Please note: This article is transcribed from our Healthcare Facilities Network video titled “Career Paths into Healthcare Facilities Management.” Watch the video of this transcription here:

So as you may have heard, if you’ve listened to our videos before, one of the underlying goals of Gosselin/Martin Associates and the Healthcare Facilities Network is to increase the pipeline of professionals into health care facilities management. And so this particular column is going to focus on career ladders. One of the questions we get a lot in our recruiting capacity, and in our consulting capacity is what are some career paths into healthcare facilities management? 

And it’s a great question, especially now where the market is in a good amount of time off a little bit crazier than it has been in the past. And so we thought this video might be instructive. What we did is we have a great database of resumes. And so we went back through some of those resumes. And we looked at what career paths did different individuals take into the director role of healthcare facilities management, because the paths that people take are very varied. And so what we do in this particular episode is we show you some of the career paths that people have taken to get into where they are and as we have said before, it is varied. There is not one typical career path. 

When we look at people who are applying for different jobs, we group hospitals into different buckets. Let me explain. We were doing a job for University of Nebraska Medical Center. And we met with the Vice President on the school side of it, the medical school side of it, and he said to us “if you’ve seen one hospital, you’ve seen one hospital.” And that is really true and it is a particular line we often use: “If you’ve seen one hospital, then you’ve seen one hospital.” 

But one of the ways you can group hospitals is by size. And so for this particular episode, and we’ll go from the smallest to the largest, we group them based on square footage. So you have starting at a critical access hospital. And if you’re not familiar with critical access hospitals, critical access hospitals are in rural communities, typically, low population, lower population, they have to be I think, 35 miles from the next nearest hospitals, from the next nearest hospital, they can have more than 25 acute care beds. They’re governed a little bit differently. Typically, they’re in very remote areas, we’ve done recruitments for critical access hospitals, and one of the big challenges is getting people to relocate. Now some people love the rural areas, they love what comes with being away from the cities. Rightly so. And I think that that can be a draw. 

But it’s also a challenge, because typically they are away from things and you have to travel to even, you know, normal things like those big box stores. So we start with critical access hospitals. And then our next bucket, as you’ll see is hospitals in size from one square foot to 250,000 square feet. And then from 250,000 square feet to 750,000 square feet from 750,000 square feet to 1.5 million square feet. And then 1.5 million square feet and above. And this is the way we’ve laid out these different resumes. And that’s arbitrary. I know. But typically, you go to 50 of community based hospitals, which people do love for a number of reasons. And then there’s the next you know, if you’re thinking about progressing in your career, these are the sizes you’re probably not going to start at a 2 million square foot hospital if you don’t have any experience. So that’s why we group them as we group them. 

One other caveat that I would say and this is relative to career counseling, and we did a show on the network a couple of days ago about this, but people used to stay at jobs a long time. And you’ll see, as we go through some of these, some of these career paths, we will have three to five years listed before you move to the next step. But I’ll be honest with you, some of that is just, you know, we were recording this July 2023, some of that is just all flipped, because people are scared of losing people, people are looking for anybody with even a modicum of experience. So some of these three to five years will be quite honest. You know, right now, it could be one to two years of experience. So take that with a caveat, because it has changed since we made this last year. It’s a little crazy out there. 

So let’s go back to critical access hospitals. So as you can see, over here on the left size, facility sizes critical access hospital, you know, I didn’t know there are 1357 critical access hospitals in America, I get the stats from Definitive Health Care, I was not I was surprised by that. But it was more than I thought. There’s 3876, acute care hospitals. And in total, and I know that this number, there’s 7335 Total hospitals in America. So out of 7335, 1357 of which are critical access hospitals, and critical access hospitals, as I said, come with their own buckets of challenges, from reimbursement to location. Some of them are really struggling these days. But you know, one of the things in your critical access hospital, since it is or since it can be a challenge to get people to relocate. And again, these are actual career paths. 

So we’ve seen critical access hospitals take their biomedical folks who have expressed a desire to transfer over to facilities, and actually bring them into facilities management. This particular person has an Associates Degree and went to Biomed, and then became a manager from the biomed perspective. You know, obviously, they don’t know everything about facilities management, but they work closely with facilities management, they know the technology, they know some of the infrastructure. So it’s not necessarily a difficult transition, like it would be by  bringing somebody in from the outside. If you’re trying to recruit critical access, a piece of advice is always see what you have internally. 

We go from our critical access to our next largest facility, our next smallest facility, which we’ve just moved from one to 250,000 square feet, that could maybe go up to 350, or 400. But again, you got to pick a number, and sometimes it’s arbitrary. Now, one thing on degrees, and we’ll talk about it a couple of times, because as we move forward, you’ll see that not everybody has a degree into these roles, even though a college degree is, is becoming more and more of a requirement. If you’re new to the network, or if you’re new to our podcast, the high reliability podcast, we’ve done a number of episodes on degrees in facilities management, the necessity to have a degree in healthcare facilities management, because organizations are requiring it. I don’t necessarily agree with that. But I will link to some of the at the end of this particular video, I will link to podcasts that we’ve done, and some shows on the facilities network that we’ve done relative to the need for a degree. And one of the one of the great ways into healthcare facilities management. And we will also see it on the planning design and construction side when we release that video. But you know, commercial construction folks, especially if they’ve worked in your hospital, can move into that manager role, if they want to make the transition. Now, a couple of the challenges, sometimes it’s money. You need to get this if you have a GC who’s worked in your hospital, maybe he was the superintendent, she was the superintendent, they probably on a project that you did. They probably know your hospital, they probably know your people. But as I said, it can be a challenge relative to salary, they probably make more but the economy who knows where it’s going within the next couple years, but from an economic perspective, you know, working in a hospital should and does provide more stability, then in the construction industry where you’re more subject to the up and down of the economy. So bringing in a commercial construction superintendent into hospital is, you know, is a path that we’ve seen quite frequently. Now.

Let’s go to our next one. Now, this looks like a large drawing. And it is. So we’re going to start over here on my left. Again, we’re still at a facility size one to 250,000. But you can see down here, so we go from top to bottom, and we call this the foundation level, there’s a number of different ways a number of different starts, that people have taken to make their way up to a director level. So what do they have at the foundation, you know, you see this associate’s degree, some folks and we’re seeing this more and more, have no health care experience coming in. They, you we did, and you’ll see it on the network. We did a show. And I was talking to one of our one of our guests, Taylor Vaughan was a political science major in college and has made her way up to a manager level. And it’s a great story of how she did it. And so, you know, she had her degree, but not in construction, or, you know, not in the trades, but made a nice transition. So again, that’s another path. And I think that we have to be open to, to looking at maybe non traditional paths these days, as the talent pool continues to be a challenge. 

So you can see, there’s a number of different ways a number of different at the Foundation, where people can get into health care. And once they get into health care, and as I said, you know, three to five years experience in these different areas, then they make their way up to a manager supervisor at a hospital, and then they become director. And so this three to five, this may be one to three. Now, to be quite honest with you, military folks always make a nice transition into healthcare. You know, typically, they’ve got the mindset that you need relative to joint commission regulatory their mind is just is is is, is shaped that way they’re used to the pace of how they’re used to the being on all the time, they’re used to regulation typically have some good soft skills that they can bring and very process oriented. So those are different ways up to that 250,000 square foot hospital. 

Over here to the right, we’re bumping up 250 to 750,000. I just want to bring attention to this one on the far right, where this person began as a nuclear submarine operator, and then became a maintenance manager in higher ed than in a medical school, and then a manager of a hospital, that nuclear submarine program. And we’ve done I should link to that too. I see this sometimes when we’re dealing with hospitals, they’ll they’ll say, oh, this person doesn’t have a degree and I’ll contract well, this person has gone through naval nuclear submarine education and and that program, if that program doesn’t prepare you for a role in health care facilities management than nothing. Well, Jim Smith, if you’re listening to this, I’m thinking to you, specifically, we talked about this a lot in our podcast. So if you see a resume and the person doesn’t have a degree, but they’re coming out of that program, you got to look at them because they have strengths that a lot of people don’t. So I just wanted to highlight that on the manager side. Now, coming to the director, and this is this big grouping in the middle we see a number of different ways that people have made their way to a director role. 

I’ll go over here to the far left. You know who you You are on this particular path, this person was a registered nurse, right came out of the military was in the Coast Guard, became an RN, then worked at a skilled nursing facility and all those skilled nursing facilities, they are regulated by the Joint Commission. So they’re used to the regulatory component. But obviously, you know, the pace is a bit different. Skilled nursing facilities are healthcare related. But there is a chain, there is a difference. But all that said, they can still make a successful transition into healthcare facilities management, but that RN background is great, because you sit, you’ve sat as a clinician, and now you’re sitting as the director of the facility.

Here we go back to the construction superintendent and our project manager, Superintendent, people who work in construction, project management, planning, design construction architects, they do make the transition into healthcare facilities management, they can make a transition into healthcare facilities management, sometimes there’s a little mindset change that can be required. You know, especially at the operations level, I guess I’m thinking more specifically, when you’re, you know, from the architectural perspective, you know, the, the design is one thing, but then the operationalization of that is another thing. But again, we do see these, you know, these groups, this person made a pretty nice transition from pm, into a tradesman in the hospital, to a supervisor, and then to the director level. This person down here didn’t get a degree. And you’ll see these people don’t have degrees through here. But they started with different things, the CHC, the construction certification, CHFM, certified healthcare facilities manager, I’m sure we’ll see somebody who started with just their CHFM. But you do see, these people did not have their college degrees, and made their way up to a director level. A lot of folks in the military attain their degree as they go, if they didn’t get it when they were in the service. So I think these particular career paths speak to folks who have done the role and didn’t get a degree to do it. 

We still stay at the 750,000 square foot level, you can see again, foundational level certifications, we just talked about degrees, then they came out, five, two years experience in trades FM, non healthcare, healthcare, two to four manager supervisor. And then the director level. So this particular persons are these people spent the number of years kind of making their way up. And that was actually more traditional, I think that was the more traditional career path. As we go, we’re skipping up to 750,000 square feet to 1.5. Now, at these levels, you know, you’re typically gonna want somebody who has worked in a hospital before and we see it right here in the middle, right three to five years, combination manager, supervisor health care experience needed, especially when you get up greater than 1 million square feet, those 1 million square feet, hospitals are large. And sometimes you’re you’re starting to get a little bit away from the the actual field and you might be in a lot more meetings, you might be in a political organizations, we tell people all the time, as you’re, as you’re interviewing, make sure that the organization is a fit for you, especially if the politics are coming into it relative to organizational politics. And you’ll see down here, you know, it is much more it is much more it is more unlikely to get hired into the size hospitals without that college degree. But you see, so and that’s what we say, you know, in rare circumstances, experience can be considered in lieu of the degree but quite honestly, we’re seeing that go away a little bit more, where the degree is becoming, you know, more mandatory. So you come out, you get seven to seven to 10 years experience trades, healthcare manufacturing, we’ve said this before, in you know, pharmaceuticals, manufacturing, education, you know, those are FM worlds where people do transition into healthcare facilities management. Sometimes they do find it difficult relative to pace, maybe not so if they’re coming out of pharmaceuticals, because they’re, they’re highly regulated.

To begin with, but sometimes, folks from those disciplines of healthcare facilities management do struggle, relative to the risk component of it, the compliance portion of the program, the pace of it, certainly, healthcare as, as we’ve said a number of times is around the clock. I don’t need to add another three hours to the day. So, you know, those are always consideration as we look at this bucket of seven to 10 years experience hopefully before they go to a director level. They do come in with some combination Should a manager supervisor at a hospital, it’s much easier. And we’re not trying to get people to leave the discipline, we’re trying to get people to come into it. But, you know, being a director in a hospital environment, it’s kind of like playing at the major leagues. And when you can play at the major leagues, then you can drop down to AAA if you want, I don’t mean to say that as a slight as all but if you you know, it’s easier I feel to go from healthcare to academia, or pharmaceuticals or manufacturing, the pace is a little bit different, the demands are a little bit different. We will find, though, that occasionally, there are people who transition out of healthcare and they go to a different field, and then they want to get back in because they missed the pace. Healthcare is kind of like a drug for folks. If you’ve been in a long time, you’re you enjoy that pace, you enjoy the mission, criticality of it, you enjoy the patient component of it. So you know, those are all things to consider as you think about, okay, who do I hire somebody who has no health care. And then conversely, if you’re a facility director now or facility manager, you’re like, Man, I’m getting tired of this pace of health care, I want to transition out, certainly you can do that. Because we do see other industries coming out of health care facility coming after healthcare facility directors.

Let’s stay with 750k to 1.5 million square feet, we’ll stay with that, before we go on, here’s a little bit of a security this person was all over the place. And, you know, I showed this one on the compliance video that we released. In late June, we had a roundtable with Michael Gorham, Craig stockless, and Patrick Reinhardt. And this is not one of those gentlemen, but you’ll see this person really took a circuitous route, but every experience here, and that’s the beauty of working in healthcare facilities management, or PDC, you know, every experience that you pick up relative to the hospital, helps you in this ultimate role, and you see a variety of perspectives. And so this person got their degree, and then, you know, security specialist, then they went into the trades, then a safety officer, then a manager, then a director, and now a director of safety and compliance. And so really an interesting path that I think shows you how, you know, there is not one set way to get where you get, let’s go now up to our largest facility size, 1.5 million square feet, you know, again, at this level, you’re probably 100% 99.95% certainly need that degree Masters, you know, Masters is preferred as you get up to, especially if it’s an academic medical center, academic medical centers are typically, you know, two plus million square feet. You’re going to need your degree to work in that environment. And I don’t know, I don’t disagree with that. Isn’t that great? I don’t disagree with that. I just think it’s, it’s needed in that type of environment. So, you know, 1.5 million square feet, academic medical centers, that degree is required, you know, 10 years minimum experience, I probably cut back on that. Now, to be quite honest with you, you’re probably going to want to have, you know, if you’re going for a hospital, that’s 1.5 million square feet, 2 million square feet, 3 million square feet, they’re probably going to want to see that you’ve operated in a large environment before, we do find some people that jumped to those big hospitals, from a square footage perspective. And they don’t like it’s funny, you know, there’s a bucket of people who love the community hospital experience. And it makes sense. If you think about it, because they’re just much closer to the patient. They’re in meetings a lot, but the meetings are a little bit different. And so if you look at our community hospitals, say zero to 450,000 square feet, there are folks who go up to this large hospital that we see right here. And then they just feel disconnected from the reason that they got into healthcare facilities management and so, so is, you know, it’s interesting, how people’s careers work out, you know, the senior director role.

Just a brief note about job titles. I always say to people, titles are bastardized these days in some way. You know, some organizations have found that, oh, man, we made everybody a VP. And so, you know, they’re, they’re, they’re taking VP titles away, and maybe they’re making somebody an executive director, or senior director, when in reality, they do have vice president level experience, it’s just that there are no VPS you know, they’re getting rid of them. They’re getting rid of title. See the same thing, relative to Director versus manager. And I know, you know, if you think about it, if you’ve been a director for 10 years, and all of a sudden, they’re coming to you and saying, Hey, we’re gonna make you a manager. Your now and your responsibilities are the same. Maybe a tough pill to swallow, especially since I’m the resume, you know, people are gonna look at that if they don’t talk to you. But they just see he was a director, she was the director. Now they’re a manager, what happened to them? So that’s always a bitter pill to swallow. But as I say, I mean, you really and I know I do this, when I’m looking at people I look at what they’re accountable for, as opposed to what their title is. Because again, this can be like that bonus step where, especially at larger organizations, where they create that senior director role, especially if you have multiple accountabilities, under you look at senior, the senior director, I wish I could see what they were accountable for, but they probably had some environmental services under them. I’m sure they had more than facilities, it might have been facilities, PDC and EDS. But I think that you know, the thing to take away, if you’re looking at these little, you know, if you’re planning your career, you’re thinking, hey, where can I go? What can I do? 

I would say, this degree at the bottom is really important. And, you know, even that masters, it’s kind of like the, the, the, the education race or the degree race where, you know, the Masters is the new bachelors get not in favor of but but that’s kind of the way things are going. We just finished with with the VP of a system, this is a rather linear, linear path. And I think it put this one in here, because out of the energy sector, I guess, with a lot of these just tried to show some different paths where they’re not at all, okay, you know, I started at the hospital, I became a manager, or became a supervisor and became manager, then it became a director. That’s pretty straightforward, right. But the energy sector, especially due to sustainability, and the demands of decarbonization, and whatever is coming down the rabbit, we know that energy focus is not abating. It is gaining and so, you know, folks coming out of the energy sector can make that transition into healthcare facilities management. Now, they might have the energy component, but they don’t necessarily have the risk, the compliance, the hospital, but they can be, you know, certainly they have the foundation needed to get into healthcare facilities management. So that’s why I want to show that because this person came out of the energy sector with management experience.

So, so I just wanted to show some of those paths, and it’s certainly not comprehensive way that people get in. But I think it shows the variety of ways that folks get in. And so if you have questions, you know, about career paths or careers, feel free to reach out. And I think if, you know, if you’re considering a career in healthcare facilities management, there’s a number of different ways everybody’s got a unique journey. It’s part of the reason I like doing what we do. As I said, you know, when we were talking to Taylor Vaughn and Clayton Smith at Dallas Children’s the other day, you know, she was a Political Science major coming into healthcare facilities management, Clayton started on the construction side, working for a CM. So as I said, I think the bottom line out of this, if you’re an organization, be open to these what might have been considered non traditional career paths, every individual is unique look at what they have, if they’ve got the soft skill component of it. Maybe you can teach them the technical skill component of it. We’ve done a number of shows on the healthcare facilities network, where people have talked about how, what they look for in hiring in different traditional ways. Now, one final comment, and I’ll close with this one, if you do hire somebody who doesn’t have that healthcare background, and that can be a huge risk, you got to make sure that you mentor them and train them. Because they’re going to need help. If you hire them, and you just leave them on their own. They’re going to fail. And I know that and I’ve been guilty of this too. It’s very easy to say or it’s the time you can say, you know, I’ll help them, train them up or mentor them. But then actually doing it is another whole step in its entirety, as you know. So anyways, those are career paths into health care facilities management. We’ll do another episode we’ll do the PDC route. We’ll do the VP route.