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).