The problem of stuffy hospital CEOs

Rather than pay, tenure or organization size, one determinant of hospital and health system leaders deserves outsized importance: their humanity. 

No one who leads or operates a hospital or health system wakes up in the morning and chooses to be out of touch, dull, overly regulated or a walking font of corporate-speak. Instead, these regressions likely occur over time and are influenced by the close company one keeps, ego, and connections — or lack of — to one's community, among other things. 

While becoming out of touch has always been a risk for people who sit in positions of power, tolerance for arrogant leaders will only diminish in a time of heightened scrutiny of CEO earnings and hospitals' nonprofit status, a delicate workforce that is continuing to eye the door, and needed focus on health inequities that have persisted and are even worsening

The problem stands to compound the problem. If leaders are out of touch to start with, there's no promise they'll read the room now and course-correct. Here's how that could play out: the stuffy CEOs will get stuffier and the down-to-earth servant leaders will only command more attention — deservedly so. 

Ivory towers aren't inevitable. Some health systems are fortunate to be led by people who hold meetings in diners to level the playing field, refuse to accept the office furniture upgrades that come from the promotion of senior vice president to executive vice president, wear sneakers with suits, write handwritten thank-you cards, give credit always, condemn all-talk, no-walk posturing, broach difficult topics and conversations with front-line staff and, most importantly, see their job as ensuring that healthcare providers have what they need to do their job and do it well. Everyone can lead this way if they choose.  

Here are a few ways the out-of-touch and grounded leaders stand apart: 

1. How they talk about their vulnerable patients. Out-of-touch leaders tend to discuss them with a tone of otherness or paternalism, sharing stats like 56 percent of Americans being unable to cover an unexpected $1,000 bill as if it is shocking. Or perhaps they latch onto one patient story to illustrate challenges people face in navigating our dysfunctional healthcare system. A single mother working two jobs missed a doctor's appointment? No kidding.

Down-to-earth leaders, on the other hand, don't do much hand-waving around patients' limitations or disadvantages. They treat cultural competency as an inherent responsibility, and see patients who are poor, non-English-speaking, uninsured or underinsured, isolated, technologically challenged or experiencing other vulnerabilities in the center of what they do — not on the fringe or in the category of "other." Instead of seeing their role as alerting others to their existence, down-to-earth leaders put their energy toward serving their communities with more inclusive and accessible healthcare. They have a wide range of programs and initiatives their organizations have enacted to better reach people, and results to show for it. Their actions far outweigh their words. 

2. The questions they answer and the questions they dodge. Every leader has a ratio of the number of questions they squarely answer and those they walk around. Media is in a privileged position to get a sense of this, whereas front-line employees may have fewer glimpses into it unless leadership routinely rounds or conducts town hall meetings. Out-of-touch executives indirectly answer questions, require preparation or previews, or lean on talking points that are saved in a Word file. At a certain point, it's understandable if people feel executives are paid too well to not answer a question. It's a shortcoming that's difficult to justify. 

Down-to-earth leaders come to play. If they don't have an answer, they look into it and find out. Their answers may not be the most eloquently phrased or coin a trademark, but they address the question. Their response may change as they learn more or as events transpire. Their approach is undeniably human and a good-faith effort to show their cards. It's a big part of how they earn trust. 

3. How seriously they take themselves. Healthcare is not the most welcoming of spaces. Between the advanced degrees and education required to work in it, the longstanding and futile complexity in how it is regulated and financed, the deterrents from cost to wait times for people trying to access it — there are a lot of barriers to entry. The last thing we need is leaders who exude the same effect by being unrelatable and perpetually an arm's length away.

Self-effacing leaders go a long way in healthcare, the ultimate team sport. They recognize their limitations, faults and idiosyncrasies. (Spoiler alert: We all have them.) They welcome devil's advocates and hole-poking to their thinking before getting too far ahead of themselves. They talk openly about their mistakes and mistrials, and deal productively with disappointment. They genuinely connect with others and have an easy time building relationships. They take their work seriously, not so much themselves. 

Importantly, grounded leaders recognize the problems healthcare faces are too big and thorny for any one person or group to go it alone. They do not see themselves as the sun with everything revolving around them, and instead build strong coalitions, teams and the leaders who will succeed them.   

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