5 reflections on next generation leadership with Carolinas HealthCare System's Chief of Staff Debra Plousha Moore

A new class of leaders is set to succeed their baby boomer predecessors, and these up-and-comers will manage a very different type of health system due to the rapid development of new ideas, policies and technologies, according to Debra Plousha Moore, system chief of staff and executive vice president at Charlotte, N.C.-based Carolinas HealthCare System.

Ms. Plousha Moore shared her thoughts on the next generation of healthcare leaders during a conversation with Russell Williamson, vice president and general manager of enterprise corporate accounts for Dublin, Ohio-based Cardinal Health.

New leaders must be able to lead through the disruption of changing patient-provider relationships, care delivery models, health plans and more, according to Ms. Plousha Moore. She and Mr. Williamson discussed the main attributes this new class of leaders must demonstrate to successfully manage constant change and how their leadership roles — and expectations — will differ from their predecessors'.

Note: Responses have been lightly edited for style and clarity

Russell Williamson: How would you describe the transformation in today's healthcare industry?

Debra Plousha Moore: A couple of things stick out in my mind. One is the use of technology, which has changed everything in our world, and changed healthcare. The EMR allows us to connect with patients throughout our entire enterprise to improve the patient experience and provide continuity of care.

How we deliver care is also changing. We're moving away from the model where patients have to come in and wait 45 minutes for a very brief interaction with a provider. The patients of today want access and convenience – and they want information quickly. We've responded to how we deliver care based on how patients and consumers have approached us about how they want their experiences. First we saw the emergency department as the access point to convenient care. Then it was urgent care. Now we have virtual visits, where patients can interact with providers online.

Another big change in the industry is hospitals providing incentives for teammates, employees and associates to improve their own health and to create, within employer plans, individual experiences designed by the consumer about how they want to access health. This is a much more interactive experience, influenced by employees.

RW: How would you describe the challenges faced by the next generation of healthcare leaders compared to those faced by their predecessors?

DPM: As a baby boomer, I'm coming to the end of my career as an executive. It is very rewarding to see the next generations of healthcare leaders. They are managing a very different business than what we managed. When most of us came into healthcare, it was very physician-driven. We didn't have Internet access to look up our own symptoms and voice opinions about our diagnoses.

The transformation of healthcare is happening right in front of us and will continue to change. When many of us started our careers, our patients and clients were passive consumers. Today we have active consumers, and that shift takes a different kind of leader. New leaders have to be comfortable with changes in health plans, delivery models, information access and the immediate needs of customers. They need to be comfortable with real time feedback about the care experience and people sharing insights about how we can improve care.

There is a difference between disruption and chaos, however. It is important to be the kind of leader who builds trust with every stakeholder, because change without trust is chaos.

RW: How is the relationship between healthcare providers and consumers changing?

DPM: The demographics are changing. Medical school enrollment over the last 25 years has evolved to 50 percent women or higher. As you bring more women, more people of color and more international diversity into the healthcare delivery model, the relationships between providers and consumers change.

When I was just starting in healthcare, it was not unusual to have mostly men as OB-GYNs. I made a conscious decision to seek out a female OB-GYN, which was a big deal at the time. Now, there's so much more diversity in healthcare, and the current generation would probably wonder why my decision to see a female physician was one I had to say out loud.

Now, patients are making more decisions about who they want as their providers and what they want their conversation to sound like. People no longer feel that they have to be associated with any particular practice or health system. It's about who they are comfortable with as healthcare consumers.

RW: What elements of leadership do you consider most important for this next generation?

DMP: Next generation leaders need to have strong communication skills. Confidence is also important. Leaders need to be able to answer questions with 99.9 percent accuracy, and if they can't, they need the commitment to go research it and come back with an answer. They also need to be accessible, authentic and transparent when they can, while also understanding that some things are confidential.  

Young leaders have to present themselves well and be good role models because leadership roles are far more public than they've ever been before. Every decision about where they are, what picture they take and how they post it is front and center.

RW: Many healthcare systems across the country are trying to navigate this transforming and increasingly undefined healthcare landscape. What advice do you have for their leadership teams about preparing the next generation of leaders?

DMP: I'm not a huge sports fan — I follow enough to be relevant — but I like to look at leaders as coaches. If you look at coaches in the NFL or the NBA, they're constantly active and engaged. They're on their feet, going up and down the court or field. That's how I see leadership. It's active, not passive. People love being on a winning team, and a winning team has an active coach. If there is failure, the coach takes 100 percent responsibility. When there's success, the coach says it was all due to the remarkable team.

A coach must also have rules. One of my rules is I don't send emails out after 7 p.m. because people need to have time without me. On Fridays I usually say, "Thank you for a great week. Go enjoy your family." I never say, "Monday at 6:00 a.m., I need a briefing!"

The biggest rule is even when you know how to do something, teach the next generation of leaders how to do it, and give them enough space to either be successful or fail. If you've got great talent, keep that coaching until you get to perfection.

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