10 Challenges Healthcare CEOs Can No Longer Ignore

Healthcare presents a number of urgent challenges that executives can no longer afford to put off. I was considering what advice to give CEOs facing this brave new world when I heard a remarkable speech at the National Center for Healthcare Leadership's annual event. Michael Dowling, the president and CEO of NorthShore-Long Island Jewish Health System, made some incredibly prescient points upon receiving the NCHL's Gail L. Warden Leadership Award.

Mr. Dowling believes we are at a historic crossroads in healthcare that demands not just run-of-the-mill courage, but truly gutsy action. What he said brought tears of recognition to my eyes. The following points incorporate some of his views with some of my own on dealing with a time of fast-paced change that, if you don't watch out, will knock you off-balance.

1. Don't live in denial. Healthcare leaders need to step up to the plate and cope with change. Mr. Dowling warned the industry is about to undergo significant change, and I couldn't agree more. Undertaking a few changes here and there, he said, isn't going to pass muster. Many of the changes we face will come through the Affordable Care Act –– a law that faces many challenges, including a Supreme Court review next spring, followed by an election that could bring a new party into the White House and Senate. Faced with these unknowns, some healthcare leaders are simply not willing to undertake any change at all. They want to wait until they know exactly what new regulations under the law are going to be. They are, sadly, frozen in place.

This is a losing strategy. Whatever happens in the Supreme Court case or even if there is a new administration, many facets of the healthcare law are likely to stay in place. The wind of change is blowing. We face an unyielding trend toward creating new modes of healthcare to keep costs in check, and it won't go away. Hospitals or systems that hold back now will be left in the dust. There is going to be much less money to throw around in the future, Mr. Dowling warned. Healthcare leaders are going to have to do more with less.

2. Take risk and make it your friend. A hospital CEO has to take chances. Great leaders make mistakes and you probably will, too, but it won't be the end of the road for you or your institution. We've all gambled at some point in our careers. Of course, make sure when you take risks you have as much data at your disposal as possible. You want the percentages to work in your favor. But great leaders do not succeed by shying away from risk, and they can't be afraid to make changes, when necessary. Mr. Dowling argued that some CEOs will have to start all over again, turning their organizations upside down, if necessary. I wonder how many CEOs would have the courage to pull it off. Your watchword should be: "Learn to cope with change."

3. Break down the silos. No organization can function properly unless everyone is on the same wavelength. It's easy to stay in your own silo, where we can deal with people just like you, in your own comfort zone. But this won't move an organization forward. A football team or any kind of sports team has no chance of winning if each member goes off in his or her own direction. The silo mentality is very powerful and hard to break free from. It is up to the CEO to break the silos down. The culture of the institution, whether in the non-profit or for-profit sector, won't be enough. This kind of work requires an extraordinary effort. It involves persuading everyone to embrace the mission and vision of the organization, as set by the CEO. You might start by putting up a sign that says, "No silos here!"

4. Behave like a CEO. It is up to you to set the tone and the culture of the organization you are leading. That takes intestinal fortitude and a great deal of transparency. Tell everyone in the organization what you intend to do and why you feel it is in their best interests. That sounds rational enough, but many leaders let others take charge while they busy themselves with other matters both inside or outside the campus. Too many CEOs forget the main mission of any hospital or hospital system is to take care of people and make them well. In many cases, this is why they chose the field of healthcare.

5. Treat patients as customers. A lot of people in healthcare are still allergic to seeing patients as customers. Caught up in old-fashioned ways of thinking, they continue to believe healthcare is somehow different from a business. The fact is that when you are ill, you want to be treated with dignity and respect, just like a customer is treated. Too many times, patients are treated like an afterthought and not the main purpose of the institution. All patients should be accorded first-rate service no matter what their station in life. They are human beings who came to your organization for comfort, relief and healing. Customers are the lifeblood of any business. Whether or not we like to think so, what we do is a business. We should all accept that fact.

6. Communicate with everybody.
Communicating doesn't just mean talking to people in the C-suite; it means reaching out to every last person in the institution and keeping in mind every last patient who comes through. Follow the lead of other industries that have learned the art of keeping customers and employees engaged by making sure each patient and each employee is fully informed about everything that affects them. Be honest and forthright with information and let people know what is going on. Secrets, innuendos and muddled communications should be stopped immediately. These channels, though unofficial and unauthorized, can destroy the organization if allowed to flourish. Inspire your people by letting them know how proud you are to be serving them and how you are going to make the hospital the best it can be.

7. Tolerate dissent. Embrace those who would disagree with you. Make sure they know what you are trying to do and how you intend to carry out your strategic plan. Quite often, people who disagree with you simply need to be better informed about what you are trying to do. When you explain yourself to people, it disarms them. Sometimes even your most stalwart opponents become your strongest allies. Always be willing and open to those who oppose what you are trying to do. Make sure they are, if anything, over-informed on matters so they can never say you hid your plans from them.

Having a well functioning workforce means setting your people free. Build strong teams and turn them loose to do their jobs. Mr. Dowling said a true leader understands that without quality people dedicated to the mission of the organization, the goals that have been staked out will never be met.

8. Always be visible. Great leaders never shirk from being visible. Too many CEOs think they should stay in their offices. In fact, they should be doing the exact opposite. The real mission of any hospital lies outside the corporate offices, where your patients are and your services are actually provided. To have any hope of inspiring people, you have to be willing to enter into their realm and be with them as often as possible. This kind of work could be called "walk-around management." Be as visible as you possibly can. That alone will give people inspiration and make them feel special!

9. Reach out to the community. Be willing to talk to community groups as often as you can. Let the community know what its hospital is all about. Speaking takes time but if people understand your mission and the challenges you are facing, they will be more willing to assist you. It takes an extraordinary amount of time but it is absolutely necessary. One of your biggest potential problems you face is a community that does not understand your mission and vision. A hospital or health system cannot survive without the support of its community.

10. Be proud of healthcare! Healthcare is the greatest force for good in the world, and it will always be. You are a key player in the business of serving others. Let them know what your standards are and how you plan to overcome the obstacles and challenges this great industry faces. You are desperately needed to lead. The reason people come into healthcare is to serve others, but CEOs also came into healthcare to be challenged. For a true leader, this is a great time to be a healthcare CEO. Relish it and shine –– and never, but never, give up. Healthcare needs more leaders like you!

With every one of these points, inspired by a very perceptive healthcare visionary, the message is: Don't let change happen to you. This is not a time for half measures. It is time to take all of the bold dreams you have been shying away from but secretly knew were on-target and make those dreams your own.

Chuck Lauer (chuckspeaking@aol.com) was publisher of Modern Healthcare for 33 years. He is now an author, public speaker and career coach who is in demand for his motivational messages to top companies nationwide.

More Articles From Chuck Lauer:

Chuck Lauer: Finding Optimism in Healthcare Change
Chuck Lauer: What New Healthcare Leaders Should Know
Chuck Lauer: The Gentle Art of Listening

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