Time Capsule: Dark Side on Line One: If Cash Really is King, Now’s the Time to Leave That Hospital Job

I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).

I wrote this piece in February 2010.

Dark Side on Line One: If Cash Really is King, Now’s the Time to Leave That Hospital Job
By Mr. HIStalk

These days, more and more industry people are using Willie Sutton’s famous answer to why he robbed banks. “Because that’s where the money is,” they say. The current form of the question is this: “Why are you leaving your hospital job to work for a vendor or consulting company?”

I’ll be honest … I thought self-serving university people were full of it when they predicted big shortages of healthcare IT people. The sky is falling, they cried, but it sounded like a lame pitch to boost enrollment in their informatics degree programs. ARRA or not, it just didn’t seem likely that implementers and project people would suddenly be in big demand.

The anecdotal evidence I used to support that belief was this: many of the best people who work for the vendors my hospital uses have been laid off. Experience = higher salary = first to go, at least in the minds of dimwitted vendor VPs whose own ill-informed revenue projections fail to pan out, meaning he or she gets the elevator while the worker bees get the shaft.

I figured there must be lots of talent available, considering vendors are still cutting people loose. Plus, I didn’t (and still don’t) think federal handouts are going to provide enough lipstick for the pig that most doctors visualize EMRs as being (it’s not EMRs they are resisting – it’s USING the EMRs. Sounds the same, but isn’t.)

I guess my lesson learned is to never bet against the money. Cash will presumably get doctors to use EMRs they don’t really want. It’s also working to pull several hospital CIOs and other IT people to (or back to) the vendor dark side.

One non-profit CEO asked me if I thought he should continue working in his current role, which is good for society but not necessarily so great for his wallet. As altruistic as I can sometimes be, I gave him the classic answer from MBA economics: take the better-paying job and donate more to charity. Buy carbon credits for selling out. The window is wide open and this opportunity may never repeat.

Vendors and consulting companies are loading up. The talent they can most easily afford comes from hospitals. From there come the fresh troops, getting their call like a minor league baseball player being offered the chance to move up to The Show.

For those with short memories, though, vendors are just as quick (quicker, actually) to unload FTEs when conditions slip. If you have a loving, loyal hospital spouse who makes you happy and puts up with your idiosyncrasies, then think carefully before running off with the tarted up, drug-seeking vendor stripper who is whispering in your ear to throw it all away to run off to Las Vegas with her to gamble. It’s not nearly as fun as it looks.

The hospital IT people I know are in two camps. Some have worked for a vendor and wouldn’t go back at gunpoint, or have enough roots and loyalty to resist the siren song. You’ll see the second group at HIMSS – former colleagues who suddenly show up in a vendor both wearing shiny new Koolaid-stained suits, so flush with newfound enthusiasm that you would be jealous if you didn’t know the odds of eventual disappointment.

It’s like when low-paid civil service employees quit public service to work for fat cat contractors. It’s a shame, but nobody can really blame you for taking advantage of the cards you were dealt. There’s no unattractive scar even if you did just sell your soul.

I’m not even slightly tempted. I don’t like suits, travel, lumbering bureaucracy, and strategies developed by bean counters who don’t understand healthcare. The second happiest day of my work life was when I was hired by a vendor; the happiest was the day I quit. The years in between are a vaguely unpleasant blur.

But if your hospital job isn’t so great, if the economy has killed the hope retirement, or if you just want a change of scenery, the time is now to do something strictly for the money. The great thing about hospitals is that they won’t hold a grudge if you have to come crawling back in a couple of years.