Hiring Inferior Candidates as a Strategy

In Part II of this series I directed attention to the difference between filling a position and building a program, arguing it is always preferable to hire people with the understanding that the ultimate goal is to build a program. Every person who is hired should be looked upon as a building block to a secure foundation, not someone who is simply picked up to fill out the transplant team roster.1

I also described the issues surrounding the recruitment of an external candidate when a viable internal candidate is expected to compete for the same position.1 I admittedly took a hardline position on the competition between internal and external candidates. If there is a strong internal candidate, and everyone agrees this is so, there is no reason to compete the position. However, if the decision is to compete the position, and the external candidate prevails, the internal candidate should be required to voluntarily resign, and move on. If not, they are likely to be little more than an interpersonal albatross for the external candidate. Let's face it: losers aren't content. They're negatively disruptive.

On this occasion, I want to deal with another topic that irks me - hiring an inferior candidate as a preferred strategy when, despite the ominous signs I have previously described, filling a position is intentionally given priority over building a program.1

Every now and again I receive a call or, more likely, an e-mail requesting recruitment assistance, wherein the unstated but clearly expressed goal is to hire someone who is only, shall we say, so-so. In effect, the person contacting me doesn't want to hire anybody who's better than the "talent" they've already got. In these situations I usually conduct a quick personnel inventory of the program, and it immediately becomes clear that the current "team" is average or worse, having the very distinctive characteristics of vanilla fudge. Somehow, and for whatever reason, I typically find a boatload of marginal characters who are perfectly content to tread water while celebrating, or even embellishing their all too obvious mediocrity.

This presents me with a difficult situation, given they're asking me for assistance. In some cases it would be prudent, and certainly most expedient, for me to turn down the engagement on grounds that I'm really too busy to take on another recruiting assignment. I could send them off to any one of a number of commercial recruiting outfits which typically have the collective intelligence of a "pet rock."2 They're fortunate if they can spell the word "transplantation." Alternatively, given the potential for forgone work and lost income, and my personal goal of helping transplant professionals build better programs, I carefully weigh my chances of being an effective catalyst for program enhancement. The required elixir certainly doesn't come in a bottle, a pill, or an injection. Instead, I think this way: maybe by being honest they'll welcome my candor and, with a bit of luck, engage in some serious introspection. Citing the two "M's" - mediocrity and marginality - perhaps I can convince them an organizational "enema" may be beneficial. Surely, they must understand there is little security associated with a bunch of misfits, but I'm uncertain. Insulting people carries a significant risk, a risk I may do well to avoid.

Now, at this point, it seems we have a potential solution, but no assurance of success. However, before we embark on an organizational journey that may result in institutional transformation, we need to proceed in a stepwise and deliberate manner. One can liken this to walking on eggshells. I start with the results of the crude personnel inventory mentioned above. I then meet individually with all relevant members of the proverbial team. Within minutes, the problems that have been historically denied, or more likely ignored, become obvious. While the process can be gut wrenching, and prone to outbursts and accusations, I find people usually enjoy a little bloodletting provided everyone contributes a little in the process. Consequently, over time, people become increasingly comfortable talking about the opportunity to raise the bar, and they start thinking in terms of program building, while recognizing the merits of bringing in one or more persons with whom they've previously been uncomfortable, in principle or in reality. Although it's a struggle, their thinking might be as follows: maybe, just maybe, it's not so bad being better than we've been. By now, everyone pretty much agrees: progressive decay doesn't bode well for long-term job satisfaction or, for that matter, security.

At this point, we're only part way home. There are actual candidates to be considered, and it's imperative that they fully understand the circumstances surrounding their incumbency. At this juncture some people might start talking about "transparency," and "hanging out the dirty laundry." However, I prefer to think in terms of "informed consent." We must let all candidates know what we've determined - the program they're being asked to join is mediocre, there are problem people, interpersonal differences, and a morass of unresolved matters. Frankly, a well-informed candidate, one who has taken the time to do their homework, is usually aware of the issues, and is undoubtedly skeptical. In effect, when conveying our thoughts to them, we are merely confirming what they already know. Eureka! Today, in the Internet age, it's hard to hide what you don't want other people to know.

We've now set forth what could be called the terms of engagement, but we haven't set transformation in motion. In other words, we have the makings of a crucible wherein action will take place, but we've got to get with the program in trying to convince the wary candidate that our intentions are good, and our goals can be achieved by enlisting s/he as a change agent.

Let's face it, transplant programs are of uneven quality. We all know this, and we use many adjectives to describe the general state of our colleagues' efforts around the world. There is an underlying continuum, of which we're all aware. Some programs are in decay or, more politely, disarray. In stark contrast, other programs are energized and "on the way up" and, as a result, are increasingly recognized as the pathfinders and trailblazers of the future. These programs are envied by everyone, except those programs which are similar to the one we've heretofore described, and are now valiantly attempting to rectify.

Unfortunately, along the continuum, the majority of transplant programs are fair to middling. To set them apart from the rest of the pack, they're in need of a spark that often comes with a new hire, such as the wary person described here, or a timely innovation the program has pioneered or, more likely, stumbled upon. However, the source of ignition should not be left to chance and, serendipity, as impressive as it can be, doesn't qualify as a sound business plan. Therefore, we're back to where we started, recognizing that programs are people, and that recruitment is the primary means to institutional transformation. Once again, our goal is to build a program, not maintain status quo by filling out the roster.

As programs go through the process I've described here, they gradually realize that the two M's - mediocrity and marginality - are no basis for celebration, and should be eschewed. Collectively, people need to think in terms about the change agent potential external individuals represent. On the one hand, we can't simply plop people into an organizational quagmire and expect them to thrive. On the other hand, new people who are familiar with the errors of the past, and are candid about their prospects of winning in mudwrestling, are in the best position to pave the freeway of the future. Indeed, there will be discomfort because dim prospects usually have had a long history. Change, including that associated with the recruitment process, is disruptive and challenging. And to top it all off, no matter how hard we try, there's no guarantee we'll get it right.

Where does this get us? At this point we know this much: transplant programs must diversify, avoid homosociality,3 and welcome people with what have been considered strange, unworkable, or unusual ideas. We must also be realistic as the change process unfolds. We're trying to enhance the competitive nature of a previously maligned organization but, along the way, the weaknesses we continue to confront are more likely to be highlighted than strengths we've gained, leading to despair. This is a situation to be avoided. Instead, when times get tough, we must spend less time tearing down through cynicism, and more time building up through optimism.

Source: http://www.ishlt.org/ContentDocuments/2013FebLinks_Evans.html


  1. http://www.ishlt.org/ContentDocuments/2012DecLinks_Evans.html
  2. http://en.wikipedia.org/wiki/Pet_Rock
  3. http://www.ishlt.org/ContentDocuments/2012NovLinks_Briefs.html