HealthCare Voice

He Has Reached Rock Bottom And Started To Dig...

DALLAS, Texas (April 23, 2009) -- Much has been written in the past year about leadership in healthcare. With the economic crisis continuing to batter the financial performance of many U.S. hospitals, I am willing to bet much more will be written over the next several months.

In my role as an executive search consultant working on C-suite engagements, I am beginning to believe that our little economic mess is setting the stage for a fundamental shift in the competencies and style of the leaders who will be successful as we emerge from this havoc, hopefully in early 2010. I think this experience will impact the way all of us look at our responsibilities and our level of accountability.

Enough of the serious ideas for today. In every serious conversation, there is a moment when a break is necessary – to allow us to sit back and poke a little fun at ourselves. This is one of those moments – hopefully!

In Andrew J. Harvey’s gutsy new book, Leadership: Texas Hold ‘Em Style, he provides some sample evaluations of leaders from the files of the British Royal Navy.

1. “His men would follow him anywhere but only out of curiosity;
2. This officer reminds me of a gyroscope – always spinning at a frantic pace but not really going anywhere;
3. Since my last report, he has reached rock bottom and started to dig;
4. He sets low standards and then consistently fails to achieve them;
5. This pilot should not be allowed to fly below 250 feet;
6. Works well when under constant supervision and cornered like a rat in a trap; and
7. This man is depriving a village somewhere of an idiot.”

After scanning through the first chapter, I have added this one to my “must read” list and I have added it to my recommended book list with a link to Amazon.Com on the right column of this blog.

John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry. You can reach John at [email protected]. His office number 214.220.1234. You can also follow him on Twitter.

The Role Leaders SHOULD Play

SAN FRANCISCO (April 16, 2009) – Long airline flights are conducive to swollen feet and great periods of reflection. I have been thinking a great deal about the important role that leaders play in moving their organization to best-in-class status. Or, the blame they deserve when their organization’s fail to deliver.

For health system or hospital Chief Executive Officers, best-in-class performance means meeting a robust set of standards for patient care quality, safety and the satisfaction of their customers – from the physicians, their patients as well as family members. The best of the best organizations also focus an enormous amount of energy and resources in achieving through-the-roof scores for employee satisfaction.

Let’s be clear. When we talk about best-in-class performance, we are not talking about best effort. No, we are talking about a record of consistently delivering perfection in patient care, safety and customer satisfaction, or as close to perfection as humanly possible.

This type of extraordinary performance does not happen by accident. The CEOs who hope to get anywhere near this level of accomplishment must build exceptional teams who are passionate about this vision. Then, the CEO must champion significant investment in education and development – in the current bad times as well as the good. Without this type of investment in human capital development, best-in-class results cannot and will not occur.

A great many CEOs, when pressed on the issue will most certainly boast that they spend an enormous amount of time on developing their people. OK, let’s face it, far too many CEOs – a startlingly high number – are blowing smoke. The clinical quality and poor financial results just do not support any other conclusion.

There are two ways to ferret out truth from fiction.

1. Does the CEO (and the CFO) view spending money on developing their leaders and managers as an investment or an expense? Again, one only must look at how little is budgeted for human capital development at so many hospitals. This certainly helps explain why we have so many continuing problems with quality care and safety, including preventable deaths. I do not mean to unfairly demean, but is there any other conclusion?

2. In his wonderful book “Talent Is Overrated,” Geoff Colvin writes that companies like to brag about their commitment to human capital issues. Colvin quotes Noel Tichy, a University of Michigan professor and top authority on this subject: “Testing their commitment is easy. Just show me the CEO’s calendar."

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is a Co-Founder of the Firm. A former investigative reporter and crime writer with more than 30-years of leadership experience in public relations, national marketing and business development and as Chief Executive Officer of hospitals, and consulting firms, Mr. Self is highly regarded for his keen insight into business culture and the types of leaders who will succeed. You can contact Mr. Self at 214.220.1234 or [email protected]. Or you can follow him on Twitter at Self_JohnMarch.

Business Lessons From The New York Times

SAN FRANCISCO (April 14, 2009) – Here are three great business lessons I gleaned from this Sunday’s New York Times.

First, Terry J. Lundgren, Chief Executive Officer of Macy’s told Times business writer Adam Bryant that early in his career – as a management trainee at Bullock’s department store – he was assigned to a buyer who delegated jobs that Mr. Lundgren believed were stupid, menial tasks. In visiting with the corporate recruiter who brought him to Bullock’s following his graduation from college, Mr. Lundgren outlined his frustration and asked to be transferred to another department where he could do more. “The corporate recruiter just nodded and then pointed over his shoulder to a poster. It had a little tree in a pot., and it said, ‘Bloom where you are planted’.”

I wonder how many administrative residents and fellows who are now beginning their healthcare careers this summer will need to be reminded of this lesson at some point over the next year?

Second, John C. Bogle, a stellar money manager and founder of the Vanguard Group and one of the few moral authorities left standing on Wall Street following the recent carnage, argues that America is anything but an ownership society. Instead, he believes that America has deteriorated into an agent society – we have turned over our savings to mutual fund agents who are afflicted with a conflict of interest.

Speaking to Gretchen Morgensen, the outstanding columnist for the New York Times business section, Mr. Bogle questioned “how so many highly skilled, highly paid securities analysts and researchers [could fail] to question the toxic filled balance sheets of Citigroup and other leading banks and investment banks?”

Ms. Morgensen, a champion of shareholder and investor rights, points out that these failures occurred in spite of the Investment Company Act of 1940, which states that “mutual funds should be managed and operated in the best interests of their shareholders rather than the interests of their advisers.”

Mr. Bogle suggested that one should not ignore the fact that many of these fund managers operated with multiple conflicts of interests – their fees for mutual funds were significantly higher than those they charged to pension funds and that many of these fund managers worked for public companies whose stockholders were pushing for (read: demanding) higher returns.

Mr. Bogel believes that we should force our agents to relearn what a fiduciary means. We need to become a fiduciary society, Mr. Bogle argues.

“A fiduciary, these managers seem to have forgotten, acts for the sole benefit and interest of another,” Ms. Morgensen writes.

However, alas, Ben Stein, a conservative writer and television personality who pens a periodic column for the Times’ business section, seems to be focused on the real reason for all this turmoil and unprecedented loss of wealth. His is the third lesson from the Sunday Times.

“I know people and I know money, at least the basics. Wall Street knows how to get its hooks into government. This is how the world works. Money talks.”

Now a fourth lesson. Consider it value-added wisdom. To paraphrase several authorities – from Ayn Rand to the Bible: Money is the root of all evil, but man needs his roots.

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is a Co-Founder of the Firm. A former investigative reporter and crime writer with more than 30-years of leadership experience in public relations, national marketing and business development and as Chief Executive Officer of hospitals, and consulting firms, Mr. Self is highly regarded for his keen insight into business culture and the types of leaders who will succeed. You can contact Mr. Self at 214.220.1234 or [email protected]. Or you can follow him on Twitter at Self_JohnMarch.

Employee With The Box: Another Economic Statistic

DALLAS, Texas (April 4, 2009)- As I entered the elevator yesterday for the quick 39-floor ride to the lobby of my office tower, my only fellow traveler was a young woman holding a white document storage box – the kind employees use for their personal possessions when they leave the office for the last time.

The expression on her face clearly telegraphed feelings of apprehension and sadness. No tears. Just a look of abandonment and probably the realization that she had just become another statistic in America’s severe recession.

These are times that try men’s souls and, sadly, spur sales of these little boxes.

Over the past couple of weeks, I have seen increasing numbers of people in elevators and walking through downtown Dallas carrying these innocuous boxes that seem to scream: I just lost my job!

Yesterday, while driving to a marketing strategy meeting, I thought about that young woman in the elevator and the more than 663,000 other nameless and faceless souls who lost their jobs in March. Losing a job based on poor performance is one thing. Anger is usually replaced with resolve and, within months, a new job. Losing a job caused by poor policy, political miscalculation or the leadership mistakes of others is another matter.

In a deep recession, there is shock, sadness and fear. The victims know that the number of available jobs is shrinking each week. Some industries are hiring – healthcare included – but even the so-called recession-resistant sectors cannot absorb these kinds of unemployment numbers.

There are no quick simple fixes for this mess. I believe that the economy will get worse before it gets better. There will be more months with equally staggering job loss numbers.

There is a growing sense among employees that they are virtually powerless to avoid the consequences of this economic train wreck. However, I would like to suggest that if you have a job, focus on your performance and the value you contribute to the enterprise. Do not become so obsessed with keeping your job that you forget to DO your job. If you are not a team player, it may be too late, however, you might want to quickly convert to that religion. Be flexible. And unless you are bullet proof, update your resume.

One last piece of advice: When you see people carrying these little boxes – leaving their job for the last time -- keep a good thought for them. Abandonment and fear are two emotions not easily overcome. Household expenses – mortgage payments, credit card bills and the cost of utilities, food and care for the family – do not stop.

John G. Self is Chairman and Senior Client Advisor of JohnMarch Partners. He is a Co-Founder of the Firm. A former investigative reporter and crime writer with more than 30-years of leadership experience in public relations, national marketing and business development and as Chief Executive Officer of hospitals, and consulting firms, Mr. Self is highly regarded for his keen insight into business culture and the types of leaders who will succeed. You can contact Mr. Self at 214.220.1234 or [email protected]. You can follow John on Twitter.

Healthcare Leadership, John Griffith and Much More...

ANN ARBOR, Michigan (March 19, 2009) – One of the great parts of my job is speaking to healthcare executives, early careerists and graduate management students across the country. For me, the real value is the opportunity to spend time with some very bright people like Dr. Christy Harris Lemak and discuss how we can improve our leadership and the performance of the organizations that we lead.

Today I spoke to a large group of graduate students at the University of Michigan’s top-rated health services administration program – the home of the legendary John Griffith, teacher, mentor, author, and renowned thought leader on the management of healthcare organizations. In so many ways, for so many years, Professor Griffith has set the standard for educating future healthcare leaders and for setting important standards for running a well managed hospital.

The University is paying tribute to his accomplishments through the development of the Griffith Leadership Center that will focus on health management and policy. Linda Grosh, the Center’s Managing Director, and other faculty members are planning some exciting and innovative initiatives. I will not step on the Center’s public relations thunder because so much of what they hope to do in the future is in active development. Suffice it to say that I think this Center will become an invaluable resource for healthcare CEOs who seek to adjust their leadership styles, values, and priorities to the varied challenges that will change and/or intensify with lightning speed during the span of their careers.

The University of Michigan is working hard to educate exceptional graduates – our future leaders – who will be less siloed, who will be more aggressive in challenging accepted systems and outcomes, and who will see opportunity that no one else sees. How timely, since we cannot afford to operate the world’s most expensive healthcare system with clinical and safety outcomes that are far from cutting edge.

In our world today, hospital CEOs are frustrated, doctors are unhappy, and employees are stressed. The current economic peril in which we find ourselves threatens to blur our focus on improving quality and ensuring safety. To make matters just a bit more interesting, business leaders, unions, pro-business trade groups and even industry insurance lobbyists all now agree that we can no longer afford our brand of healthcare. To make matters more interesting, some members of Congress seem to be trying to exert more control over the solution.

So to the many students and healthcare professionals that I have seen this year, and to the hundreds more that I will meet next week in Chicago when I speak at three sessions of the American College of Healthcare Executives annual Congress, I urge you to think critically about how we can reform our industry in a way that improves quality, safety and access while reducing costs. Speak out here, on the HealthCare Voice site, or any and all available venues. Please do not stand on the sideline while our trade association policy gurus, the Washington policy wonks, economists, business roundtable types, unions,insurance lobbyists and the other usual cast of suspects make decisions concerning the structure, delivery, and reimbursement of healthcare.

The vast majority who will weigh in on healthcare reform have never taken care of a patient, run a hospital or a long term care facility or managed a medical practice. It is extremely important that the aforemention list of healthcare reformers listen carefully to those of you who are in the trenches – those of you who can make considered and thoughtful recommendations.

John G. Self, Chairman and Founder of JohnMarch Partners, is the Firm’s senior client advisor. A 32-year veteran of the healthcare industry, he is a former investigative reporter and crime writer for a major daily newspaper. Candidates and clients say he is one of the most thorough executive recruiters working in the healthcare industry. You can reach John at 214.220.1234 or email him at [email protected].