I sometimes wonder if people think that I am hard on hospital leadership. I want to stress that there is nothing further from the truth.
The reason I talk about it from time to time as being somewhat different than almost anything else is because health care is a different animal than any other business. Whereas most of us get to decide which store we want to go into and when we want to go, and then purchase whatever we want to and go home, health care doesn’t work like that.
Why? Because other than the people who work there, nobody ever wants to go to either the doctor or the hospital. Even if you’re only going to a doctor for a physical, you’re basically taking yourself out of your comfort zone and going somewhere so that some person can touch you all over your body while you’re naked, and then make you get blood drawn or sit through an x-ray. Who thinks that’s any fun?
For the most part, it’s a flawed business model. Both hospitals and physicians often have to take chances with how they’re going to get paid. Sure, they can ask for co-pays upfront, and then bill your insurance company, but there’s no guarantee that the insurance company is going to pay the bill, let alone pay the bill on time. The expectation is great, but that’s about it.
Also, health care is the only business where you have a set fee for providing certain services that you’re never going to get paid by almost anybody. Insurance companies have fee schedules where they will only pay a certain dollar amount regardless of what you’re charging. The days where you got to bill patient’s 100% for services done, which has never been fair by the way, have changed to a point where almost all hospitals in the country now (if they have any sense) are discounting self-pay amounts in some fashion.
Finally, at least on the medical end, there’s this expectation by its consumers, aka patients, that everything is going to be 100% error-free, no mistakes, everything fully up to snuff. In health care that’s critical because even the smallest mistake could result in someone’s death; deal with that for a moment. However, everybody knows perfection is a myth, but that’s still the expectation.
This means health care leadership really has a lot of things on its plate. Add to that the problem of leadership skills and you’re faced with a daunting problem.
Patients don’t care so much about leadership skills, but hospitals need to. Hospitals need to know that they have hired not only people who are technically skilled, but inspiring leaders who can get their employees to do the best work possible while making sure that no shortcuts are taken, that everything is washed as thoroughly as it possibly can be, that patients are treated with courtesy and respect, and that their revenue not only maintains at a sufficient level but finds a way to increase.
As someone who has been in health care for more than 30 years, I know what the problems are but also know these are the types of things that need to be in place but aren’t. So I talk about it.
You know who always has leadership training? Chief executive officers, that’s who. And they should because the job they have is really difficult. Not only do they have to oversee all aspects of the hospital, but at varying times they have to be great politicians, cheerleaders, marketers, principals, number crunchers, teachers, and reporters. They have to work with a diverse group of people, sometimes stroking egos, other times laying down the hammer, but the buck always stops with them.
All other positions in the hospital? There’s no guarantee that any of them will have the proper leadership skills to get the right things accomplished. That sounds scary on the surface until you realize that most businesses and companies don’t have people in leadership positions with that skill. At least in health care the person at the very top has been given some leadership skill training; there are plenty of businesses that have a CEO who has never received any leadership training nor cares to. Also, at least in health care you know that every department director has some technical skill over a portion of their area… we’ll leave that alone for now.
I believe that no business runs well if its leaders don’t know the basic leadership skills it takes to work with other people. It might work well for a time, but it can’t sustain itself. Steve Jobs himself learned that lesson the first time he was let go from his own company, and even though when he returned he was still a driven man, he had learned some humility and that it was better to work with people than it was to try to do bully them into doing it his way.
So, it’s not that I pick on leadership in health care as much as I advocate for better leadership in health care. Based on what I’ve seen over the years, I don’t think the message gets through.
Whenever you take sales training, those folks are always saying that sometimes it takes as many as 16 initiations of conversation with prospects to get them to even notice you’re there so that you can begin the process of trying to market to them. I’ve spent portions of the last 13 1/2 years on this topic because I’m hoping that more people at the top levels of health care leadership will hear this message, understand it, take it seriously and then hopefully work to do something about it.
In today’s climate health care is taking a beating in the public eye. In my opinion, having more leaders who know how to lead rather than just how to technically take care of things can go a long way towards eradicating many of the issues. Empowering more people and getting more ideas for improvement is always the best way to go.
After all, the best people to help get things accomplished are the people who are already doing it on a daily basis. But if you don’t work with them they’re just going to stay silent, and leadership can’t fix things if they don’t know what’s broke.
Who out there really think this is unreasonable? I hope to hear from you as well as the people who think I might be onto something.