Great question - it seems that management is either clinicians turned managers after a long career at the bedside or young MHA graduates without any clinical experience. Where is the middle ground or mechanism to attract and train / foster clinicians that become managers?

I don't think there is a recipe for success in this area. The answer (if there is one) will depend on size and culture of the organization as well as the type of market in which it operates. A larger organization will have more opportunities to recruit talent to handle more specific tasks. If it operates in a competitive and/or growth-oriented marketplace, one would expect to see increased turnover of mid and senior level leadership, leaving advancement opportunities for early careerists.


In the situation of a smaller organization located in a non-growth oriented rural market (the other end of the spectrum), management is often as described by Shannon and Felicia, i.e. those with long careers at the bedside who have lasted long enough to climb into management positions. These folks, while possessing a vast level of practical experience in their particular discipline, generally do not possess or seek skills in management. In my opinion, an early careerist can be recruited to fill the important role of a catalyst of change and serve as a workhorse for the Administrator. This helps the Administrator keep the organization advancing with the industry, but separates him/her from the potentially negative political ramifications of change. The early careerist, particularly the career-driven one, is never expected to remain at the facility for a long period. If it is a system hospital, loyalty within the system can be achieved, though, through internal promotions. In exchange, the early careerist has been exposed to a crash course, if you will, in the full range of hospital administration. This positions him/her well for a jump into another.

On the opposite end of recruiting and retaining fresh talent are the existing and sometimes obsolete senior management styles. Some of the older managers are still doing business the way it was done 10 years ago and that is no longer effective. How does an organization rid itself of senior mangers, who may be very accomplished clinicians, that are reluctant to adapt to new, more effective, management methods?

This is an interesting question because the older employees tend to have a great knowledge base and stable, whereas the younger employees have enthusiam, innovation, and want to move quickly. There has to be a balance to harness the best from both groups. We have employee referral, mentor/buddy, and succession planning programs which helps. Also our HR department has a talent management group who explore other options.

One opinion many organizations have used is to offer internship and fellowship programs to recruit younger applicants. Many recent Masters graduates learn about the organization and end up getting offers or choose to stay with an organization that continuously offers developmental opportunities.

This is an area that I believe the hospital industry has not been agile in change. Having been in the industry for 30 years, I was recruited for advancement based on my performance in the front line positions. There was never any training for my position that I was promoted to. I went from a manager of 2 large units to a Vice President position without a mentor or a coach. I studied leadership styles and evidenced based leadership qualities from best seller authors. I learned what not to do by leaderships styles that I disagreed with. Often, due to egos or not embracing servant leadership. Many administrators go into leadership roles for the wrong reason.
The younger generation has different expectations from their careers than the 30 year veteran. Organizations (not just hospitals) must develop career development tracks that once a new employee is hired, they are given a career path that matches their desired growth. Setting goals, expectations and given growth opportunities can identify the future leaders. If hospitals do not attempt to help the younger generation meet their goals, they will go elsewhere. I agree with Sandra on the need for mentor/ buddy and succession planning programs. tuition reimbursement, scholarships programs and work commitment contracts for education are great options.
In response to Thomas question regarding senior managers that are reluctant to adapt new, effective , management methods; the fish rots at the head. If the CEO is not willing to make the tough decisions to hold his senior leadership team accountable or if the CEO is not able to do this himself or herself, you may not have any choice to move on to an organization that embraces the leadership style that works best for you.

I believe that HCO's need to first look at this younger generation and how they communicate, and what they have to offer. Do we communicate with them on their level? For example texting, face book, twitter, this is commonplace in their lives, second do we stimulate their need for growth and knowledge? We need them for succession planning and we should ask for their opinions etc. This is a hard issue to conquer. Especially if you are in a more rural area with no real thing for singles to do. Recruitment and retention is an ever present issue for us in our small military town.

I agree with Sandra Evans. We do need the knowledge, experience, and wisdom of the older employees as well as the younger employees’ enthusiasm, new ideas, and their technical knowledge. Diversity in healthcare is essential either age, gender, race, or ethnicity. I wonder how does an organization attract and retain practitioners and employees from diverse background or manage such a diverse workforce. Any best practices?