Doing good work doesn’t always lead to the next promotion. Sometimes getting ahead means looking beyond the traditional career ladder.
By Dustin Telford, AAMIF, CHTM, CBET
Every career in healthcare technology management (HTM) comes with an org chart, and the org chart comes with a story: Learn the equipment, get certified, wait your turn, and the title above yours will eventually open up. I believed that story for longer than I like to admit.
Early in my career, I became the person who took the troublesome calls. I learned the equipment, helped newer technicians, and assumed the next senior opening would be mine. Then a reorganization erased the opening. The break came from a project manager who had noticed my handoff notes during an equipment replacement. She asked me to help standardize the work across several sites. I had been staring up at a missing rung while someone down the hall was offering me a different ladder.
The title ladder is real, but it is the part of advancement everyone can see. Most of what moves a person is the part nobody writes down.
I offer four unwritten rules. They are observations from field practice, not research findings. Test them against your own experience.
Rule 1: Competence gets you the work. Being known gets you the next work.
Plenty of excellent technicians are invisible because the only people who know how good they are work in the same hallway. Promotions are decided in rooms you are not in, by people who need a name to say out loud.
During a networked patient-monitor rollout, I kept a short list of recurring configuration problems and sent it to clinical IT after each phase. Months later, their lead asked for me on another project. He had never watched me repair a monitor. He knew I closed loops.
Take action: Pick one thing you fix well and write down, in three sentences, what it saved. Send it to your manager and one person outside your department. That is not bragging. It is giving people a name to say.
Rule 2: Your manager is not your career plan.
A good manager helps. A great one opens doors. But the person whose calendar depends on you staying put cannot carry your whole career plan. Organizations vary in how much structured support they give, and one point of failure is something we are professionally trained to dislike.
I once waited through two budget cycles for training that was always coming “next time.” I finally paid for a short association course, then volunteered to reconcile an equipment inventory with a renovation plan. That small decision introduced me to equipment planning and put my career back in my hands.
Take action: Write one sentence about where you want to be in three years, and then list one thing within your control that moves you toward it. Learning counts, whether that’s an association course, manufacturer training, or a conference you pay for yourself.
Rule 3: Mentors are asked for small things first.
Nobody wants an application form titled, “Will You Be My Mentor?” People say yes to a specific, answerable question. “How did you decide between the imaging track and the management track?” gets an answer and often a second conversation. A grand invitation gets a polite deferral.
My first useful mentor conversation began with a question about a service contract I did not understand. Instead of rescuing me, he asked what evidence would change my recommendation. That question followed me into later decisions, and the occasional cup of bad conference coffee became a long professional friendship.
Take action: Choose one person whose path you respect. Email one question they could answer in two lines. Offer to buy coffee, real or virtual. Ask once. Do not wait until the question is perfect.
Rule 4: Sideways is a direction.
The ladder assumes up is the only way to go. In reality, HTM careers run into regulatory work, consulting, equipment planning, information technology, research and development, and teaching. A lateral move is often how a bench person first sees the whole building. Troubleshooting a failure you cannot see is useful in more places than a repair bench.
I took a sideways assignment reviewing service documentation after a survey finding. At first I treated it like paperwork detention. Then I saw how one vague close note could weaken an otherwise sound maintenance program. That work changed how I wrote, supervised, and eventually advised other shops.
Take action: Ask a colleague in a neighboring department for 20 minutes, and ask what a normal week looks like for them.
What to Do This Quarter
Rules are useful when they turn into calendar entries. Here is the checklist I would hand a technician who has heard “get certified; be patient” often enough to stop listening. Pick one from each line before the quarter starts:
- One move. Take a specific step toward a role you want: a course, a rotation, a cross-training day, or a project that touches another department.
- One mentor ask. Send one person one small question in the first two weeks.
- One visible win. Describe one result in three sentences, using a number or a clear before and after, and share it with someone who does not see your work daily.
At the end of the quarter, ask: Did I make the move? Did I ask the question? Does anyone outside my department know what I fixed? A no gives you the next quarter’s plan. Three yeses mean you are building a reputation that travels without you.
None of this replaces certification or patience. Both matter, and the best technicians I know have both. They are the floor, not the ceiling.
Trade Stories with Me
Which unwritten rule do you wish someone had told you in your first five years, and what did it cost you to learn it? Send your story to [email protected]. If you try the quarter checklist, tell me what happened, including what did not work. I will compare the patterns with mine and keep the details private unless you ask to be named.
The ladder was fine. It just was not the only thing holding me up, and it will not be the only thing holding you up either.
About the author: Dustin Telford, AAMIF, CHTM, CBET, CRES, CLES, is principal of Healthcare Technology Strategies, LLC, Omaha, Nebraska.
