitations regularly, apparently nothing much was done.


I had also observed:

  • Is this how state-of-the-art biomedical companies might be expected to manage their recruitment?

A response telling me to de-activate automated alerts from a company's clearly broken e-Recruiting system was not exactly what I considered in the best interests of shareholders.

Finally, in an ironic twist, hunting for unicorns with broken e-Recruiting software might prevent companies from finding the computational linguistics and other talent needed to fix these very systems.

-- SS
4:08 PM