News / Periop Café

Ten Reasons Directors of Surgical Services Quit Their Jobs

July 2, 2019


Ten Reasons Directors of Surgical Services Quit Their Jobs

Historically, the role of director of surgical services is a relatively high-turnover position. Tenures of 18 months to three years are common. Typical factors such as retirement and increased income opportunities play a role in turnover, but so do many position-specific factors. Here are the top ten reasons directors of surgical services quit their jobs:

1) The role is different from what was discussed during the interview process

Unfortunately, employers sometimes make false promises during the interview process to attract candidates. Organizations use anything from enticing projects to offering a great mentor to get people interested. When these lures are overstated or nonexistent, a new director feels manipulated and deflated. This combination of personal disappointment and professional frustration frequently manifests itself as a short tenure for the director.

 2) Advancement (or more money)

This is a typical career progression—the director leaves for more scope, more money, or a promotion. While this is customary for any professional, it’s important to remember the scarcity of talent in the director of surgical services industry. High turnover and strong competition create more opportunities for directors to keep their eyes open for greener pastures.

 3) Toxic work environment/bad physician behavior

Hospitals and the OR department in particular have large casts of strong-willed, driven stakeholders. In order to minimize conflict in this stressful environment, a good director must be skilled at managing these various personalities. Fundamentally, this is a large part of the job. However, combustible personalities that poison the work culture exist and are often cited as reasons directors seek employment elsewhere.

Once the situation escalates past the point of being able to manage or even tolerate the behavior, directors and managers may jump ship. This is particularly true if key staff below them are already deflecting. Hiring, training, and managing their own staff is key to a director’s success. If other’s behavior prevents the director from retaining employees, they will often feel stuck in a no-win cycle.

 4) Not enough support due to a lack of managerial layer beneath them

This is a component of management that often gets overlooked – not just in the OR Department, but in organizations in general. There is often a propensity for funneling all management to one level in the org chart. Delegation is what separates a great manager from a mere high-performing individual worker. Whether this is due to an attempt to keep payroll down or merely an over-reliance on existing management, sometimes a director is most effective with leading a team of middle management beneath her/him. A lack of support in this area can lead to quicker burnout for the director as well as frustration from direct reports who feel they themselves suffer from poor management from their over-taxed boss.

 5) Lack of administrative support from above

The flipside to #4. Directors of surgical services have hundreds of details to manage in their positions. However, a lack of administrative support results in directors feeling the organization won’t provide them with necessary resources. A good director of surgical services is looking to improve staff training, turnaround times, efficiencies, safety and reduce errors. These initiatives take resources and political capital. A lack of support to make meaningful change will result in frustration, disengagement and ultimately a vacancy in the role.

 6) System Mergers

System mergers are an industry constant. While these events can and should be undertaken with as little disruption to an OR department as possible, there is always going to be friction. A merger can result in a sudden shakeup in management, reporting, processes, accountability, finances, staffing, and pretty much every major and minor component of day-to-day operations. Weathering this storm is frequently a challenge for multiple departments across both the parent system and the system being reorganize. However, with continued pressure to keep revenues high, the OR can take the brunt of the growing pains. Fortunately, system mergers offer opportunities for engagement and growth. Unfortunately, there is always the chance that your director of surgical services is one of the early casualties of a disorganized merger.

 7) ASC brings on a management company

Surgery centers come in all sizes and can vary greatly in their management structure. When a smaller surgery center with a homegrown management team brings on a corporate management company, mixed results often occur. Often, the management company brings relief to the current staff by taking on the hefty administrative workload allowing the director to focus on patient outcomes. Unfortunately, there is also always the risk of disenfranchising the current leadership. New management style, philosophical differences, and the risk that the director feels beholden to the new management can lead to their eventual exit.

 8) Transition to interim work

Ironically, the reasons listed above that can lead to a brief director of surgical services tenure are what contribute to #8. With every departure, there is a sudden void in the director role and finding a replacement can take significant time and effort. This is where interims are both valuable to a facility and an attractive career choice to directors.

The move to interim leadership—on the face of it—can be tremendously rewarding to a director of surgical services. Flexibility, financial incentives, and lifestyle advantages are obvious perks to interim leadership. However, interim leadership is also appealing to directors who want to take on unique challenges and make meaningful change. The reasons for quitting listed above are now intriguing challenges to an interim leader. Thus, it’s not unheard of for a facility to lose its director to an interim role elsewhere while then bringing in a new interim to help get (or keep) the train on the track.

 9) Dream job

It happens. While most of the list above are negative factors that can cause a director of surgical services to leave their job, not all resignations are due to workplace unhappiness. Occasionally an opportunity falls out of the sky that is too good to pass up. Maybe it’s a chance to work with a mentor or former colleague. Maybe it’s to return to a previous facility in a more senior leadership role. There are many reasons beyond money where an otherwise happy director may still move on.

 10) Personal reasons

Directors of surgical services are human, and just like with every employee there are a multitude of reasons why they might leave their job. Most are unavoidable and understandable. However, there are signs that a hospital might want to make sure there is solid succession plan in place:

  • Retirement
  • Ailing parents
  • Health problems
  • Wanting to step down in responsibility/burnout
  • Geographic preference
    • Following kids to college
    • Spend more time at their retirement locale
    • Nicer climate
    • Return to family

The director of surgical services role will continue to be a high-demand and critical role for the bottom-line success of hospitals and surgery centers across the country. Hopefully being aware of some of the factors that lead to turnover will help with retention and possibly avoid vacancy in this important role.

About the Author

Chris Harter is a Client Partner at Whitman Partners managing a portfolio of diverse candidates and client searches.

Chris arrived at Whitman Partners after 16 years of sales and operations experience in the travel sector, initially as a Program Coordinator with the largest educational travel corporation in the world, and more recently as the Director of Sales and Operations at a startup where he was instrumental during his tenure in positioning the company as the industry leader in expedition cruising.

Pulling from his background in court-appointed mediation and international contract negotiations, Chris’s strengths lie in his advisory, service-minded approach with clients to ensure effective and lasting placements. Chris brings years of consultative selling and operational restructuring experience to his role as a Client Partner with Whitman Partners. With each search, Chris’s focus lies in regional- and domain-relevant candidate recruitment.