Executive insider: 3 health system CEOs on role models, nonnegotiables and great reads

Molly Gamble and Emily Rappleye -

We caught up with three top healthcare CEOs — Nancy Howell Agee, president and CEO of Carilion Clinic, Chris Van Gorder, president and CEO of Scripps Health, and Randy Oostra, president and CEO of ProMedica — to hear about the people who have influenced and inspired them, what they value most in a colleague, how they expect the unexpected and the books they couldn't put down.

Question: Who is a CEO, in healthcare or any other industry, who you most admire? Why?

Nancy Howell Agee, President and CEO of Carilion Clinic (Roanoke, Va.). I don't have a particular CEO in mind (there are so many I admire, respect and from whom I learn!). I do often think of a colleague of mine who was a constant mentor to me. Dr. Charles "Buck" Crockett was the associate dean of the School of Medicine for the University of Virginia and the head of Carilion's medical education department. He specialized in internal medicine and hematology, but his true passion was teaching and helping develop the future generation — including me, a fledgling administrator at the time.

Buck was brilliant and kind and had a wonderful, engaging personality. He never met a stranger, was always supportive and yet, was clear, compelling and disciplined, expecting the best from others. His curiosity — asking 'Why?' and 'What if?' — allowed us to dream big and achieve much more than we even imagined! He changed how I think, and that characteristic is one I constantly try to emulate.

Chris Van Gorder, President and CEO of Scripps Health (San Diego). This might be a different answer than you wanted, but I've always admired General Colin Powell. As Chairman of the Joint Chiefs of Staff, he pulled together all of the different branches of the military, worked with the leaders of multiple countries, the President of the United States and the Congress to manage the Persian Gulf War. He had many personalities to deal with and did so effectively. He went on to be National Security Advisor and Secretary of State. My wife and I met him once and spent some time privately with him. He was generous with his time and humble. Those are the characteristics I admire in a leader and a CEO.

Randy Oostra, President and CEO of ProMedica (Toledo, Ohio). A man I really admire and who has served on our ProMedica board is Russ Ebeid, the former Chairman of the Board at Guardian Industries and President of the Guardian Flat Glass Group. Russ is an incredibly modest man who made some extremely significant accomplishments in the glass and glazing industry during his career. He helped launch 28 glass float plants worldwide, but he will always tell you his biggest pleasure was in watching his managers grow and succeed. He is a man from humble roots who had an incredibly blessed and successful career, but he never forgot his roots and always takes the opportunity to help others. He is a tremendous example for us all.

Q: What is a "nonnegotiable" that you look for in employees or colleagues? What character trait, habit or philosophy must they possess for you to work well together?

Ms. Agee: Compassion and commitment. Working in healthcare, those two qualities are vital. I have been fortunate to be a part of a team of amazing people who put their hearts into their work. It's no secret that high-quality care and exceptional service are characteristic of America's best hospitals and healthcare organizations. And to achieve that kind of quality, service and experience, employee commitment and engagement are critical.
 
Mr. Van Gorder: This is a simple question for me – honesty, integrity and transparency – in that order.

Mr. Oostra: There are a number of character traits and philosophies I look for in leaders, colleagues and employees. Leaders have to help define reality for employees, establish a sense of urgency, push people to do better in an environment where excellence is expected, and they are action-oriented. As individuals, I look for people who are humble, naturally curious, good listeners and who question the status quo.

I believe in a philosophy of servant leadership, and that we are all incomplete leaders — no one single person can be the flawless leader. We can't be all things to all people. We need a team of people, board members, leadership, physicians, clinicians and staff — all working together — to truly be a complete leader.

Q: What was the last piece of healthcare news that truly surprised you — in a positive or negative way? Why?

Ms. Agee: The rate at which technology is disrupting healthcare continues to surprise and impress me. Three decades ago, telemedicine was "science fiction." Today, its commonplace and in ways we couldn't have imagined even a few years ago. Who knew that telemedicine would be in the form of apps on our smartphones? In the past decade, an individual's ability to track her health has dramatically changed. People see their own medical record 24/7, track their weight, steps, and miles walked, count calories and observe sleeping habits. Individuals are becoming more responsible for their own health, and that is tremendous for our society. And even though I know it is coming, I expect to be amazed by what entrepreneurs and researchers will do with all that data coming from those apps.
 
Mr. Van Gorder: I've tried to think of something that truly surprised me, but I can't come up with anything. I guess that is because I've come to "expect the unexpected" in healthcare today. Part of my job as a CEO is to research and forecast the possibilities ahead and as a result, my team and I spend considerable time with contingency planning which means thinking about and planning for the unexpected.

Mr. Oostra: There was an article by Michael Porter, Ph.D., and Dr. Thomas Lee recently in the New England Journal of Medicine that suggests by improving outcomes and improving efficiencies we will enhance our financial success and professional satisfaction. That strategy, while sound, doesn't go far enough.  Healthcare needs to join voices — to be the strongest voice — to address the health impacts from hunger and other social determinants of health. Healthcare needs to be about going beyond our four walls, beyond the episodic moments of care people receive at our hospitals and our physician offices, to those moments where health is actually impacted – in our homes, our schools and our communities.

Hospitals and health systems will need to focus increasingly on being the integrators of care for communities, not just focusing on clinical excellence and reducing costs within our hospitals. We need to concentrate on a strategy that creates value not just for the patient — we need a strategy that yields a healthy individual and a healthy community — which ultimately will achieve better outcomes, enhanced quality, greater efficiencies and improved margins.

Q: The last great book you read — what was it and why did you enjoy it so?

Ms. Agee: The truth is I am a bookworm. I have audiobooks on my smartphone and piles of books on my desk, shelves and bedside table. Usually the best book I read is the last I read! So, here are two — one, fiction and the other, business. "The Nightingale" by Kristin Hannah is a well-researched, beautifully written story about two sisters during World War II in occupied France. The depravation of that gruesome war can knock you off your feet and yet, the beauty and celebration of life remains. I enjoy good fiction to relax my mind. But, of course, I am always reading to propel learning. We have a couple of book clubs here at Carilion, and we've just finished Atul Gawande's excellent book, "Being Mortal." We are now reading "Decisive: How to Make Better Choices in Life and Work" by Chip Heath and Dan Heath. The book shares decades of psychological research about inherent biases that often trip up judgment. I'm a firm believer on continuous learning. Anytime I have the chance to learn, especially with others like a book club, I jump at it!

Mr. Van Gorder: I've enjoyed Atul Gawande's books, and the last one I read was "Being Mortal." My wife and I have lost both of our parents now, with my father being the first to pass away back in 1980. He did not have the benefit of today's palliative care and hospice programs and as a result, the death was very difficult for all. I think the experience would have been very different today.  Dr. Gawande teaches like I like to teach — with stories. "Being Mortal" discusses serious issues but in a constructive and memorable way but in a compassionate style.

Mr. Oostra: I am currently reading "Our Kids: The American Dream in Crisis" by Robert Putnam, which is a follow-up to his best-selling book "Bowling Alone," both of which speak to the issue of the decline of American life, and in particular the widening gap between the haves and the have-nots. The story Putnam weaves about the social fabric of American life, and the expanding income and social gaps, echo what we in healthcare are challenged to address relative to the social determinants of health. So much of health is determined by what happens away from the doctor's office or hospital, like hunger and health, infant mortality and mental health. So this book really struck home for me.

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