My worst fear: I miss a cancer. Of all things to miss, I worry about this the most. Miss a myocardial infarction, stroke, or appendicitis and you figure it out quickly because it smacks you right in the face. Conversely, cancer simmers along. A few months or even years go by and everything seems fine, then all hell breaks loose. The symptoms reach epic – if not life-threatening – proportions. Systems fail. No matter what you do, it may be too far gone, and you are left wondering what the hell did I miss?

Not long ago I missed a cancer. The jury’s til out on the ending but the bottom line is that m poor history-taking, diagnostic skill, and not trusting my gut had led to a potentially fatal outcome affecting all involved. Even if the result isn’t death, things won’t ever be right again. I have to live with that. The effect it had on everyone involved, the cost, the heavy emotional toll – it all results on my shoulders and I’ll carry it to my grave.

You are probably wondering what type of cancer I missed. Gastric, lung, a glioblastoma? No; if only it were that limiting. I missed the worst type, the most insidious kind of disease. I made a bad hire.

Pathology of a Bad Hire
Bad hires are cancer. You aren’t aware of the pathology at the outset. It’s hidden. Much like the nodule hiding on the chest x-ray, during the interview, bad hires don’t jump up and down screaming, “Don’t hire me, I will infect the staff, ruin the culture, and lead to the collective downfall of the department or organization if not quickly eradicated.”

In their heart of hearts, bad hires know they are bad hires. Worse, they know how to hide it – for a while. During their interview, they know how to mask their pathology. They smile, ask relevant questions, and may have even researched your organization. They “kiss” your aspirations. They have to fake it or no one would ever hire, date, marry, or befriend them.

Within a few months, the “cancer” I hired reared his ugly persona. He was a master at managing up: high-fiving, fist bumping, pet names, he knew all the tricks to ingratiate himself. Behind closed doors, however, he belittled the staff, was arrogant, non-responsive, condescending. He was simply a bully and defined disingenuous behavior. His one “redeeming” quality: He was a puppet and would do whatever his superiors would tell him.

Others missed it for a bit, but after a while, you can’t hide the facts. Employees left in drives, patients went elsewhere, once-loyal leaders became bitter rivals, service deteriorated, and it became “just a job” to team members. Unfortunately, he was in a leadership position, and once in place, friction took hold and he became hard to displace. Like Nero, he fiddled while Rome burned. The rest of the staff called him “The Vowels,” or “AEIOU and sometimes Y.” Always Egotistical, Ignorant, Obstinate, Unaware and sometimes a Yes man.

Jim Collins, reviewing the book The Rare Find, by George Anders wrote, “The most important thing a leader can do is to make great hires.” Ok, then, I screwed that one up. What did I miss?

How Not to Make a Bad Hire
I have literally hired hundreds of people. Back in the day, I would tell new prospects to meet me at 5:30 a.m. at the base of a mountain that I hiked up four or five times a week. If they showed up, made it up the mountain, and didn’t complain or make excuses, they had a foot in the door. I learned a lot about them just from those factors alone. I finally got wise to the fact that this methodology ran contrary to the Americans With Disabilities Act so I switched to behavioral interviews.

Behavioral interviews, at least to me, help you look from the “bottom up” on a resume. I start y looking at “what else” people do. Are they runners? Have they done a marathon? Are they tri-athletes? What have they read? How has it changed their way of thinking or how they approach challenges? Have they gone back to school? What other hobbies do they have? Where have they failed in the past, how did they respond, and how have they changed their approach? Do they demonstrate empathy? In other words, what have they learned? Do they volunteer, play an instrument, mentor? Are they constantly trying to improve themselves? Can they identify their deficiencies? What are they doing to correct them? We all have deficiencies upon which we can improve. The best marker for future success is not “What is the deficiency?” but what someone is doing to improve understand the person sitting in front of you.

Although it’s great if someone has been successful on every one of their previous assignments, you really don’t learn much about them, (nor they about themselves), from their successes. It may have been pure luck (right place at the right time). They may have had others on the team who did most of the heavily lifting. They may be taking credit for accomplishments for which they had little impact. Contrast that with a person who has started a venture that failed or worked tirelessly on a business that only achieved a modicum of success. Given the chance, you can bet that what they learned from that experience will help them (and your business) in the future.

So what did I learn? In the end, persistence and the ability to communicate effectively are the two “must have” traits in people I hire. As Calvin Coolidge said, “Nothing in this world can take the place of persistence.

Talent will not; nothing is more common than unsuccessful people with talent. Genius will not; unrewarded genius in almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent. The slogan ‘press on’ has solved and always will solve the problems of the human race.”

Take home points: Trust your gut. Read the resume from the bottom up. Ask the tough questions; go deep to probe beyond the canned answers. Ask why and what did you learn and how ill you change your approach in the future?
Great organizations are made up of great people. Finding and retaining great teammates takes a concerted and unrelenting effort. If you persist, your organization will flourish beyond your expectations. But if you let your guard down just once, a bad hire, like an undiagnosed cancer, will slowly destroy your organization.

Missing a ‘Cancer’

John Shufeldt, MD, JD, MBA, FACEP

Chief Executive Officer at MeMD, LLC, Mentor and Author at Outliers Publishing, Principal at Shufeldt Consulting, Founding Partner of Shufeldt Law Firm