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

With Inga Walter

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 director Inga Walter, based in Zurich, sheds 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: 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.