Biggest Challenges Healthcare Executives Have Faced: 4 CEOs Weigh In

Hospital and health system CEOs face a variety of challenges throughout their careers, but some challenges loom larger or taught more valuable lessons than others.

Here, four hospital and health system CEOs share some of the biggest challenges they have faced during their time as a healthcare leader.


Robert Garrett, CEO of Hackensack (N.J.) University Health Network: One of the challenges that I faced was to reopen Pascack Valley Hospital. There was some opposition from some of the local hospitals because they were afraid of competition. It was a long process to obtain the certificate of need approval. It took four years. The good news is that, at the end of the day, the need for the hospital was established and the community really supported it. Patience and perseverance is the way I overcame it. It would have been tempting to throw up my hands. But I believed in the cause and in the fact that the hospital was very much needed by the community. And I was so gratified that the New Jersey Department of Health granted the CON. It was the right thing to do. 

John McCabe, MD, CEO of Upstate University Hospital (Syracuse, N.Y.): I think the hardest lesson I had to learn is that that you can't always get done what you want to get done. For example,McCabe the hospital had been looking at acquiring a nursing home in the area for a long time. My team did a great job with researching it and everything, and then we took it to the state of New York and the SUNY [State University of New York] board and it died there. It is frustrating, and it was not the outcome I would have liked.

So I've learned that there are walls that you hit and you can't get past, even when logic would suggest that you could get past it.

MehtaSonia Mehta, MD, MBA, CEO and CMO of Loretto Hospital (Chicago): One of my greatest challenges is implementing a change in culture. Even though there are other challenges that are equally as difficult; we know there's nothing easy about working out finances and succeeding in the struggling economy. But, working on a cultural change about what we think about what we do, why we do it and how well we do it is really tough. You need the full engagement of your senior leadership team and buy-in and participation from the entire organization.

Here at Loretto we're trying to create a cultural change. We're trying to make everyone accountable for their role in the lives of our patients and in the success of this hospital. Every time I've tried to change culture, I've looked at senior leadership and said, "Do we have the right people in the right places to bring accountability to their work?" We are a mission-driven hospital, we are not in a rich area and we do a lot of charity care. Unless you have the right mindset and believe in the mission and values of this hospital, you will never create that accountability, and having the right people is the key.
Ninfa Saunders DHA, MBA, MSN, CEO of Central Georgia Health System (Macon): One of the most significant, ongoing challenges any leader faces is sustaining momentum around the interrelated nature of strategies, operations and people. We understand intellectually the three are intertwined; however, this concept is not consistently reflected in or supported by our practices. Such a disconnect inhibits the execution and sustainability of our work.

Furthermore, external and internal demands too often divert our attention to the more pressing daily aspects of our work. This tension is one I navigate constantly because it is only through a focused, consistent articulation of strategy, operations and people — with a weighted focus on people — that we are able to define value.

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