Responding to my blog article entitled, “Why do CEO’s get fired . . . ” Bill Eikost, a long time aquaintance of mine in a comment raised the following question:
“In one facility, the hospital had contracted with a large consulting practice to come in and do an assessment of the organization. As I understand it, when they made their presentation, which included some tough decisions be made, the board objected to it not being in the best interest of the organization or the community. Why have them come in in the first place then? The CEO supported the idea of the change but was met with resistance from his board. In almost all cases, I would bet the board wins. As a result, many of the senior leadership left and they brought in or promoted new leadership to continue the course. ”
I have been mocked for having epiphanies. People tell me they are tired of hearing some of the stories I use to make a point or illustrate a concept.
Recently, I have been dealing with some vexing problems related to matters beyond my control and entrenched, recalcitrant culture. It was during a personal low point of frustration, depression and demoralization about these matters that I had yet another of my epiphanies.
Heart surgeons regularly carry out miraculous interventions that result in people that would otherwise be dead walking from the hospital under their own power healing of their afflictions. One of the more difficult aspects of being a cardiovascular surgeon is case selection. CV surgeons and their practices are continuously evaluated by all sorts of local and national statistics. One of these statistics is mortality. What percentage of patients treated by this physician ended up dying? Talk about a Hobson’s choice! On one hand, the physician is motivated to do everything within his power to give the patient the best possible chance of survival. On the other hand, there are times when the probability of a surgical intervention being successful is nominal. A surgeon that is too aggressive taking high risk cases will have an above average mortality rate and be branded a bad doctor. Can you imagine what it must be like to look another human being in the eye and tell them, “There is nothing I can do for you.” The surgeon knows that putting the patient through a procedure would be unlikely to be successful but he also knows that he is in many cases effectively issuing that patient a death sentence. I could not do this and I have respect for these surgeons that I cannot articulate. I do not think I could do this and live with myself. The next time you see one of them, thank them for their service.
Getting back to my epiphany, some of the things needed to ease the stress on the organization were going to require some community leaders and Board members to step up to challenges and take on controversy they did not sign up for. Sometimes the easiest thing to do is nothing and if this were to occur, I was finished. I had reached the point where if this was to be the case, there was nothing more I could do for my organization (patient). In the middle of the night I awoke in a cold sweat when this realization dawned upon me. Suddenly, I had insight into what it must feel like for a surgeon to tell a patient they cannot be helped. If the resolve in the organization and the Board to take on the hard work was not there, I was done. It would make no sense to continue to play along burning up time and resources on a hopeless cause.
All of us have heard the admonition, “Do not go to the doctor unless you intend to do what he tells you to do.” Compliance in medicine is a huge problem. If I was at this point, I could easily log some more time but effectively it was over.
I have seen this phenomena before but I did not see it in this light. I have seen several organizations go through this process. In one case, an organization that had never had what I would describe as a professional materials manager expressed resolve to recruit one. An outstanding incumbent was recruited following a long, arduous retained search. And of course, less than six months into his run as he would say, “the defecation hit the rotary oscillator.” Seemingly over night, the organization that said it wanted a materials manager changed its mind when the realization of what actually having a materials manager really meant starting dawning. Sadly, the new executive’s tenure ended up being very short, his career and his family were disrupted and the organization went back to doing things as they had before. This was the first but certainly not the only time I have seen this happen.
Time for another digression. About the materials manager referenced above. His case is fairly typical. Sometimes the fit is not right but that does not mean the person is bad. While no one would recommend anyone going though a situation like the one described, the manager emerged from this trauma a better person for the experience, stronger, wiser and with a clearer vision about evaluating opportunities. He has gone on to have a distinguished career and currently holds one of the largest material management jobs in the entire healthcare industry and thank heavens, the two of us are still on speaking terms.
A lot of people say they want a lot of things until they fully realize what is involved or what the ‘desired’ change implies. For example, I described what it takes to obtain an advanced role in an organization in a previous blog article. A lot of people say they want the lifestyle and income that comes with higher level jobs until they find out how long and hard the road is to get there. Unfortunately, I do not know of any way to assess in advance the point at which resistance will be encountered or how it will be addressed.
In my recent personal case, I have seen support I would not have believed possible come to bear in an effort to achieve the favorable change for the hospital and the community that is there for the taking. You never know what people are going to do until the chips are down and the hard questions are on the table.
Kevin Rutherford, a trucker, radio commentator, author and producer of a trucking website ends his shows with the admonition to, “Do the hard work and master the journey.” I like to say that you will never find the walls unless you are willing to push the limits.
Success is not measured by how long you last in an organization. It is not measured by how good you are at ‘staying off the radar’ when the organization is seeking to improve itself. It is not measured in how adept you are at keeping your job. Success in my opinion is defined by the degree to which you demonstrate selfless leadership to take your area of responsibility to the next level. I have posed the pertinent questions before. Are you and your area an example of the best of their type in the industry? Are you an example of what others should aspire to become? Are you and your area an example of best practice? Is your expertise sought out by peers striving to improve themselves? Do you know what data is used to make these determinations? Do you compare favorably with all of the statistics available to evaluate your leadership? Are you taking initiative or are you waiting for someone to come along and tell you what to do?
An honest self-assessment is very difficult but in my experience, no one that was ‘left behind’ should not have seen it coming.
If you would like to discuss any of this content or ask questions, I may be reached at firstname.lastname@example.org. I look forward to engaging in productive discussion with anyone that is a practicing interim executive or a decision maker with experience engaging interim executives in healthcare.