10/9/2006
Career Building: Are You in the Right Place?
Leslie Ann Fox, MA, RHIA, Patty Thierry Sheridan, MBA, RHIA, CCS
Thank you to Advance Magazine for permission to use this article

Leslie: Recently the Wisconsin Health Information Management Association asked me to speak at their fall conference on the topic "Career Building: Are You in the Right Place?" I was intrigued by the topic, so I accepted their invitation and started to reflect on the importance of career building no matter how early or late you are in your career. For, not only is our profession in the midst of a historic transformation, but the world of work in the 21st century will be very different for everyone in our society.

Patty: I can see that career building is important for those early in their careers or in the middle of their work life, but why is it important for those who are near retirement?

Leslie: The "baby boom bubble," which started turning 60 this year, will redefine retirement as it has every stage of life it has passed through. They can't all just leave the workforce as they turn 62 or 65 as in previous generations, because there are not enough people in the generation behind them to fulfill the future workforce needs. This is especially true in the health care industry.

Patty: Do you think that senior HIM professionals will want to keep on working?

Leslie: I expect that many HIM seniors will want to continue working, but they will want work situations with a lot of flexibility. I anticipate many senior HIM professionals will be in part-time positions, working as independent contractors on special projects, and as consultants and for consulting and temporary staffing companies.

Patty: It sounds like opportunities abound for HIM professionals of all ages, but we all need to make sure we have positioned ourselves throughout our careers to take advantage of today's opportunities. So how did you answer the question, are you in the right place?

Leslie: I can't answer that question for another person, but by using career development strategies, people can determine for themselves if they are well positioned, or if they need to make some adjustments.

Patty: How can our readers get started on that path?

Leslie: I suggest they start by taking some quiet time away from their busy office and family life. It's hard to find a few hours but, if one can schedule as little as 5 minutes to shut the door, turn off all electronic devices, i.e., the phone, e-mail, radio and TV, to just think, one can begin to envision a new future. The exercise I recommend is to take a sheet of paper and some crayons, and simply start to draw a picture of the ideal career future. Dream a little, and be creative. Drawing the picture rather than writing a job description invokes the right side of the brain. People are often surprised at the beautiful future that their right brain creates with greater ease than the left brain, which is sometimes locked into old paradigms.

Patty: It sounds hard. Where would I start?

Leslie: Draw a picture of your future workplace, the view from your window, your furniture, your co-workers, your boss, your customers, tools you will use in your work. Draw what you will look like in that setting. Make it a single drawing or a series of scenes. If you prefer, make it an abstract drawing. Draw how your work will impact your co-workers, your customers, your family and society.

Patty: Leslie, 5 minutes isn't enough time to draw such a picture.

Leslie: Probably not. But if you can carve out 5 minutes of solitude every day for a few weeks, the picture will evolve. It may start out blurry, but in time the details will emerge. But remember, no words; just images. Once you have a fairly clear picture of where you would like to be in your life's work a couple of years out, you can start to do some analysis.

Patty: At that point it's easier to start comparing where you are today to the picture of where you dream of being in the future.

Leslie: That's right. You can start by asking yourself some questions. How close are you now to achieving your dream job? Are you 25 percent, 50 percent, 75 percent, 90 percent, or already there? Are you doing work today that will prepare you to realize your ideal career picture? Are you getting the right experience? Are you making the right contacts? If not, what obstacles could prevent you from realizing your dream? What will it take to overcome these obstacles? Will your current job soon change so much with the transition to electronic health records (EHRs) that fewer people will be needed with your skills?

Patty: Leslie, these questions can really raise one's anxiety.

Leslie: I think the anxiety is already there. Recognizing and confronting the challenges that make us anxious helps calm us. The decision we make about our careers going forward must come from a calm, thoughtful place deep within us.

Patty: I agree. If one is frightened, angry or paralyzed by the thought of coming changes or potential threats to their current job, they need to first calm themselves and accept that like many things in life, changes in their work life are inevitable in this day and age. However, people do have choices about those changes. How one chooses to manage one's self through this time of unprecedented change in our profession and industry will determine more about one's future success than the type of job or employer one selects.

Leslie: Knowing the difference between change and transition is a good way to start getting a handle on the volatility created by the transformation of HIM from paper to EHRs.

Patty: The work of William Bridges, Managing Transitions: Making the Most of Change is a good source of information on transitions. Bridges distinguishes change, which is external, a shift in the world around us, or an event that we may or may not control, from transition, the internal process humans go through in response to a change.

Leslie: When changes are anticipated, planned for and welcome, the transition period goes more smoothly and is less traumatic. However, when you are blind-sided by a change, and it is an unwelcome change, the period of transition can seem like a nightmare.

Patty: That certainly validates your assertion that everyone should be doing career planning and development all of the time.

Leslie: Bridges explains that transitions have three phases: endings, the neutral zone and new beginnings. As one starts to anticipate a change, one feels a sense of loss that comes with endings. It is important to think about how you will acknowledge your losses. For example, if you are a coder anticipating working from home, how will you acknowledge and come to terms with the fact that you may miss seeing your HIM department colleagues face to face daily?

Patty: You will also need to decide how to manage the stress of going through the neutral zone, a period of uncertainty and disorientation. While it can be a time of confusion, it is also an opportunity for creativity and innovation. For example, perhaps in recognition of the loss of a daily support system, you and your colleagues will schedule a weekly conference call to discuss problem cases, new diagnoses, procedures and codes, or changes in the reimbursement system. You will maintain contact with your support system.

Leslie: The time in the neutral zone varies for different individuals, but eventually it gives way to the new beginning, a more comfortable place for most people, but one in which new habits and traditions will still need to be established and cultivated.

Patty: As one contemplates losses, it is also important to keep in mind that change creates new opportunities. The EHR may shrink the size of the brick and mortar of the HIM department, but it will open up opportunities in other departments that create, collect, manage, store, retrieve or use health information, such as IT, informatics, revenue integrity, risk management, patient safety, etc.

Leslie: And, those opportunities are just in health care provider organizations. HIM opportunities with software vendors, outsourcing companies, research firms, pharmaceutical companies and other types of health care organizations will continue emerging far into the future of a transformed HIM profession.

Patty: It is a lot of change, but the important message is to stop thinking about how to adjust to the changes, and start thinking about how to capitalize on them. Do you have suggestions for doing just that?

Leslie: Yes. I recommend another book by William Bridges, Creating You and Co.: Learning to Think Like the CEO of Your Own Career. In it, he suggests that individuals should engage in a strategic business planning process just as business entrepreneurs who continuously scan the marketplace for new opportunities.

Patty: Is he suggesting that everyone should go out and become an independent contractor?

Leslie: Not at all. Bridges states that "in the postjob world employees need to forget about their jobs and start looking for work that needs doing." They should view their organization as their marketplace. The challenge is to discover what specific markets within your organization need your core competencies? Thus, an HIM professional should not think of working only in an HIM department, but in any of the departments that have needs for the broad array of knowledge, skills and experience of HIM professionals. It takes what Bridges calls "marketing imagination."

Patty: So the paradigm shift is seeing health care organizations as a collection of many overlapping markets for HIM professionals. With this new view in mind, you must get to know people in the other health information departments such as IT, informatics, revenue integrity, etc. Listen for mention of special projects for which you can provide expertise and then volunteer to help. Expanding your network of contacts within the organization is important also so that when assignments that need HIM skills arise, your name will be top of mind.

Leslie: While scanning your organization as a market for work that needs doing, you also need to plan how to keep growing your knowledge and skills. Continuing your education is important, but so is building and documenting a portfolio of experiences and accomplishments. The new world of work relies more than ever on cross-functional teams, especially as more HIM related functions become decentralized. Your resume should always be current to use as a marketing tool within your organization to demonstrate your breadth of expertise as one assignment ends and others emerge.

Patty: This may be a different way of thinking about career building for many of our readers, but one that fits well in a rapidly changing world of work.

Leslie Ann Fox is chief executive officer and Patty Thierry Sheridan is president of Care Communications Inc., a national HIM consulting and staffing company headquartered in Chicago. They invite readers to send their thoughts and opinions on this column to lfox@care-communications.com or pthierry@care-communications.com .