Living Like a Leader: A day with RWJBarnabas Health's Hospital Division President Thomas Biga


"I think it's critical to our well-being to decompress and let things go ... As I'm always telling my kids, you can't obsess over what you can't control. If something doesn't work and you can't control that outcome, you must move on. Otherwise, you get engrossed in what didn't happen and have trouble moving forward."

Between driving growth, meeting clinical objectives and navigating complex payer dynamics, there don't seem to be enough hours in the day for healthcare executives.

Leaders succeed despite these challenges, each with their own habits, hacks, styles and methods — and Thomas Biga, president of RWJBarnabas Health's hospital division, is no exception. 

In his role as president of the hospital division, Mr. Biga oversees operations at the West Orange, N.J.-based academic health system's 11 adult hospitals and four children's hospitals. This includes managing the clinical product lines at each facility.

Mr. Biga first joined RWJBarnabas Health in 1993, serving as vice president of operations at Long Branch, N.J.-based Monmouth Medical Center, one of the system's community hospitals. He was then appointed to CEO roles at three different system hospitals, including St. Barnabas Medical Center in Livingston, N.J., Clara Maass Medical Center in Belleville, N.J., and Irvington (N.J.) General Hospital.

Mr. Biga also has two kids.

Mr. Biga recently spoke with Becker's Hospital Review for our "Living like a leader" series, which examines influential decision-makers' daily routines to offer readers an idea of how they manage their energy, teams and time.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What is the first thing you do when you wake up?

Thomas Biga: I check my phone to ensure nothing happened at the system overnight. It puts my mind at ease and lets me know everything's running smoothly. If a situation requires my attention, it will be the first thing I do.

Q: What do you do before you get to the office?

TB: I have a 43-mile drive to work, so I use my commute as an extension of the workday. En route, I'll typically participate on conference calls, return voicemails or make other calls that allow me to be as productive as possible. The good thing about a long drive in today's world is, in some ways, it's irrelevant whether you're in the office or in the car — technology allows me to get so many things done before I get to the office, or wherever I'm beginning my day.

Q: What’s the first thing you do when you arrive at work?

TB: While I have an office in our corporate building, where I work varies depending on the day's agenda. As president of the RWJBarnabas Health Hospital Division, my role is unique in the sense that I'm not always in the same place. I'll often be back and forth between our corporate office and one — or several — of the system hospitals in one day, so my "office" can really be anywhere along 70 miles of the Garden State Parkway in New Jersey. Because there's so much variation in my schedule, a lot of what I'm doing daily is simply making sure I'm optimizing my time.

Q: How much time do you spend with your direct reports?

TB: My direct reports, for the most part, are the hospital CEOs and several service line executives. We're in touch on a regular basis, with formal group or individual meetings every other week and management operating reviews among the hospital C-suite executives at least once a month. There are many other ad hoc meetings and functions depending on current initiatives or discussions taking place, so it's certainly fluid each month.

My current role is much different than being a hospital CEO. I'm not leading the "daily huddle" at each hospital or spearheading local operations — that responsibility falls to each facility's CEO and leadership team, who oversee those day-to-day details. With such a large, comprehensive system as RWJBarnabas Health, there are geographical constraints to consider. I can't be at all our various hospitals all the time, but I do have multiple touchpoints each week with my direct reports.

Although I miss the local camaraderie and the family feel one gets when being immersed in one institution 24/7, my job allows me to impact the way many varied entities come together, operate and function as one system.

Q: How do you think your routine differs from other healthcare executives?

TB: I think the degree of variation in my routine differentiates it from other executive positions. My days don't follow one set pattern or formula because my responsibilities take me all over the system and all over the state. There's a level of flexibility that's unique, because much of my job is dependent upon the demands of the day and the specific needs of my direct reports.

Q: What is the hardest part of your day?

TB: It always depends on the issues at hand. I'm a morning person, so I like to do things earlier rather than later. Just today I had a 7:00 a.m. meeting, which is my preference. But because this is a 24/7 business, you need to accommodate the schedules of a variety of constituents from physicians who are seeing patients all day, to board members who are extremely busy, to employees on the third shift. So, the hours can be long and varied.

Q: What’s the most rewarding part of your day?

TB: When I can sit back and reflect on everything that's been accomplished that day, that week. There's never a shortage of things to be done, and some days are more rewarding than others. But the truly gratifying days are when we can see improvement in our core mission — improving the lives of the people in our communities. It's rewarding to see improvement in our high reliability patient safety metrics, progress in our social impact and community initiatives, or expansions of the system in a meaningful way. These expansions can take the form of new relationships, like our recent partnership with Rutgers University [in New Brunswick, N.J.,] adding new physicians to our network, creating new ambulatory facilities or enhancing services at our existing hospitals. When you see RWJBarnabas Health building an environment that expands services to our patients and communities — these are the days that I feel the proudest of the work we're doing across the state.

Q: What is the last thing you do before you leave your office?

TB: Before I end the workday, I lay the groundwork for the next day; organizing and determining what I'll need for whatever location I'll be in next. Preparing as much as possible the night before streamlines the process the following morning and makes the day run more smoothly.

Q: How do you unwind at the end of the day?

TB: I think it's critical to our well-being to decompress and let things go. At least until the next day or when you return from vacation. Over the years, I've gotten much better at compartmentalizing issues and not carrying them around as a burden. As I'm always telling my kids, you can't obsess over what you can't control. If something doesn't work and you can't control that outcome, you must move on. Otherwise, you get engrossed in what didn't happen and have trouble moving forward.

I'm not an avid golfer, and my game reflects it, but as they say: Your most important shot is your next shot. You can't obsess over the ball you just hit in the water. This principle holds true in business — and in life.

Q: How does your past experience inform your work today?

TB: I think it's very important if you're managing executives who run hospitals, that you've run a hospital yourself. That firsthand experience helps you appreciate what your CEOs are going through and understand on a deeper level the various issues they're dealing with. As the former CEO of three RWJBarnabas Health hospitals, I'm able to bring that personal knowledge to the role, which is critical for effective and empathetic leadership and is something that I believe resonates with my direct reports.

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