For several years I have been writing about hyper competitive markets and the impact the intense competition for patients, physicians, and skilled workers has on leadership.
Now there is a new term being floated by a growing band of outspoken leaders and patient advocates concerned with the state of US healthcare — hyper accountability. Our costs are too high and our quality of care and patient safety, two important measures of how we are performing, continue to be a problem despite the industry spend of hundreds of millions of dollars to reverse these troublesome trends. There seems to be an undercurrent within the industry that these issues are just part of the cost of being in the business of healthcare.
Last year, in a speech to more than 350 healthcare leaders, that is precisely the reception I received — they were polite, they seemed to enjoy the talk, and said so afterward, but then they moved on. This is a fairly typical response, I am told by those who have far more experience in this field than I.
Why do we appear to be so numb to this very serious problem?
We put more effort into meeting financial targets than making meaningful inroads to improve quality and reduce the shocking number of preventable deaths that occur each year in hospitals across this country.
Hospital CEOs and senior leaders are fired all the time for missing their financial numbers, said a long-time friend who has run major hospitals and is now teaching and consulting. Being fired for missing your quality or patient safety targets — that is to say delivering care that is substandard or outright dangerous — is very rare, especially in the investor-owned hospital world.
“There is no resounding industry outrage over this very serious issue,” said a patient advocate who has been “harping about this for years. I know this sounds harsh, but I sometimes wonder if what we are really saying is, let’s pretend this didn’t happen.”
© 2015 John Gregory Self
Now, here, you see, it takes all the running you can do, to keep in the same place.
If you want to get somewhere else, you must run at least twice as fast as that!
The Red Queen, Alice Through the Looking Glass
The vast majority of healthcare executives I have interviewed do not see themselves as entrepreneurs. Innovators, turnaround experts or change agents, but an entrepreneur? Definitely not!
The definition of an entrepreneur is “a person who organizes and operates a business or businesses, taking a greater than normal financial risk in order to do so,” according to Dictionary.com.
If you look at the characteristics of a successful entrepreneur, especially those who launch innovative start-up companies, they recognize the enormous risks, that the odds are against them — if you look at the number of failed startups each year — and that these ventures require an enormous amount of physical and mental energy, hard work as well as long hours.
To succeed, most entrepreneurs understand that they have to put the business and its needs ahead of all else. The serial entrepreneurs who have launched more than one successful business, typically will confide that it must be all about the idea, the concept, serving customer needs and the bottom line success, not someone’s inflated self importance. There is no safety net — aka severance – for these executives. The smart entrepreneurs who are afraid of failing typically run twice as fast, and most go twice as far. Fear for these people is a potent motivator.
For all those executives who push back against being called an entrepreneur, I want you to consider this: You are, in fact, an entrepreneur over at least one aspect of your professional life: career brand. Here you work for yourself (and your family). You do take risks in how you position yourself reputationally by the jobs you choose to take on (yes, for a salary) and, despite the salary, still being exposed to the significant risks of failing, especially when an industry is experiencing a transformative shift in the business model as is the case with healthcare today.
Moreover, I would argue that in this period of unprecedented change, salaried healthcare executives would be better off if they approached each salaried job as an entrepreneur, at least when it comes to the part about a passionate commitment to the concept (the mission and vision of the organization), serving customer needs (better quality, improved safety and satisfaction at a lower cost), and bottom line results (profits or retained earnings).
When executives incorporate the spirit of entrepreneurship into their leadership style, their organization, and the communities they serve, will be better off. And so will their careers.
Become a better entrepreneur in your career. The financial security is not always what it is cracked up to be and you will probably go twice as far.
© 2015 John Gregory Self
TYLER, Texas — I am here meeting with contractors regarding the reconstruction of my home. For those of you who have not been following this ordeal, a very, very large tree inflicted major damage to my house on Memorial Day. It is amazing how time consuming an insured loss can be. The adjusters and the contractors have made a lot of progress but it is not moving as fast I want it to move.
When you experience a huge loss, in my case, property — and we have excellent property/casualty insurance through Kemper which has been unbelievable in their customer service — you can appreciate how a person feels when his or her career/financial livelihood has been uprooted. It’s shocking, and nothing moves as fast as you want it to — the house repair, or the job search.
As I absorb this upheaval in my life — all our personal belongings in storage and living in a temporary condo (the active word being temporary), and not really knowing how long any of the reconstruction will take — I have been thinking a lot about the hundreds of candidates I have interviewed who have found themselves in career transition – in a massive life transition – far greater than mine.
They usually do not have a superb insurance company like Kemper backing them up as I do, and it is easy to understand how panic can set in. In my case, I know exactly how much I am responsible for. For a candidate who has experienced several job rejections and sees his severance quickly evaporating, there is no certainty and little comfort.
Disruption, the destruction of your home, or the loss of a job, is terribly unsettling. Throw in the uncertainty of healthcare reform on the job loss side, and you have an unholy, uncomfortable reality.
When you loose your job in the face of unparalleled industry change it is a fast way to develop high blood pressure. If you are one of those people who doesn’t embrace change, the pain is just that much more daunting.
I am one of the lucky people. I love change. I did not like seeing a large part of my house obliterated by this huge tree, but I quickly processed the event: I knew that I had excellent insurance with an incredible company. While all of this has been disconcerting, I have been able to put the management of rebuilding my home in the hands of my highly knowledgeable and compassionate claims adjuster as well as the skilled construction company and focus on my business and the other parts of my life. I am able to trust that the house is being taken care of.
The truth is that many executives, even those with good severance benefits, have enormous emotional difficulty when they experience a disruption in their professional lives.
A tree has crushed their career house at the same time business reform has destabilized the job markets. For those who sit around waiting for people to offer them a new opportunity, most will be disappointed. The job market rules have changed. It is up to the individual to pursue his or her next opportunity. It is up to them to manage their career dreams.
I may have many weaknesses but the one thing I do well is excel at dealing with change. For me, if change is in the middle of a busy freeway, I am the guy dodging traffic trying to understand it and trying to understand how I can benefit from it.
Behind the upheaval, there is always opportunity.
© 2015 John Gregory Self