Find the source. Listen. Intently.

A month ago, a fellow MHA friend told me about a conversation he had on the golf course with a current MBA student.  Though not friends, it turns out the two had something in common: they were both interested in jobs in the health care field.  The MHA friend then asked the MBAer, “Why health care?”

The MBAer’s response?  “For the money.”

Insert appropriate jaw drop here.

The above conversation transpired around the same time of a couple of synchronistic news stories.

Ohio execs sentenced for $1.9B fraud

Memorial Regional Hospital Administrator Resigns

3 Southern California hospitals accused of using homeless for fraud

The shady dealings of some health care leaders prompted a few blogosphere conversations (as well it should) on the poor decision making skills of accused (see above) leaders.  Not everyone puts the needs of patients first, occasionaly money gets in the way.

Much of the debate surrounded a licensure process for hospital CEOs.  While that type of credential is unlikely to keep out fraudulent individuals, it would provide a base level of knowledge for health care executives.  And isn’t that what a license is all about anyway, knowledge?  If that’s the case, then we already have a process in place: Fellow of the American College of Healthcare Executives.  If it is a “board certified” CEO that a hospital seeks, requiring that individual to be a Fellow of ACHE seems to be a solution.

But that doesn’t solve the general problem of improving decision making as a leader.  A lack of knowledge  is a factor in poor decision making.  We know that the complexities of both medicine and health care are tremendous—it seems nearly impossible to expect any one person to be well versed in both.  While I have no statistics to back this up, my assumption is that the physicians who do decide to take on executive roles often end up dedicating the majority of their time to the business role over the clinical role.

This is how a hospital should work: physicians have knowledge of the business side and the business people have knowledge of the medical side.

One of the solutions proposed in the Health Beat post is this:

In an article titled “Physician as Hospital Chief Executive” published in Vascular and Endovascular Surgery earlier this year, Robert E. Falcone, MD Bhagwan Satiani, MD, MBA, go a step further, suggesting that, perhaps, the management of medical care is so important that it should be left to doctors.

I don’t think that is necessary.  But it is imperative that health care leaders (the ones without medical degrees, me) be able to completely understand both the business and medical ramifications of a decision.  But how?


A former summer job (laborer) taught me an important lesson on the power of a can of soda on a hot day.  It does two things: 1) breaks down barriers and 2) provides an insightful look at the front line.  The lesson: given the opportunity and due respect, people are more than willing to explain what is important.  But you have to listen.

Instead of perching in a top-floor office find the information necessary to make an intelligent decision that balances the needs of all stakeholders.  The “power-of-one” observation is a principle of former Medtronic CEO Bill George.  The system often gets in the way of successful communication.  The importance of some decisions is such that the only information that matters is straight from the source.

As written in “How the Wise Decide:”

What George and other leaders who diligently practice the principle of Going to the Source understand is that firsthand information is the best information. It is unfiltered by others, it provides subtle details and nuances that are lost in Power Point presentations and, most important of all, it shows us reality in all its messy details and emotion. Without face-to-face encounters with the people who are driving the future of your business, you will miss out on the power of emotional input.

How did he make it happen?

Bill George knew the tremendous value that derives from making power-of-one observations. In any given year he spent an astounding two thirds of his time in the field gathering first-hand information. Not many CEOs can find a way to do that, but George set up a senior management team that took care of other matters to allow him to get out of the office.

Read about Mr. George’s “power-of-one” observation here, here, and here.

Find the source.  Listen.  Intently.  So we can avoid future iterations of this.