Armando Llechu serves as Chief Administrative Officer of Golisano Children's Hospital of Southwest Florida for Lee Health.
On May 24th, Armando will give a presentation on "Administrators and Physicians: Synergism or Antagonism" at Becker's Hospital Review 11th Annual Meeting. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place on May 24-26, 2021 in Chicago.
To learn more about the conference and Armando's session, click here.
Question: What, from your perspective, is the biggest challenge about the future of work for hospitals, and what can they do about it? (i.e. automation, desire for more flexibility, clinician shortages, etc.)
Armando Llechu: As I watch a continuing trend of physicians leaving the bedside to transition into administrative roles, I question the sustainability of the physician supply. Medicine is hard and it is getting harder. Practicing medicine is becoming increasingly difficult as a result of the bureaucracy that surrounds payment and authorizations, regulatory pressures, and increasing patient demands. I can see how and why physicians are struggling to find satisfaction in care roles, but the migration of so many talented physicians away from direct care and towards administrative roles increases the pressures on a system that is already at a disadvantage with physician shortages. This is especially of concern in the pediatric world where certain fellowships have become unattractive and we are seeing physician shortages nationally. It pains me to say this, but it is far easier to be an administrator than it is to be a physician. It takes a special intellect and drive to be a good physician, and sadly those are the ones we need most. We need physicians practicing medicine, for all of our sake and our children’s sake.
Q: How can hospitals reconcile the need to maintain inpatient volumes with the mission to keep people healthier and out of the hospital?
AL: I envision a day when hospitals will be reserved for only the sickest of patients. The era of medical-surgical units will surely end during my career. As we continue to see a transition to ambulatory and outpatient care, and a move to healthier communities, the next likely development will be more highly evolved in-home care. Systems need to be part of the solution for healthier communities and prepare for the inevitable change in healthcare delivery, even if it comes at the risk of lost revenue in the short-term. Long-range vision is key at this moment in our history. Through higher specialization reimbursement methodologies, such as the DRG program, we have seen and will continue to witness the move towards acuity-driven admissions. The real advancements in out of hospital care, primarily in the home, will also surely follow regulatory and payment models reforms which will enable and reward the location of care changes. The future is coming faster than we could have ever predicted This is a very exciting time in healthcare and I feel so blessed to be a part of it.
Q: What's one lesson you learned early in your career that has helped you lead in healthcare?
AL: One of the greatest things I learned about leadership was taught to me by a former mentor. He always said, take care of your team, they will in turn care for your customers, and let the customers worry about the bottom line. It can be difficult in a healthcare leadership role, where quality and “measures” are all so important, to have faith in your team, to trust that the teams you empower will do what is right for the patients and the organization. This approach has gone through several iterations with me over the years. In that time, I have settled on a few tenants of my own approach to leadership in that
- I surround myself with the best people I can find. These individuals usually have significantly different backgrounds and opinions than I do. We rarely agree on strategy or approach but collectively we come to the best conclusions as we challenge each other’s assumptions and bring out the best in one another.
- I am the “boss” of no one. My role is to empower, enable, and when needed, provide cover for the teams I lead. No one wants a boss. What professionals do want is a clear expectations and goals, with some guardrails. They in turn will deliver what is needed.
- There can be no leadership without vulnerability. Simply stated, I have to be willing to shoulder the failure of our team in order to inspire them to be the best they can be. I also have to make peace with my own failures and reveal them as appropriate. Leadership is about trust, empowerment and care for the teams we work with. Only then will we see them be the best versions of themselves and produce the greatest outcomes.