18 Years Later …

On July 7, 2000, I accepted employment as an administrative project coordinator with the nursing resource center at Spectrum Health. The organization—then just three tumultuous years into the merger between Butterworth Hospital and Blodgett Memorial Medical Center, and under a strict federal consent degree to boot—offered no benefits for my temporary/on-call role, but it did feature a generous hourly salary and flexible scheduling. I wasn’t especially drawn to healthcare; I just needed a job and the hospital paid better than retail. So I signed the employee agreement.
Eighteen years later, I now depart the organization.
It’s been a wild ride. In my first two years, as a resource admin, I performed a series of odd jobs: Medical records filing, documenting a perioperative process improvement project, staffing the donor-records processing area of the Blodgett-Butterworth Healthcare Foundation. Then I did some weekend-only intake work for the Care Management team. From there, I was hired full-time around 2002 as the administrative assistant (and later, the data analyst) for the director of Care Management. Over the next eight years, I stayed with her department as it morphed to include patient placement, registration, scheduling, denials, pre-bill management, etc. In 2010, I became the team leader for the hospital’s Revenue Cycle Informatics group. A while later, a series of executive realignments commenced and by 2012, my team was dissolved and I was transitioned into the corporate Information Services team. I did that job for about a year—mostly Epic reporting for the Spectrum Health Medical Group—until I decamped in 2013 for Priority Health, the organization’s managed-care arm. In 2014 I was promoted into management, leading the Quality Improvement Analytics department. In early 2018, my department restructured and the role of manager was eliminated. I’ve been doing special projects on work-for-home from the last three months. I declined to return to individual-contributor ranks and so have taken the severance pathway.
On April 27, 2018, I turned over my badge and laptops to my human-resources business partner. I’m technically “on the books” as an employee until May 2, but that extra few days is merely an administrative convenience to obtain one additional month of benefits.

I did not expect on that long-ago summer day that I’d begin a career. As a philosophy major at Western Michigan University, I thought I was bound for the seminary, or if not that, then the professoriate. Spectrum Health was a bridge job to launch me to greater things. But funny thing: I liked the organization, the people, the subject. I stayed a while. Then I was entrenched.
Over the years, I’ve been able to stretch myself in various ways that I think helped the organization:

  • I served for four years as the hospital’s administrator for the biomedical ethics committee, putting my degree to use on behalf of patient needs
  • I developed the first Revenue Cycle Scorecard, a 100-page monthly databook, and later the Revenue Cycle Scorecard, an executive reporting package
  • I helped reengineer the patient registration audit program and the process for obtaining access to health plan verification portals
  • I oversaw the implementation of a community EMR to support some outpatient case-management functions
  • I offered primary outcomes evaluation services for the high-risk maternal/infant health program
  • I provided direct operational support to the facility revenue-cycle leadership team for things like budget and labor planning
  • I built complex databases for community case-management resource lists and for daily hospital bed-availability reporting
  • I calculated the 30-day downstream total community cost from avoidable surgical-site infections
  • I assessed decadal trends in the use (and abuse!) of ADHD stimulant drugs
  • I developed part of the process for providing high-level assessments of new corporate initiatives
  • I coordinated the business-side process for HEDIS 2016—which included not only the normal annual process but also a complete codebase revision (PL/SQL to Informatica), a vendor transition and the complete outsourcing of medical-record review
  • I architected a “zero defects in care” member registry that accounted for individual-level insight into compliance with USPSTF guidelines for adult well care
  • I led the business-side implementation of an exploratory virtual server environment for advanced data management and statistics

All the while, I was supported professionally through memberships in the American Statistical Association, the American Society for Quality, the American Evaluation Association and the National Association for Healthcare Quality. In fact, after years of volunteering with NAHQ, I’m now privileged to be in year three of a four-year term on the national board of directors, and a recognized subject-matter expert in the field of health data analytics by my peers across the country.

Next week, I’ll be disconnecting entirely. No email, no texting, no social media. When I return online on May 8, I launch Gillikin & Associates, Inc., a healthcare quality consultancy focusing on analytics, population-health management and quality culture. I’m probably going to spend part of the summer writing a textbook to orient analysts to analytics in healthcare quality management.
In addition, I’ll have a bit more time to offer Caffeinated Press, Write616 and Vice Lounge Online, as well as a few social and political commitments I’ve taken aboard. That includes bolstering my long-running editorial-renovation consulting work for DotDash (which, at half-time status beginning in mid-May, will alone pay my bills). With the stress of Priority Health now off my plate—it’s only now that I appreciate just how emotionally taxing the last year or so has been—I have some mental bandwidth to commit to reading more, exercising often and eating prudently, in addition to the joyful pursuit of a successful consultancy.
That said, I’ll miss my co-workers. I’m proud of the Exploratory Analytics team I leave behind (Satish, Jen, Brad, Brittany) and many dozens of colleagues who’ve challenged, supported and enlightened me during my career.
Eighteen years is a long time. But you know what? It’s also a long time to get dangerously comfortable. Comfort is a toxin, I think. And I’m purging that toxin from my system. Independent consulting will be a challenge, but one I eagerly embrace. Fresh challenges yields new growth.
Leaving is bittersweet, but I trust I’ll be better for it in the long run.

Baking a Career from Scratch in 10 Easy Steps

Fourteen years ago this Thursday, I began employment with Spectrum Health, and this week I celebrate an altogether different kind of opportunity within the company as the result of a promotion. This new direction in my career prompts some reflection on how younger workers get from Point A to Point B.
But first, gather ’round kiddies, because grandpa has a story ….
I applied to Spectrum Health in the spring of 2000 on a bit of a whim, as yet another company to which I could shotgun my resume. Those early working years were a bit chaotic. I started in 1994, at the tender age 16, working for Meijer Inc. as a grocery bagger, eventually moving to roles as a cashier and as a service-desk associate. I worked for the company for five years at two different stores; in the middle, I also spent two years working for the now-defunct Michigan National Bank.
In mid-1997 I left both Meijer and MNB and began a series of gigs with various temp agencies. Some of them were literal day jobs while others (like a year-long stint doing quality assurance for one of Tower Automotive’s metal-stamping plants) had a bit more substance. By early 1999 Frey Foundation hired me out of a temp assignment, but internal restructuring led to my departure in the spring of 2000. Not long thereafter, I began work on the golf course, but that kind of job really isn’t a steady year-round opportunity — not during Michigan winters, anyway.
I was still pursuing my bachelor’s degree so I needed something flexible. At Spectrum Health, the hospital’s Resource Center functions like an internal temp pool, so I was hired in July 2000 to do part-time, on-call secretarial work. I could note my availability and then be scheduled for work within my preferred timeslots. At first, I got short-term assignments: A few weeks doing medical-records filing for Peds General, a few weeks supporting process-improvement initiatives for Periop, etc. I eventually landed a pair of concurrent longer-term assignments, one doing weekend intake for Care Management and the other doing donor-records processing for the hospital’s foundation office.
That Care Management assignment led to a transfer from the part-time/no-benefits job in Resource to a full-time, full-benefits job supporting the department director. Over time, my role with Tracey evolved from secretary to data analyst. By 2006, I was a measurement and evaluation specialist in her area, coordinating various data-analysis efforts related mostly to hospital-based case management and care transitions. I earned the Certified Professional in Healthcare Quality credential that year and joined both the National Association for Healthcare Quality and the American Statistical Association.
Health care, as an industry, isn’t stagnant. Between 2006 and 2012, our division underwent substantial change — with our entire mission and org chart sometimes being rewritten semiannually. But by 2011 I was appointed the team leader of the Revenue Cycle Informatics group, a passel of nine analysts servicing the registration, scheduling and coding areas of the facility.
In 2012 our CFO left and the new guy had different ideas. My team was disbanded, Tracey moved from the hospitals to the medical group, and one colleague and I were involuntarily transferred into the I.T. department to help staff a new business-reporting group. Fiscal 2013 was the year I had six separate formal supervisors in the payroll system. I stuck it out for nearly a year, but by June 2013 I had applied for, and was granted, a position as a medical informatics consultant in the quality-improvement team at Priority Health. PH is Spectrum Health’s insurance arm — same corporate CEO but otherwise a different world altogether.
Last week, my boss promoted me, so when I head into the office tomorrow, it’ll be as the new manager of quality improvement analytics for Priority Health. Six members of the team will report to me and I got a nice little raise out of it.
During my time with Spectrum Health, I’ve enjoyed other work, too — I was a newspaper editor at the Western Herald in the mid 2000s and I’ve run a part-time communications consultancy since 2008. This year, I’ve joined the board of Caffeinated Press, Inc., a local micropublisher of books and (eventually) literary magazines.
Yet a 14-year journey from part-time secretary to department manager in the same large organization isn’t a small thing. As I look at where I’m at right now, I can share several valuable lessons for early-career professionals plotting their own long-term trajectories.

  1. Be smart about what kinds of work you do in your late teens or early 20s. Why bag groceries or flip burgers when you could get an entry-level or summer job doing something closer to your intended career path? If you are interested in veterinary medicine, work as a “gopher” at the local zoo. If you want to be a dental hygienist, work as a dentist’s receptionist or file clerk. Even if you can’t find an ideal entry-level position, getting something close enough can help differentiate applicants for their first real full-time jobs. As a hiring manager, given two academically similar newly minted statisticians, I’ll hire the one who worked as a data-entry tech for a marketing agency before I’d hire the fry guy from Burger King. Working in many different settings for a temp agency also makes sense — it’ll increase the list of industries and settings you can say that you’ve encountered; this diversity of experience makes for a more well-rounded applicant.  It’s never too early to think about the place and nature of your earliest job experiences.
  2. Expand your resume with your extracurriculars. Things around the periphery of a person’s working life matter. Volunteer. Do exciting things that earn awards. Write stuff that gets published. Earn industry certifications. Invest in hobbies that lead to credentials or outcomes you can note on your resume. I’ve had several discussions with recruiters specifically about my amateur radio license and scuba certifications because they set me apart from others even if they weren’t directly related to the job at hand. Such items aren’t obvious and often overlooked, but they paint a picture of a person who achieves goals outside of the office — a subtle but important signal for employers. Diversify the skills and experiences you can share with employers to fill in the white spaces of an early-career resume.
  3. You only need to be a half-step smarter than the next smartest person in the room … Always learn more than you need to know about the kinds of work that you do. Experts say that continuous learning matters, and it does — but it matters insofar as you can justifiably claim the expertise to be invaluable to others and to remain current on industry trends. But there’s a point where you can be too smart: Earning a Ph.D for a job that can be done by a B.A. may make it difficult to get your foot in the door. Over-specialization can lead to stereotyping that ultimately leads to a loss of opportunity. Learn enough to be broadly useful but don’t get so specialized that you become a permanent niche player.
  4. … but being a know-it-all is a surefire career killer. One of the chief lessons I learned from Tracey was that even though I often already knew the answer to a problem within five minutes of starting a meeting, I’d earn more goodwill with colleagues by subtly guiding the conversation and letting someone else claim the “aha! moment” at the end of the discussion. Such a strategy proved more prudent than asserting a solution up front and leaving others to feel embarrassed about not getting there as quickly as I did. Few acts inspire such deep but silent resentment as being made to feel stupid by an overconfident whippersnapper. The smart folks usually nurture understanding within a group, instead of wielding their erudition like a poison-tipped stiletto.
  5. Keep your commitments. If you say you will do X activity on Y date, do it. Even if blowing the deadline doesn’t matter and even if you have to work late to get stuff done, do it. Younger workers, in broad relative terms, lack the urgency and punctuality of folks currently in senior management ranks. Earning a reputation as being someone who only sporadically meets agreed-upon targets will kill a career almost as fast as a sexual-harassment allegation will. Never fail to meet expectations.
  6. Fit in with your targeted peer group. Dress and speak the part of your peer cohort. If your intended peer cohort is several ranks higher than you, aim for that level. The guy who wears sloppy jeans and ill-fitting Hawaiian shirts on Casual Friday — even if everyone else at his level does the same — puts himself at a cultural disadvantage if he aspires to break into the group who dress as if Casual Friday is a misguided sop to the underlings. Speak carefully and respectfully, without gossip and without betraying confidences. Think five times before saying something catty. Structure criticism in terms of opportunity instead of defect. Praise others in public and in private. Comport yourself like an executive.
  7. Never say no. Responses like “that’s not my job” or “sorry, I can’t help you” are never acceptable. Instead, outline the things you actually can do to help. Whether the task is as trivial as shepherding a customer’s phone call, or as complex as negotiating deliverables when someone cashes in an IOU chip, the right answer is to help frame expectations about what you can and can’t do, and on what timeframe. Skilled practitioners can give a “yes” that’s effectively a “no” through a respectful process of engaged and honest level-setting of expectations.
  8. Brush up on your psych and communication skills.  Master the awesome power of behavioral economics and human psychology, and leverage your understanding of human psychology (Maslow’s Hierarchy, the Keirsey Temperament Sorter, etc.) to speak to people in a way that resonates with their specific needs and inclinations. Effective interpersonal communication is the chief way people fertilize relationships that ultimately nourish careers. For example, you wouldn’t explain the failure of an automated report in the same way to a tech-savvy perfectionist boss as you would to more forgiving boss who has trouble with the Intertubes. Study basic readings in human psychology and apply that newfound knowledge to your interactions within the workplace.
  9. Network. I’ve sat on too many hiring committees to believe that the best resume always wins. Opportunities are given to people, by people, so expanding your circle of fellow professionals you “know, like and trust” is vital to getting ahead. For example, my volunteer work within the National Association for Healthcare Quality and the Michigan Association for Healthcare Quality gives me access to a large number of peer professionals I can speak to about best practices, new ideas or approaches to vexing problems — and since we’re all working for different companies, we aren’t really in competition for anything nor do we have to manage hierarchical relationships. I’m acquainted with a heck of a lot of vice presidents and directors of quality at health systems across the country; if I am in the market for a higher-level role in five years in a different state, you bet your bottom dollar that I have “binders filled with people” who would recognize my name when my cover letter hits their inbox. And, significantly, vice-versa. Get involved early and engage vigorously with various national, state and local industry affiliation groups and connect with people at conferences.
  10. Play chess when others play checkers. Being successful in the long run requires solid strategic-thinking skills. Managers, it’s often said, handle day-to-day operational tasks, whereas leaders think about what tasks will be necessary five years down the road. Especially in fast-paced, rapid-turnaround environments, thinking about long term improvements proves more a luxury than a daily requirement. Yet it’s vital to encourage strategic planning. What good does it do a company, for example, to buy a new, pricy software app that only runs on Windows 7, when you know that in the next 18 months, the company will migrate to Windows 8? A respectful voice pushing against the fierce urgency of now, demanding that attention be paid to the ironclad demands of tomorrow, engenders more respect than the go-along kid who blindly follows others down avoidable dead-ends. Younger workers can employ what-if hypothesizing to introduce new ideas into a short-sighed project plan.

I look forward to this new chapter in my career that begins this week, yet I cannot help but wonder where I’d be today if my first dozen years as a working adult had been managed with greater care.

Five Fridays

This coming Friday, I will have finished my first week on the job at Priority Health, where I now work as a medical informatics consultant. The role presents an interesting career change and my first major shift in 13 years with the health system. I look forward to seeing the industry from the insurance carrier side, instead of the delivery system side. I’ve already had to buy a book on SQL programming, at the suggestion of my new boss. Interestingly, Bob will be both the first male supervisor I’ve had at the company (apart from a few transition weeks last summer), as well as the sixth formal upline I’ve had this fiscal year — started with Mary, then Tracey, then Big Jason, then Hollie, then Meghan and now Bob.

This past Friday, I packed my desk at Spectrum Health. Most of the Business Analytics team was off for meetings or work-from-home, so the wrap-up was quiet. I spent the morning updating my transition plan on the Confluence wiki and gathering my stuff into boxes. I got a hug from Vicki, then went to the Seward Street offices to give Meghan my hospital badge, laptop and parking pass. I left the kibble bowl (the candy dish) for everyone. It was, symbolically, empty. I left a note on my white board: “So long, and thanks for all the fish.” It’s a good group; I’ll miss them — Jen, Vicki, Alaric, Meghan, Gary, Lisa, Steve, Ronda, Gina, Allison, Bonnie.

The Friday before, I spent most of the day journaling, while encamped near Rock Harbor at Isle Royale National Park. Lots of insights gleaned that day.

The Friday before that, I struggled to get all my contract work done before I headed off on vacation. It was a day mostly spent as a freelance consultant, and the pressures that sometimes flow from it.

The Friday before that, I started telling my colleagues at the hospital that I had accepted an offer, the day before, from the insurance company. Thus marked my status as a short-timer. Folks started to come out of the woodwork, privately, to express their thoughts.

Five Fridays, each of which marked something significant.