From a truck repair garage to the hospital C-suite: 5 CEOs reflect on their first jobs

Graduation season is a time of celebration and excitement, but for many people, it is also a time of trepidation. As newly minted college graduates prepare for their inevitable launch into the surly real world, guidance and words of wisdom from professionals who have demonstrated exceptional career success are extremely valuable.

Here, in their own words, five healthcare CEOs reflect on their first jobs — both within and outside of healthcare — and offer advice for those who are preparing to begin their own professional journey.

Nancy Howell Agee, President and CEO, Carilion Clinic (Roanoake, Va.). My first job was doing inventory in a truck repair garage run by a friend of my dad's. I was 14. This was tedious, dirty work in an environment where girls were mostly absent and largely unwelcome. You were paid by how many bins you completed by day's end. 

I learned several important lessons. First, after a long day, I suggested that I invite my friend to help. Lesson one: Teamwork pays off. Second, be grateful for a job; it was a heady experience to have my own paycheck! Thirdly, working hard, organizing bins and having focus meant you worked faster and got more done, which resulted in compliments from the boss and a bigger paycheck. The fourth lesson: An unfriendly environment can change pretty quickly when you appeal to what inspires people … like homemade chocolate chip cookies for the truckers and garage workers. Lastly, I learned that the last place I wanted to work was a garage!   

Chris Van Gorder, President and CEO, Scripps Health (San Diego). I have been working since I was thirteen years old — first in a bookstore, then a fast food restaurant and during college for a hospital and a couple of police departments. After I was injured in the line of duty as a police officer and retired, I went to work as a department head in the hospital that had cared for me after my injury and back to graduate school for my graduate degrees. My first job after that was as a vice president for support services at Anaheim (Calif.) MemorialHospital, a 240-bed community hospital.

I've loved all of my jobs and learned many things every step of the way. I learned about customer service as a clerk in a bookstore and fast food restaurant where I first learned to supervise employees. I loved my job as a clerk in a hospital emergency room — as a hospital security officer and then in the hospital's laboratory. And as a police officer, I learned a great deal about people in stress and trauma, and about teamwork and taking care of your people. When I finally entered hospital/healthcare administration I learned how to work with a variety of clinicians and staff and over time, the "business" of healthcare. But my mentors and previous work experiences taught me to always focus on the patient and the people who care for those patients.

By the time I got into healthcare administration, I was in my mid-30s. Since this was already my second career — first having been a police officer — I was convinced this would be my final career. I was determined to maximize the opportunity. I could have lost my life when I was injured as a police officer but I was blessed to survive. I saw this second career as a special opportunity that was not to be squandered. Besides, I loved the patient care and supporting those caring for patients and maintaining our facilities. When I started supervising those in support service, I discovered early on how hard these dedicated employees work — environmental services, food services, facilities management, etc. — and how rarely they are appropriately recognized.  

My first environmental services team gave me a handmade American Indian Feather Headdress since I was their "chief." I still have that headdress and it reminds me daily that I have hardworking staff caring for patients every single day for which I am responsible. The biggest takeaway I've learned: Take care of your people and they will take care of you.

My core work ethics I learned from my parents, but they have been extended by learning from the many people I have worked with and for. I also learned to link every job in healthcare to patient care — even if you never see a patient. Almost everyone could make more money in other industries but we have chosen healthcare for a reason; it's a mission and a calling. And I have tried to find a way to stay connected to patients in my own way. Being an EMT and developing our Scripps Medical Response Team has given me the opportunity to deliver patient care personally in places like Haiti and after Katrina in the Gulf.

To new graduates entering the workforce, I advise you to find a reputable and high-quality organization where you will be proud to work. Find a mentor, learn from your people and support them in their work and calling.

Darlene Stromstad, President and CEO, Greater Waterbury (Conn.) Health Network/Waterbury Hospital. When I first graduated with a Bachelor of Arts in journalism, jobs were scarce and I was thrilled to get an entry-level reporting job at a small daily newspaper. I wasn't filling a vacant "beat," so my first assignment by the news editor was to write a few profiles on local businesses for a special edition. The directions weren't more specific than that. I had to find my own direction.

It was then that I began to understand that everyone, no matter how they first present themselves, has a story — a story worth hearing. For some people, it just takes you a little longer to find out what that story is. Over my few years as a reporter, I became more skilled at examining and understanding issues, breaking complex situations into understandable parts, always on the pursuit of understanding "the story."

I loved that first reporting job; everyone always returned my phone calls. Seriously, I had the very special and humbling opportunity to speak candidly with people at very unique — and frequently very difficult — moments in their lives. I also learned the power of ink is lasting and written words do not go away. That requires the responsibility to be thorough, ethical and make every attempt to get it right, even when it takes more time.

The hours were long and the satisfaction that goes with doing a good job, or the shame of doing a not-so-good job, were mine to understand internally and alone. While the byline makes your name recognizable, reporting is a vocation carried out in isolation. The work ethic, the attention to detail, the experience that allows you to trust your own judgment, the respect for other people's stories, the ability to analyze, understand and define the story — those traits I learned as a young reporter have served me well in a long, satisfying career in healthcare. The continuing pursuit of understanding the story serves as a foundation for continuous education and learning that are necessary for all contemporary healthcare executives today.

Embrace your first job with energy and enthusiasm. Learn to question, seek to understand, and you will end up developing your own story.

Nancy Schlichting, CEO, Henry Ford Health System (Detroit). My first job after graduate school was serving as a fellow of the American Hospital Association and Blue Cross Blue Shield Association in Chicago for one year. I loved the job since I had the honor of working with the CEOs of both organizations and their leadership teams. I was exposed to "big picture" policy and system thinking at a very young age, and learned about both healthcare delivery issues as well as healthcare financing issues.

This opportunity had a major impact on my career path. I have always gravitated toward hospitals and health systems that pursued strategies that addressed both the delivery and financing of healthcare (e.g. integrated health systems). I also met Gail Warden during my time at the AHA — he was the COO at the time — who had a profound impact on my career journey, including recruiting me to Henry Ford Health System 20 years later!

I remember learning a valuable lesson about work ethic from Walter McNerney, who was the CEO of Blue Cross Blue Shield Association when I was a fellow. He said to always work on a project immediately after you attend a meeting that discusses it, since you will have the information fresh in your mind, and will have the energy and focus to accomplish your best work. I have found that he was absolutely right.

My biggest takeaway was the importance of creating your network of colleagues from the first day of your career and staying in touch with those individuals throughout your career. The amazing people I met as a fellow have influenced and guided my career for over 35 years.

My fellowship opportunity paid the lowest salary of the options I had as a new graduate, but clearly was the most important and exciting opportunity. I have always advised new graduates to not worry about salary and title for their first job. The most important factors are having a great boss who is interested in you and a great organization that is values-driven and strives for excellence.  

Barry Arbuckle, PhD, CEO, MemorialCare Health System (Fountain Valley, Calif.). My first job following completion of my doctorate degree from the University of North Carolina was in the Children's Hospital at Long Beach (Calif.) Memorial. The position was a newly created one focusing on developing programs for hospitalized children and their families — and seeking grant support for those programs. That hospital — Miller Children's and Women's Hospital Long Beach — is part of the MemorialCare Health System where I have worked since.

It was a rewarding job to be sure.  However, as time passed, I offered to take on more and diverse responsibilities that effectively set the trajectory for where I am today: president and CEO of the MemorialCare Health System.

My first job had a marked influence on my work ethic. It taught me everyone in healthcare works a remarkable number of hours. However, one must always be aware of keeping some balance in life … or at least returning balance to life following the inevitable 70+ hour week.

New graduates should approach their first jobs as a remarkable opportunity to — as my mentor of many years is known to say — bloom where you're planted. Opportunities will follow from there. They should embrace the remarkable change the industry is experiencing as change always brings about opportunity for those who see it and seize it.

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