Insights into Global Executive Recruiting: Looking Across Borders for Healthcare Leaders

With Inga Walter and Nathaniel Hook

The competition for executive talent in healthcare has become much more of an international affair than in the past. In this Q&A, WittKieffer managing directors Inga Walter, based in Zurich, and Nathaniel Hook, based in London, shed light on trends and challenges in the marketplace for hospital and health system leaders.

Q: Executive talent in healthcare traditionally has not crossed borders much. Are you seeing this change?

Walter: This is true. Healthcare has historically been a national affair and executive vacancies, whether on the clinical or administrative side, tend to be filled with domestic talent wherever possible. Not only do regulations and accreditations change from country to country but language and culture also play a big role. Exceptions are growth markets (i.e., emerging markets in Asia or the Middle East), which are still building out their health systems and are often unable to find executives with the right industry experience domestically.

Increasingly, we have seen hospital groups and healthcare systems creating cross-country alliances, partnerships or even organizational expansions. Such organizations have started looking for leaders that have worked across borders before. Since few healthcare executives have a track record of doing this successfully (and the few there are tend to be in high demand), clients either pick a trusted internal executive or at times consider hiring executives from other industry backgrounds such as retail or hospitality. Furthermore, many developed markets are faced with a declining domestic talent pipeline on the clinical side (at the chief/chair level as well as physician and nurse leadership). They may not always directly fill leadership positions with overseas talent but are often bringing in doctors and nurses from overseas at an earlier career stage.

Q: Are there specific positions which are more “global” and for which executives tend to move around internationally?

Walter: Clinical positions (physicians and nurses) have seen an increase in opportunities globally due to domestic shortages in many countries. This is, however, not necessarily the case for leadership roles where we see a lot more case-by-case situations. For instance, an academic medical center established in partnership with a U.S. partner in Asia may decide to search for a leader who has worked across both the U.S. and respective Asian systems. A CEO may be a more typical role to fill with a global healthcare executive than a CMO or CFO position. Clients often try to recruit for these positions locally or domestically as they require executives to be able to understand and successfully navigate the local regulatory and health systems.

Q: Is the demand for physician executives a global phenomenon? What’s to explain it?

Walter: Some hospitals and hospital systems make it mandatory for their CEO to be a physician by background (predominantly in academic/teaching environments). In other cases, a physician background may be strongly preferred but is not seen as a prerequisite necessarily. Experience, track record and cultural fit are paramount. All things being equal, when clients have a choice of two equally strong candidates, one being a physician and the other one not being a physician, it is likely that they will pick the physician executive. Physician leaders tend to get easier acceptance and support from the clinical leaders and staff across the organization.

Q: How is the revolution towards a more digital, consumer-oriented brand of healthcare impacting executive talent?

Hook: The role of digital in transforming healthcare delivery globally will be profound; we are just at the beginning of this transformative journey which will inevitably lead to much greater collaboration across intersecting sectors within the healthcare ecosystem. For healthcare systems, technology can and must be the principal enabler going forward. From integrated hospital EPR systems designed to cover all aspects of patient care and management to the rapid emergence of mobile health and wearable apps, underpinned by cutting edge healthcare analytics and clinical decision support tools designed to help clinicians optimise the quality of care delivery across all clinical settings, the inevitable convergence of healthcare and technology is set to be the defining theme within healthcare over the next ten years.

Critically it is technology that will ultimately deliver on the promise of integrated care. Healthcare transformation which places technology-enabled service redesign at the heart of key decision-making will demand leaders who truly embrace a new operating paradigm and are thus able to demonstrate strategic innovation and creative contribution. Identifying, accessing and aligning this talent will be critical to the success of any organisation operating within the healthcare market in the future.

Q: What roles and position titles are evolving to address this digital future?

Hook: Specifically, this shift towards digitization has resulted in the emergence of a number of new roles. Some of the most prominent are Chief Digital Officer, Head of Artificial Intelligence, Head of Customer Experience and Chief Innovation Officer. The question longer-term will be the extent to which digital will enable closer connection between back-end systems development and front-end customer/patient engagement and maintenance. Longer-term digital health will be truly transformative and any hospital and/or health system will need to be increasingly smart in how they engage with and, ultimately, deploy their digital tools. Q: Which other roles are in great demand and perhaps in short supply in terms of executives to fill them?

Walter: Chief Transformation/Strategy Officers are in demand, a sign that healthcare is dramatically shifting everywhere and needs leadership for this purpose. In addition, roles related to quality, safety and operational excellence are in great demand in today’s market.

Q: Are there leadership skills in healthcare at a premium that perhaps weren’t five or ten years ago?

Walter: Healthcare is an incredibly complex field and its complexity is oftentimes underestimated. As health systems experience an ever-increasing pressure on cost, efficiency, quality standards and changes in regulatory demands, executives have to be able to navigate such complexity at the highest strategic level whilst not losing sight of the smallest details. Healthcare is a rather unforgiving industry when it comes to oversight or lack of standards, especially in the areas of patient care.

In addition, consolidation and growth pressures are omnipresent so executives need to be financially savvy. Finally, the opportunity to develop or integrate the latest technology and e-solutions in providing cutting-edge services to the patient population whilst also being able to utilize this data to enable better decision making in the future are global trends. Those who miss the boat are vulnerable to external disruption.

Q: As executives become more mobile in their careers, how much does “cultural competence” play into their success when taking roles in foreign countries?

Walter: The ability to embrace and successfully operate in other cultures when taking up a role in a foreign country is perhaps the most important criterion. Such culture fits (whether societal or organizational) are case-by-case evaluations and come down to a very individual selection. There are few executives who have the skill to adapt to just about any culture, but those who are perceived to have that skill tend to be in extremely high demand and are often able to demand a premium on their hire. We have seen clients in different geographies point to the same specific executive in the industry who they believe would be a fantastic fit for their organization.

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