MarieAnn North

At the start of 2008, I made a major career decision.

I left the longest-lasting job on my resume (nine years). Previously, I had changed jobs for the usual reasons-promotion, greater income, opportunity with an organization I wanted to be a part of, change of geography, a merger or acquisition that resulted in position elimination. This time was different. I loved my work, I was content with my income level, I continued to learn and expand my skill set, and even the travel and time away from home were a price worth paying to work with the most amazing medical schools in this country. No one was pushing me out, so why change?

My reasons were different from what they had been earlier in my career. They were much more subtle and took more introspection. I recognized that I had accomplished all that I was going to at that organization. I needed to make a decision-to choose my destiny-to find a new environment and a different culture. Simply put, it was just time for a change.

An extraordinary number of my colleagues at executive levels of healthcare administration have been making the same decision to leave their positions-also for those more subtle reasons. What is shared here is the collective wisdom of many people as they have struggled with difficult decisions. What follows are many important considerations focusing on system issues as well as personal considerations when the "stay or go" decision is not entirely clear-cut.

When Visions and Values No Longer Mesh

Taking the pulse of one's current organization should include an objective look at culture, vision, and values. Not the nicely crafted statements in the marketing materials, but rather how these beliefs are exhibited by the organization's leaders.

When the organization has a vision statement, but the leadership of the organization has no vision, it may be time to say goodbye. If senior leadership appears to be satisfied with the status quo, and you feel you are becoming ineffective in initiating positive change due to a lack of sponsorship or political capital, you may have worn out your welcome.

Healthy organizations grow, change, and evolve; they have visionary leaders as well as empowered teams that can execute. In an era of uncertainty in the business environment, it is all the more crucial to know that everyone at every level of your organization shares the same definition of success. When you can't clearly articulate what you will be doing to promote your organization's vision in one, three, or five years, it may be time to move on.

As critical as vision are the values of the people leading your organization. Studies show that an organization's climate (how people feel about working there) accounts for 20 percent to 30 percent of business performance. Leaders have great impact in the cultures they create, both intentional and unintentional. When people are driven by fear, anger, and anxiety, performance always suffers. When people feel optimistic, enthusiastic, and committed, performance soars.

Do you know what your leadership stands for?

Do you share those values? Do they mentor you, encourage you, and invest in you? Is someone committed to your personal success? Styles may vary, but there should be alignment on substance. When your organization's focus is on revenues rather than customers, you may have a mismatch in your values versus those of the leadership of your organization. When you have lost respect for your direct reporting relationship (in either direction), it is time to say goodbye.

Other Signs

Most organizations and individuals do not deal well with conflict. Issues that should be addressed aren't, glowing performance evaluations continue when performance doesn't warrant such, and key individuals are marginalized without even knowing it. Perhaps it's time to look for subtle red flags. That feeling that you should watch your back may be more than just paranoia-you may be sensing a withdrawal of support by key leadership (they just neglected to tell you). The person you report to may start to relay third-party anonymous concerns to you ("they said"). Individuals who report to you are permitted to do end-runs around you. You are suddenly excluded from providing input on key decisions that affect your area. You no longer have the authority to surround yourself with the team you want. It now takes three months for you to get on the calendar of a key senior leader. Senior leadership no longer returns your phone calls or e-mails in a timely fashion, or worse yet, refers them to subordinates for follow-up. When you have fallen out of favor with those above you, it is time to move on.

Sometimes through no fault of their own, people can find themselves in a dysfunctional organization. Senior leadership begins employing creative accounting activities that obfuscate true financial and operational performance. Organizations that are headed for trouble look only inward and fail to compare themselves with regional and national peers. More effort is spent negotiating the peace among members of the senior team than pursuing common strategic and operational goals. Your company reorganizes every quarter, and the person you report to becomes a moving target. You are afraid to stand near the exit door for fear of being trampled by the sheer numbers of people leaving for other places of employment. Under these circumstances, it's likely in your best interest to join the exiting crowds. Organizations change; it's good to take an objective look every couple of years. Just as you would review your insurance policies periodically to make sure they still fit your circumstances, your should review whether your place of employment is still the place where you can do your best work.

Finally, it's time to move on when we have used up our best ideas. Presidents are elected for four years with only one possible additional term. Demanding jobs take a lot out of people. People should not be made to feel like a failure when their best work is done. Organizations need new blood. Individuals need new growth opportunities. Is it taking you more and more effort to accomplish less and less? Are you bored? Does your mood start changing on Sunday afternoon as Monday morning approaches? Do you spend your off time worrying about things beyond your control at work? Is it time to admit that your performance is suffering, perhaps from sheer lack of enthusiasm? If it just isn't fun any more, it's not worth doing.

Saying Goodbye

Change is good. It refreshes and re-energizes. It teaches new ways and new possibilities. It imparts new knowledge. It expands our imaginations and our creativity. It upsets our orderly lives and makes us feel less in control, but more alive. It blesses us with new colleagues, who, if we are fortunate, become friends. When we find ourselves reading incoming "headhunter" e-mail solicitations before reading e-mail from colleagues, subordinates, or senior leadership, it's probably time for a change.

Saying goodbye to the familiar and the comfortable is hard, but staying in a place where you no longer feel any passion for the job is slow death. When it's time to say goodbye, it is also time to welcome a new adventure-to discover that we can give more to others and gain more job satisfaction ourselves-to find that "perfect fit"-that place where we can be our personal best.

MarieAnn North, FACMPE, is CEO, Posada Consulting, Charlotte, N.C. (

Publication Date: Tuesday, April 01, 2008

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