July 19, 2024 • 36 mins
Summary
Dana Oaks, a former hospital executive, shares insights on making work better in the healthcare industry. He emphasizes the importance of caring for employees and showing them that they are valued. Dana believes that a leader's role is to curate, uplift, and maintain a culture of excellence. He shares examples of how he personally connected with employees and patients to build trust and create a positive work environment. Dana also discusses the challenges of being a CEO in the healthcare industry, including dealing with regulations and unexpected issues. He advises future executives to understand the sacred privilege of working in healthcare and to prioritize taking care of people.
Takeaways
- Caring for employees and showing them that they are valued is crucial for creating a positive work environment.
- Leaders should curate, uplift, and maintain a culture of excellence.
- Building trust with employees and patients is essential for effective leadership.
- Dealing with regulations and unexpected issues is a challenge for healthcare executives.
- Working in healthcare is a sacred privilege that requires prioritizing the care of people.
- "Caring needs to be visible to the employees and team members."
- "Building trust with employees and patients is crucial."
- "Difficult tasks become easier with practice and finding your own style."
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:08):
Welcome to the Make work, WorkBetter podcast,
where we delve deep into the minds
and experiences of some of the mostinspiring leaders in business today.
We are your hosts, Mikayla Wallace and Dr.
Marc Reynolds.
We are thrilled to introduce youto our special guests, Dana Oaks.
Dana, thank you for joining us today.
(00:29):
Well thank you.
It's a pleasure to be here.
Dana, tell us a little bitabout your career journey.
Sure.
So my career primarilyhas been as a hospital executive.
I went to the University of North Carolinaat Chapel Hill for my graduate school,
did a master of healthcare administrationthere and a an MBA.
And that set me up, to start with HCA.
(00:51):
I was with HCA for 14 years.
They're the largest hospital companyin the United States
and a very good placeto learn hospital operations.
They do it, very, very well.
Have been at it for over 50 years,
and it was a great place to learn froma lot of wonderful, seasoned executives.
And following my time, at HCA,I went back to work with,
(01:15):
a former boss of minebefore I went to graduate school.
And he was running a lot of turnaroundoperations
for rural hospitalsand formed a company called the RH.
And within RH, I was given, the title,President of operations.
So I was running the company five monthsinto that journey, the pandemic hit
(01:35):
and we had big plansto expand our operations,
and that really curtailed those plans.
And we were just tryingto keep those hospitals afloat.
And we had some very good executivesat the helm of those hospitals.
And I got to work with, local boardmembers, who were members of the community
who were doing a great job at tryingto keep their hospitals in the community
(01:58):
going and servicing the needs,which were a lot more extensive
than they had been prior.
because local communities had to manage
a lot tougher, more acute patientsthan they were used to managing.
So we had a lot of patients on ventilatorsand in smaller, rural hospitals,
they were not used to that.
So I had five, rural hospitals and then abehavioral health facility in Las Vegas.
(02:20):
And we had plans to expand and growa lot more facilities out west.
And that didn't end up happeningas a result of the pandemic.
And in the end, several of the partnersdecided to go different ways.
And I ended up at a university.
They asked me at the university,
in the town where I grew up,it was called Utah Valley University.
If I'd come and help themhead up a healthcare
(02:43):
administration emphasiswithin their MBA program.
And that sounded exciting.
And they said, also,
we want you to stay currentand keep doing things in healthcare.
So I got into,being a co-founder of a startup,
which is an AI medical scribecalled scribematic.
And I'm having a blast doing that, becauseI get to keep working with physicians
(03:05):
and the latest and greatest stuffthat's going on in health care.
So it keeps my teeth sharpand we're having fun.
What is itthat got you into the medical side?
What is it that you loved about it?
You stuck with it too.
So what is it that drives youthat gets you up in the morning
to want to keep doing that?
Really, it's about the patient. For me,it always was.
I, I cared deeply about the patientexperience.
(03:29):
That'sbeen the highlight points of my career,
have been surroundingthe people that I work with,
taking care of the people that I work withand taking care of the patients.
And I think it's a pretty tough careerif you don't feel that
because it's full of regulation,there's tons of pressure from every angle.
You're serving multiple masters,and if you don't, at the end of the day,
(03:51):
feel some satisfactionas a result of helping the patient,
then it's going to be pretty rough seas.
From my limited knowledge,sitting as an administrator
of a hospitalwould be a really tricky spot to be.
You have doctors that are come fromall ranges of humility to zero humility.
you have everything from,
(04:12):
you know, patients who are grateful tothose that are really upset
and disgruntled and traumatizedby whatever they've experienced.
and a lot of moving pieces of technologyand people and and stuff.
That's a lot to manage.
Yeah, it is, it is a lot to manage.
And, you know,I'm sure there are physicians out there
that would say the same sorts of thingsabout administrators
that some of us have zero humilityand some have a lot of humility.
(04:35):
I heard somebody say once, if you've metone doctor, you've met one doctor.
I tried to remind physicians toosometimes if you've met
one administrator,you've met one administrator.
Yeah.
What are some of the lessonsyou've learned about how to make work work
better for yourselfor teams you have worked with,
or that have workedunder your stewardship?
(04:56):
What a wonderful question.
There are so many lessons.
There are too many to recount,but the biggest thing I learned
was that you have to careabout your people
and that caring needsto take the form of something
that's visible to the employeesand the team members.
They can't assume, or will not assumethat you care about them
(05:18):
unless you show themthat you care about them.
One of the ways that I enjoyed doingthat was going to the spaces
where people work.
So if I wanted to meet with somebody,I would often arrange for that meeting
to be in that director's officeor in the physician office.
I spent a lot of time getting in the carand going out to visit with my physicians
when I was the CEO.
(05:39):
I would get to know their officestaff, the places where they worked,
and they would usually comment that
that meant a lot to them,that if I wanted to have a meeting
they weren't expected to come tomy office, but I would go visit with them
and sometimes just even popping into see if they needed anything.
and then I would write things downand make sure the next time I went,
(06:00):
if they had a concernthat I had resolved it for them
and I could reportback of what I had done.
I took the time when I was newas a hospital CEO.
My first hospital CEO job was in 2011,
and I sat down with eachand every one of the directors
in the hospital and got to knowtheir pain points and challenges.
And and then we did a daily huddle.
(06:23):
And in the daily huddle,we would spotlight people who were doing
a good job on the thingsthat mattered to me, and to us as a team.
And one of those things was the mission.
HCA has a great mission statement,and it's, it starts out above all else.
We are committed to the careand improvement of human life.
And so we would have missionmoments, things that we would,
(06:45):
highlight peoplefor, their adherence to the mission.
This is sometimes come inthe form of patient compliments.
Sometimes these were, other employeescomplimenting the employee.
There would be notes and things,
and that meant a lotto the fellow employees to be spotlighted.
And then they knowthat you care about them.
You care about the work that you're doing.
(07:05):
And I used to get up and spenda lot of time outside of my office
just rounding and thanking peopleand telling them they did a great job.
And I also enjoyedvisiting with the patients.
So, one of the things that I would dois stop off at the nurses stations
and ask if there was any patientin particular could use a visit.
Now that could havegone in very different ways.
(07:28):
so if the nurses were intimidated by me
or my position as the CEO, they could havesaid, you know, visit, Mrs.
So-and-so or Mr.
So-and-so because they knew thatthat person would have a compliment.
But I, I felt very gooda few times when the nurses sent me in
(07:49):
to some of the battlesthat they were fighting,
with very difficult patientsand difficult patient satisfaction
issues or things that we had messed upand gotten wrong as a hospital,
and they felt confident enoughto send me in there
to apologizeon behalf of the hospital or to,
utilize my position as a team memberand administration to make things right.
(08:10):
And what that said to mewas, they trust me,
they respect me, and they know that
I have their back and they're not goingto get in trouble for this.
And I took that as a high complimentwhenever they would send me
into a troubled situation.
Let me recap what I'm hearing here, andthen feel free to correct me if I'm wrong.
So what I'm hearing hereis, number one counterculture move
(08:31):
and not playing the power gameof having them come to my space,
my territory, but insteadGoing through that effort and taking the
risk of going into their home turfas an effort to show them that you care
and you value them feeling seen and heard,and that that is an important thing.
It’s worth your effort to take the timeto see them in their element.
(08:54):
So that's a hugethat's a huge piece of what I heard.
That's that's amazing.
Another counterculture movethat I'm hearing you say here
is that you would go see patientsand not only would you see patients
but you wanted to be challenged to put itin the place where you could do the most
good and help patientsfeel seen and heard.
Right?
(09:14):
Correct.
So, so that you're goingthrough all these things
and you as executive, have madeall your choices about other people
and help them feel safe, loved,heard and valued.
That's not necessarilya typical executive mindset.
Now, there there are executives out there,and I've been fortunate to work
with a lot of amazing onesthat are humble and
(09:37):
and have that kind of servant leadershipBut what is it
that kind of puts you in that directionthat made you committed to that?
Well, that's a great question.
Part of it is a strength.
And the strengths can be overusedstrengths. Right.
Sometimes your greatest strength can beyour greatest weakness when it's overused.
(09:57):
And I feel like I was wiredto just care about people.
And that made it very difficult for mewhen we had to go through things
like layoffsor had to do disciplinary procedures.
I remember the first timeI had a disciplinary process,
with somebody that I worked closelywith, and I waited too long.
(10:18):
That taught me a lesson.
They were probably expectingit much sooner and got away with more
than they should have.
And I learned thatnot all people were wired like me.
And you can't assume that somebody iswired the way that you are.
Some people have different strengthsin different weaknesses.
And that was an early lessonthat taught me to be a little more bold
in doing the uncomfortable things.
Also, I learned that you do a disserviceto all the other employees
(10:42):
when you let somebody get awaywith something too long.
They're hoping and needing anadministrator or an executive to step in.
And that included physicians.
I had a, occasion where physicianswere stepping out of bounds
and doing things, and most hospitals have,as a requirement of their accreditation.
They'll have a disruptivephysician policy.
(11:02):
And those policies are pretty prescriptive
or should be prescriptiveabout how to handle it.
When a physician does thingsthat, are aggressive
toward employeesor make people feel uncomfortable,
and it's often the fellow physicianswho will thank you,
for putting a colleague, in checka little bit, on their behavior.
(11:24):
And it's the same thing with anybodywho's working in an environment where
there are patients, where there are,very sensitive life and death type issues.
We have to work very closely together.
And so people need to work environmentwhere there's a lot of collegiality
and a lot of trust.
And so when somebody violates that trust,you have to have somebody in the midst
(11:46):
who will do the hard thing and,and take that on.
That kind of thing early on in
my career was difficult because, I'ma little bit agreeable by nature.
And so while I can talk up,you know, some of the strengths of,
of being able to do what was easy for meand caring about people,
the flip side of the coin isit was hard to do sometimes
(12:08):
some of the very difficult things,but I didn't shy away from it
and I knew that was what I needed to do.
And it reminded me of Emersona little bit.
I thought of this quote all the time
during my career that “thatwhich we persist in doing becomes easier
not that the nature of the task changed.
But our ability to do is increased.”
And I've probably bungledthat a little bit from the actual quote.
(12:30):
But fundamentally, I got better and betterat doing those difficult things.
But I would do it in my wayand in my style.
One of my directors, early on in my careerthat reported to me,
she gave me a book about getting results.
And I remember it was a very thick bookwith lots of things.
(12:52):
But what stood out to mewas early on in the chapter,
it said,a corporation, just wants results.
And as long as you staywithin the frameworks
that they have,they don't care how you get the results.
And I found that really to be true.
I mean, HCA was very into high ethical
moral behavior from their executives.
(13:13):
And I realized, well,they don't care if I'm super nice.
I mean, they want me to be probably,but I also have to do the job
in the right way.And so I found my own voice.
I found my own styleand my own comfort level,
and what I found was I was much happier
helping other peopleto feel happy and fulfilled at work.
(13:34):
And I'll give you justa couple of examples of this.
one time I was in the post
anesthesia care unitand I was just rounding.
It was just me,and there was an anesthesiologist in there
and a nurse
and, I think I may have mentionedI became a CEO at a relatively young age,
(13:55):
or at least,I looked fairly young to some people.
One of the, one of the doctorson the medical staff said, oh, great,
we got Doogie Howser now as our CEOI took that
as a compliment, but, he was sort ofstaring at me like, what do you know?
How are you going to help us?
one day, I was.
I was rounding in the postanesthesia care unit.
(14:16):
So when patients come out of surgeryand and for the most part,
that's fairly routineand just wake them up.
But this one time, there was a patientwhose vitals were
kind of going down, pulse rate going down.
And I stood there and watchedbecause it looked like the physician was
starting to become concerned.
And indeed, this physician,an anesthesiologist, she herself,
(14:38):
being relatively young, was watchingover the patient and doing a great job.
But, I thought maybe she could need meto run an errand or something.
I hadn't even greeted her really yet.
I was just observing.
And so I said, can I do anything for you?
She didn't know that it was the CEOwho was there asking her the question.
(14:58):
She was focusedand assumed that I was a medical student.
and she said, yeah,you can get out of my way.
That's what you cando. She really barked at me
and I said, okay, well, no problem.
And I stepped awayand she took care of the patient.
The patient was fine.
And then she looked overand realized who she had barked at.
(15:20):
Now, the relationship between the hospitalCEO and the hospital based
physicians is often one of of really,an employer and employee.
I didn't really think of it that way.
You know,
there's plenty of other places they can goget contracted out there in high demand.
But the hospital CEO signsthose contracts.
If they're going to work at the hospital,and I
(15:43):
she gaspedwhen she realized, who she had barked at.
And it was pretty abrupt, I'll be honest.
And so, she just apologizedand apologized again, and I said, no, no,
don't worry about it. I'm sorry,I was in your space.
I was just trying to be helpful.
but I can see how,I may have been, in your way and she said,
“No, no, no, I'm so sorry.
I assumed you were the medical student,and I didn't know.” And anyway,
(16:05):
I left and didn't think more about it.
Well, I went back and rounded in the areaabout a week later,
and that anesthesiologist saw me again
and said,I am so sorry for what happened last week.
And I said, you know, it's totally fine.
She said, “So, can I do anything for you?”And I said, “yes,
if you don't mind,would it be okay if I gave you a hug?”
(16:28):
And she said, oh, please, please.
Well, I gave her a hug and the whole thingjust dissipated because she could see
that I had absolutely no badfeelings about it whatsoever.
And my intent was to put her at ease.
and I tried that to have people at easein their jobs and feeling good
about what they do.
(16:49):
I think that was sucha great example of a CEO or an executive
who wants to really understandtheir people
and who cares about their people and caresabout the individual circumstances
and the individualthings that are happening.
I can only imagine being her,you know, freaking out.
Like, I can't believe I did this,
you know, of course it was the CEO,not the medical student.
(17:11):
And just letting that be on my mindfor that entire week
and for you to see her,that you can offer her a hug.
I can't even imagine just how the reliefshe felt, like you explained.
And I think that's very humbleand that's very understanding.
That's such a great example of a great CEOwho cares about their employees
and really wants to develop that trust.
(17:32):
Thank you.
I think the other piece of that is
if you are needingto deliver a tough message,
but the majority of the timeyou're delivering praise and kindness,
people will sit up and pay pretty closeattention when your tone shifts versus
if you're already in the negative toneall of the time, then it's easy to dismiss
and miss something because, oh, he'sjust ornery today or whatever.
(17:55):
But when it's at a placethat that is not your usual tone,
people will pay attentionwhen things need to be said.
Did you ever have an experiencewhen either changing hospitals
or going to new medical facilitywhere you could see the morale was low
or the there was some distrustbetween the physicians and nurses
(18:16):
compared to the CEOs and executivesand how that changed
as you started administering that kindnessand trust to your employees?
Okay. So, yeah,something that comes to mind for sure.
When I was a brand new CEO,
I had a large behavioral health unit and,one of them was an acute unit.
So out of 88 behavioral health units,one of these was a particularly,
(18:38):
I think, difficult placefor some people to go and be.
And I wanted the staff to know
that I cared about the difficult workthat they were doing in their in the acute
unit and helping peoplewho really needed their help.
And I wanted them to understand
that I was not going to be a strangerto the unit.
And I went on the unit, unannounced often
(18:59):
and said hello to patientsand talked to the staff members.
And, one of the staff members commented,
it's been yearssince we've seen a CEO round in here.
And I thought,first of all, that's too bad.
Understandable, because there's a wholelot more to the medical center
then that unitand they can spend their time elsewhere.
But I wanted thatthat particular group of employees
(19:21):
to know that I cared and understoodthe difficult job that they were doing.
They felt that.
And, we had some hard workto do in that unit.
And all the behavioral health unitsof the course of the next several years.
We brought in a new director.
We brought an all new psychiatrist.
We created a reallythe first of its kind that I knew of,
kind of a hospitalist, inpatient programfor psychiatry, years ago.
(19:46):
I think it's a little more commonnow, but, all of that,
I think, was facilitated by the employeesjust seeing me there.
And then they became supportiveof the changes that needed to be made,
because they knew I cared about themand the work that they were doing.
You chose to go to the hard placeand put your time and attention
on those people,rather than, let's make the easy thing
(20:06):
shine and let's just let the hard thingskind of fade.
I love that you said that you want them toknow you care about their difficult work
because, a lot of timesyou see the service level work
or we see the best of the work
or the easiest part of the workor the joyful moments.
But wanting to care about those difficultparts of work is,
a really big deal,especially to the employees.
(20:26):
It means so much more to us as humanswhen someone cares about the hard stuff
than the shiny, great, wonderful stuffabout what we do or who we are.
That was awesome, I love it.
Yeah, great.
Thank you.
I personally enjoyed this and I startedwhen I was the chief operating officer.
I got in scrubs and would go, outwith the environmental service staff
(20:47):
and I would, purposefully ask to go
clean areas, that it would be looked uponas a little bit
odd for a, chief operating officerto be there and cleaning.
So I would scrub toilets.
I would be doing floors.
And the signal there was
nobody is too importantto do any work in this facility.
(21:09):
We are all here to take care of patients.
And indeed, it got the attentionI hope for.
People would take pictures
and say, well, this is funny,we've never seen this before.
So clearly the company was paying me
to do a job that often was at a deskor in relationships,
(21:30):
you know, making deals and doing contractsand doing all kinds of things
that were not related to cleaningbecause we had staff to do that.
But part of my jobI felt like was to curate,
upliftand maintain a culture of excellence.
And I believed that
that excellence began with peopletaking pride in the work that they did.
I never wanted to hear somebody say,when I asked a job, what do you do here?
(21:54):
If they would say, I'm just,followed by their job titles, I'd stop
and we'd have a conversation.
And so I'm just a registrar and I wouldsay, oh, no, you're not just a registrar.
Do you know how important your job is?
You're the first impression ofthe hospital or the patients that come in
and you know, when they comein, they're coming in worried about
(22:16):
a couple of things.
One is the diagnosis that they mayor may not know they have.
And number twois the worry about that diagnosis.
They may or may not know they have.
Everybody carries that worry.
And when you smile at a patient,
even if you think you'rejust registering them, but you say,
welcome to our hospitaland thank you so much for coming.
(22:39):
We're going to take great care of you.
And you may think that you're justregistering them and taking a payment,
but you're doing so much more than that.
You're setting up the whole care paradigmas I used to call it.
And what you're doing isyou're making it easier for everybody
that comes after you.
If you've made a good first impression,
they will give grace to everybodyafter that, if things get a little messy
(23:02):
But if you start off
with a down impression,everybody's digging their way out of it.
So your job is not just a register.
And that would be a conversationI would have.
I would have a similar conversationwith anybody
that was just an environmental serviceworker.
No. Your job is to keep things clean.
Infection control.
If we don't have that, what would happen?
you know, just dietaryand the list goes on and on.
(23:23):
Everybody was important.
So I'm hearing a lot of disruptivebehaviors, positive disruptive behaviors.
Right.
that are disrupting patterns,expectations, and sending very purposeful
communication to the entire organizationthat people come first.
the CEO doesn't even come firstabove anybody else.
(23:45):
That's a pretty revolutionarystyle of leadership.
that takes a lot of dedication
to making people, again,feel loved, heard, and valued.
I keep coming back to that, but that'swhat I'm hearing from your message
here is that that is a strong pieceof your leadership style.
Have you met resistance to that?
(24:05):
Have you met people being like, “whatare you doing?”
Or “that's not appropriate”or “you shouldn't”?
I mean, I couldI could see a lot of executives
maybe having an impulse to do that,but second guessing that and being like,
that's going to make me look weakor that's going to make me,
not look like an authorityor have people respect me or
take me seriously,especially since you're saying you kind of
in your younger years were consideredlike a Doogie Howser vibe, right?
(24:30):
That would bea real concern of an executive.
But you just blew right past it.
Towards something else.
Since you're you're also dothe professor thing as well as the CEO
and the startup thingall of the same time.
Say you had a student
that was in a similar situation,but was really struggling with feeling
the expectationfill normal CEO expectations and roles.
(24:51):
What would you counsel them?
What would you say?
I would tell them to get out and serve.
You can't possibly manage your reputationas well as other people can.
So you solidify your relationshipswith other people
by helping them feel valued and loved,and they'll have your back.
So if if there's a group of peoplethat are trash
talking to you or undermining you,
which is common in any largeorganization, things get political.
(25:14):
People want power or where they perceivethat there is power.
They want to tear it down.
Whether people are exercising the power
justly or unjustly,it's just part of the way that it is.
And if you have people that are alignedwith you, they'll take care of you
so that you can get your job doneand move an organization forward.
I think fulfilling your job
(25:36):
is getting everybodyaligned in lockstep to move
as fast as you can go, to get the resultsthat the organization needs to have
and in a for profit hospital environment,it was to take care of the patients
and to earn a profitwhile you're doing it.
And those two things to be congruentand to work
well,you have to have an efficient operation.
(25:57):
And that means that youyou can't over hire people.
So one of the things that I respectedand grew to really appreciate about HCA
was that they did not, lay people offvery often.
You would see a lot of other organizationsmay hire and hire, and then one day
they're surprised and then they have tojust do a big reduction in force.
(26:18):
And I thought that was a major disservice
to peoplethat could have been recruited in
and brought their familiesfrom far and wide.
And then just,oh, sorry, we're laying you off.
That's a terrible thing to do.
So having fiscal restrainton hiring people on the front door
and only hiringnecessarily is actually a kind thing,
(26:41):
even though some of our people feltvery stretched.
Often they were very stretched.
But what made it okay that they werestretched was understanding.
I'm really important here,and I'm needed and I'm valued.
If they didn't feel that when they'refeeling stretched at the same time
and they're dissatisfied, they're gone,and then you've got a turnover problem
(27:02):
and then you're recruiting inand you're almost never able to catch up.
those become self-perpetuating problemswhen you if you gain
a reputationas being a difficult place to work.
Have you ever found a situationwhere you took someone
and you could see that they were eithercausing problems
within a teamor the organization or otherwise,
(27:23):
and were able to change the paradigmor change what was happening,
to turn themfrom kind of a liability into an asset.
Quint Studer who is a great patientexperience guru we'll call him.
He wrotea book called Hardwiring Excellence.
And I implemented a lot of things,at one of my hospitals
(27:44):
from his Hardwiring Excellence book,as a lot of executives did.
And that was really tryingto turn some of those low performers
into the middle performersand then the middles to high performers.
And to accomplish that,you actually had to label them.
You really had to sit down and say,okay, where are people ranking?
And so then you could put togetherkind of a targeted list.
(28:07):
This person is not doing real well.
And then you formulate a learning capsulearound them to help
teach them and bring them up.
And if they're not responding, then,I believe it's the words of Disney, “You
invite them to seek their happinesselsewhere.” and we definitely had that.
We had both of those scenariosthat happened where we were able to move
(28:28):
people up, by mentoring themand helping them and helping them
to realize that that they were neededand that they were important.
And then also, we did definitelyhave occasions where we we let people go.
But I will say thisabout the letting people go.
I had, a mentor one time who saidthey should always know it's coming.
(28:49):
It should never be a surprise.
And that hit me,
in a way that says, yeah,that that is correct.
That's the kind of thing to do.
And that'swhat progressive discipline is all about.
And it actually works.
Usually people will decide, oh,I got to fix this problem or
(29:09):
yeah, I'm not going toI'll just wait for them to make it happen.
But they've been told all along,you know, this means this.
Don't do this.
If you do this again,
there's the door and this it's often overmonths and it's painful
and it takes a lot of time,but it's very worth the process.
If you had to share what you experienced
(29:30):
as one of the biggest pain pointsas a CEO.
And then if you have potential lessonsthat you learned from those
to overcome those,that would be excellent to hear as well.
This may not be applicable to everybody,but some of the most difficult
pain points are thingsthat you really can't do much about.
And then it's how do you live with itwhen you have no control over it?
(29:52):
And, and in hospitals and health care,
it's a strange thing to have no controlor little, little control
over seasonality, over federal government,
control, in certain ways that,that makes the job very difficult.
There is one studythat the American Hospital Association
(30:13):
did that said, for every hospitaladmission,
that comes in the door,that patient already has $1,200
worth of cost associatedwith the regulation to take care of them.
And, you know, in the United States,we don't take regulations off the books
very easily.We just adamant pile things on and on.
And so the poor administrators in healthcare today just have books and books
(30:38):
full of things that they're expectedto be managing and in control of.
And so one of the most difficultaspects of the job was you would have
an agenda set up for the day and you go,this looks like a pretty good day.
I'm going to do this, this, this, thisand this and all the things that,
that I would like to doto advance the culture forward.
And you'd get a call and,you know, some inspector was here for this
(31:00):
and somebody was there for that,and you had to deal with this fire
and put that out.
And it was just managing the unexpectedday after day after day.
And so that
became for me, how do you psychologically
deal with the unexpected all the time,and how do you get good at that?
And because I'm like on onepersonality test, I took the big five.
(31:23):
And you're probably familiar with I'm 94%extroverted, so if it didn't work for me
to process these things internally,I would just, you know, ruminate about it.
So I realized that I need a very good teamabout me,
and I had to touch basewith them every day
and go over everythingand who's got everything
and who's got this unexpected problemand where is it?
(31:46):
What are we doing with it?
And then just taking the timeto talk and discuss.
That was sometimes a challengewith some of the more introverted folks
who just wanted to be leftalone to do their job.
I got it,but I needed to process and talk about it.
So we had to balance that, right?
I think we're built as humansto need people,
even introvertedpeople have to externalize
(32:07):
in some way, shape or formand having someone who is a good mirror
or whether that's a team member, a coachor whoever, can make all the difference.
That's a really great lesson to learnhow to use your team.
to both communicate what's going on.
So you're enhancing communicationwhile also taking your own
need into account of needingto externalize our ideas.
So that's really kind of a cool solutionof hitting all those things at once.
(32:31):
Yeah.
He also made a really good point about
understanding things about yourselfand who are you authentically.
so you can find all the strengths in that.
And then understanding,okay, not everyone works that way.
So how you can work with differentpersonalities too is really important.
You are a university professor.
You're taskedwith taking the up and coming generation
(32:53):
and turning them into the leaderthat you have learned to become,
and hopefully even surpassingwhat you're able to do
So if you had to share a could put into
the mindof every future executive, on the planet,
some key lessons, then you could just say,here's my gift to you.
(33:14):
You now know this.
What would those lessons be?
I mean, I'm sure there's many,but if you had to choose 1 or 2,
what would you say.
Because I have the opportunityand privilege to teach health
care leadership in particular, it'san understanding of the industry
that I try and impart with the students.
This entails the knowledge that I havethat working in health
(33:36):
care is a sacred privilege,and I use that terminology.
The word sacred is a heavy term, butif you're working in hospitals, as I did,
it doesn'ttake much to stop and think about the kind
of a different daythat is the day of your customer.
If you think of them as a customer.
that's a very different day.
(33:56):
Nobody woke up, and said, gee,I want to be admitted to a hospital today.
Yeah.
It's just I mean, unless unless you are,you know,
really excitedbecause you're expecting a baby,
but even then, you know, hey,this is going to be a little bit painful
or a lot painful or a lot unexpected or,you know,
(34:17):
there's still a lot of anxietyeven surrounding the joyous event.
Yeah.
So you have people entering the worldand people exiting the world
in your place of business,and it is your business
to take care of that and make surethat there's a lot of dignity,
and that people are well taken care of.
So it is a sacred privilege.It's a sacred trust.
(34:39):
And not everybodyshould be doing health care.
But the people that do do it,
they need to make sure that they're upfor that challenge.
And so that's one of the thingsI try and impart with my students.
And then I get to teach, just general
organizational behavioras well in leadership courses.
And then I often talk about making surethat we take care of people,
(35:00):
that regardless of whatever industryyou're in, whatever
you're doing, if you're leading people,you're affecting lives.
And that that doesn't stop at 5:00.
What you did that day impacts
not just the employee,but it impacts family.
It impacts a whole lot of other peopleand other relationships.
So are you elevating?
(35:21):
Let's hope you're elevatingand making the world a better place.
As soon as you have any input or power,make sure you're wielding it for good.
I would have to guess thateven if you were in the tech industry
or you were in something purelywhere most are there just to make money,
I have a hard timebelieving that you still wouldn't
make it about lifting people's lives
and feeling like it is a sacred trustto make people's lives better.
(35:44):
I think that's a core value that seemsto be shining through what you do.
So yeah, no, it is a real honorand privilege to be able
to, to talk with you today.
It's been my honor and privilegeit has been awesome.
Thank you for for taking the timeto talk to me.
Everyone,we look forward to seeing you next time.
(36:04):
After this, we'll share with yousome mini workshops where we break down
some of the things Dana shared with ustoday.
Put some practical daily tips of howyou can put these things into practice,
and we look forward to followingand seeing all these wonderful people
you're mentoring upto change the whole health care business.
So thank you for doing that. Thank you.
(36:27):
Thank you.
Welcome to the Make work, WorkBetter podcast,
where we delve deep into the minds
and experiences of some of the mostinspiring leaders in business today.
We are your hosts, Mikayla Wallace and Dr.
Marc Reynolds.
We are thrilled to introduce youto our special guests, Dana Oaks.
Dana, thank you for joining us today.
(00:29):
Well thank you.
It's a pleasure to be here.
Dana, tell us a little bitabout your career journey.
Sure.
So my career primarilyhas been as a hospital executive.
I went to the University of North Carolinaat Chapel Hill for my graduate school,
did a master of healthcare administrationthere and a an MBA.
And that set me up, to start with HCA.
(00:51):
I was with HCA for 14 years.
They're the largest hospital companyin the United States
and a very good placeto learn hospital operations.
They do it, very, very well.
Have been at it for over 50 years,
and it was a great place to learn froma lot of wonderful, seasoned executives.
And following my time, at HCA,I went back to work with,
(01:15):
a former boss of minebefore I went to graduate school.
And he was running a lot of turnaroundoperations
for rural hospitalsand formed a company called the RH.
And within RH, I was given, the title,President of operations.
So I was running the company five monthsinto that journey, the pandemic hit
(01:35):
and we had big plansto expand our operations,
and that really curtailed those plans.
And we were just tryingto keep those hospitals afloat.
And we had some very good executivesat the helm of those hospitals.
And I got to work with, local boardmembers, who were members of the community
who were doing a great job at tryingto keep their hospitals in the community
(01:58):
going and servicing the needs,which were a lot more extensive
than they had been prior.
because local communities had to manage
a lot tougher, more acute patientsthan they were used to managing.
So we had a lot of patients on ventilatorsand in smaller, rural hospitals,
they were not used to that.
So I had five, rural hospitals and then abehavioral health facility in Las Vegas.
(02:20):
And we had plans to expand and growa lot more facilities out west.
And that didn't end up happeningas a result of the pandemic.
And in the end, several of the partnersdecided to go different ways.
And I ended up at a university.
They asked me at the university,
in the town where I grew up,it was called Utah Valley University.
If I'd come and help themhead up a healthcare
(02:43):
administration emphasiswithin their MBA program.
And that sounded exciting.
And they said, also,
we want you to stay currentand keep doing things in healthcare.
So I got into,being a co-founder of a startup,
which is an AI medical scribecalled scribematic.
And I'm having a blast doing that, becauseI get to keep working with physicians
(03:05):
and the latest and greatest stuffthat's going on in health care.
So it keeps my teeth sharpand we're having fun.
What is itthat got you into the medical side?
What is it that you loved about it?
You stuck with it too.
So what is it that drives youthat gets you up in the morning
to want to keep doing that?
Really, it's about the patient. For me,it always was.
I, I cared deeply about the patientexperience.
(03:29):
That'sbeen the highlight points of my career,
have been surroundingthe people that I work with,
taking care of the people that I work withand taking care of the patients.
And I think it's a pretty tough careerif you don't feel that
because it's full of regulation,there's tons of pressure from every angle.
You're serving multiple masters,and if you don't, at the end of the day,
(03:51):
feel some satisfactionas a result of helping the patient,
then it's going to be pretty rough seas.
From my limited knowledge,sitting as an administrator
of a hospitalwould be a really tricky spot to be.
You have doctors that are come fromall ranges of humility to zero humility.
you have everything from,
(04:12):
you know, patients who are grateful tothose that are really upset
and disgruntled and traumatizedby whatever they've experienced.
and a lot of moving pieces of technologyand people and and stuff.
That's a lot to manage.
Yeah, it is, it is a lot to manage.
And, you know,I'm sure there are physicians out there
that would say the same sorts of thingsabout administrators
that some of us have zero humilityand some have a lot of humility.
(04:35):
I heard somebody say once, if you've metone doctor, you've met one doctor.
I tried to remind physicians toosometimes if you've met
one administrator,you've met one administrator.
Yeah.
What are some of the lessonsyou've learned about how to make work work
better for yourselfor teams you have worked with,
or that have workedunder your stewardship?
(04:56):
What a wonderful question.
There are so many lessons.
There are too many to recount,but the biggest thing I learned
was that you have to careabout your people
and that caring needsto take the form of something
that's visible to the employeesand the team members.
They can't assume, or will not assumethat you care about them
(05:18):
unless you show themthat you care about them.
One of the ways that I enjoyed doingthat was going to the spaces
where people work.
So if I wanted to meet with somebody,I would often arrange for that meeting
to be in that director's officeor in the physician office.
I spent a lot of time getting in the carand going out to visit with my physicians
when I was the CEO.
(05:39):
I would get to know their officestaff, the places where they worked,
and they would usually comment that
that meant a lot to them,that if I wanted to have a meeting
they weren't expected to come tomy office, but I would go visit with them
and sometimes just even popping into see if they needed anything.
and then I would write things downand make sure the next time I went,
(06:00):
if they had a concernthat I had resolved it for them
and I could reportback of what I had done.
I took the time when I was newas a hospital CEO.
My first hospital CEO job was in 2011,
and I sat down with eachand every one of the directors
in the hospital and got to knowtheir pain points and challenges.
And and then we did a daily huddle.
(06:23):
And in the daily huddle,we would spotlight people who were doing
a good job on the thingsthat mattered to me, and to us as a team.
And one of those things was the mission.
HCA has a great mission statement,and it's, it starts out above all else.
We are committed to the careand improvement of human life.
And so we would have missionmoments, things that we would,
(06:45):
highlight peoplefor, their adherence to the mission.
This is sometimes come inthe form of patient compliments.
Sometimes these were, other employeescomplimenting the employee.
There would be notes and things,
and that meant a lotto the fellow employees to be spotlighted.
And then they knowthat you care about them.
You care about the work that you're doing.
(07:05):
And I used to get up and spenda lot of time outside of my office
just rounding and thanking peopleand telling them they did a great job.
And I also enjoyedvisiting with the patients.
So, one of the things that I would dois stop off at the nurses stations
and ask if there was any patientin particular could use a visit.
Now that could havegone in very different ways.
(07:28):
so if the nurses were intimidated by me
or my position as the CEO, they could havesaid, you know, visit, Mrs.
So-and-so or Mr.
So-and-so because they knew thatthat person would have a compliment.
But I, I felt very gooda few times when the nurses sent me in
(07:49):
to some of the battlesthat they were fighting,
with very difficult patientsand difficult patient satisfaction
issues or things that we had messed upand gotten wrong as a hospital,
and they felt confident enoughto send me in there
to apologizeon behalf of the hospital or to,
utilize my position as a team memberand administration to make things right.
(08:10):
And what that said to mewas, they trust me,
they respect me, and they know that
I have their back and they're not goingto get in trouble for this.
And I took that as a high complimentwhenever they would send me
into a troubled situation.
Let me recap what I'm hearing here, andthen feel free to correct me if I'm wrong.
So what I'm hearing hereis, number one counterculture move
(08:31):
and not playing the power gameof having them come to my space,
my territory, but insteadGoing through that effort and taking the
risk of going into their home turfas an effort to show them that you care
and you value them feeling seen and heard,and that that is an important thing.
It’s worth your effort to take the timeto see them in their element.
(08:54):
So that's a hugethat's a huge piece of what I heard.
That's that's amazing.
Another counterculture movethat I'm hearing you say here
is that you would go see patientsand not only would you see patients
but you wanted to be challenged to put itin the place where you could do the most
good and help patientsfeel seen and heard.
Right?
(09:14):
Correct.
So, so that you're goingthrough all these things
and you as executive, have madeall your choices about other people
and help them feel safe, loved,heard and valued.
That's not necessarilya typical executive mindset.
Now, there there are executives out there,and I've been fortunate to work
with a lot of amazing onesthat are humble and
(09:37):
and have that kind of servant leadershipBut what is it
that kind of puts you in that directionthat made you committed to that?
Well, that's a great question.
Part of it is a strength.
And the strengths can be overusedstrengths. Right.
Sometimes your greatest strength can beyour greatest weakness when it's overused.
(09:57):
And I feel like I was wiredto just care about people.
And that made it very difficult for mewhen we had to go through things
like layoffsor had to do disciplinary procedures.
I remember the first timeI had a disciplinary process,
with somebody that I worked closelywith, and I waited too long.
(10:18):
That taught me a lesson.
They were probably expectingit much sooner and got away with more
than they should have.
And I learned thatnot all people were wired like me.
And you can't assume that somebody iswired the way that you are.
Some people have different strengthsin different weaknesses.
And that was an early lessonthat taught me to be a little more bold
in doing the uncomfortable things.
Also, I learned that you do a disserviceto all the other employees
(10:42):
when you let somebody get awaywith something too long.
They're hoping and needing anadministrator or an executive to step in.
And that included physicians.
I had a, occasion where physicianswere stepping out of bounds
and doing things, and most hospitals have,as a requirement of their accreditation.
They'll have a disruptivephysician policy.
(11:02):
And those policies are pretty prescriptive
or should be prescriptiveabout how to handle it.
When a physician does thingsthat, are aggressive
toward employeesor make people feel uncomfortable,
and it's often the fellow physicianswho will thank you,
for putting a colleague, in checka little bit, on their behavior.
(11:24):
And it's the same thing with anybodywho's working in an environment where
there are patients, where there are,very sensitive life and death type issues.
We have to work very closely together.
And so people need to work environmentwhere there's a lot of collegiality
and a lot of trust.
And so when somebody violates that trust,you have to have somebody in the midst
(11:46):
who will do the hard thing and,and take that on.
That kind of thing early on in
my career was difficult because, I'ma little bit agreeable by nature.
And so while I can talk up,you know, some of the strengths of,
of being able to do what was easy for meand caring about people,
the flip side of the coin isit was hard to do sometimes
(12:08):
some of the very difficult things,but I didn't shy away from it
and I knew that was what I needed to do.
And it reminded me of Emersona little bit.
I thought of this quote all the time
during my career that “thatwhich we persist in doing becomes easier
not that the nature of the task changed.
But our ability to do is increased.”
And I've probably bungledthat a little bit from the actual quote.
(12:30):
But fundamentally, I got better and betterat doing those difficult things.
But I would do it in my wayand in my style.
One of my directors, early on in my careerthat reported to me,
she gave me a book about getting results.
And I remember it was a very thick bookwith lots of things.
(12:52):
But what stood out to mewas early on in the chapter,
it said,a corporation, just wants results.
And as long as you staywithin the frameworks
that they have,they don't care how you get the results.
And I found that really to be true.
I mean, HCA was very into high ethical
moral behavior from their executives.
(13:13):
And I realized, well,they don't care if I'm super nice.
I mean, they want me to be probably,but I also have to do the job
in the right way.And so I found my own voice.
I found my own styleand my own comfort level,
and what I found was I was much happier
helping other peopleto feel happy and fulfilled at work.
(13:34):
And I'll give you justa couple of examples of this.
one time I was in the post
anesthesia care unitand I was just rounding.
It was just me,and there was an anesthesiologist in there
and a nurse
and, I think I may have mentionedI became a CEO at a relatively young age,
(13:55):
or at least,I looked fairly young to some people.
One of the, one of the doctorson the medical staff said, oh, great,
we got Doogie Howser now as our CEOI took that
as a compliment, but, he was sort ofstaring at me like, what do you know?
How are you going to help us?
one day, I was.
I was rounding in the postanesthesia care unit.
(14:16):
So when patients come out of surgeryand and for the most part,
that's fairly routineand just wake them up.
But this one time, there was a patientwhose vitals were
kind of going down, pulse rate going down.
And I stood there and watchedbecause it looked like the physician was
starting to become concerned.
And indeed, this physician,an anesthesiologist, she herself,
(14:38):
being relatively young, was watchingover the patient and doing a great job.
But, I thought maybe she could need meto run an errand or something.
I hadn't even greeted her really yet.
I was just observing.
And so I said, can I do anything for you?
She didn't know that it was the CEOwho was there asking her the question.
(14:58):
She was focusedand assumed that I was a medical student.
and she said, yeah,you can get out of my way.
That's what you cando. She really barked at me
and I said, okay, well, no problem.
And I stepped awayand she took care of the patient.
The patient was fine.
And then she looked overand realized who she had barked at.
(15:20):
Now, the relationship between the hospitalCEO and the hospital based
physicians is often one of of really,an employer and employee.
I didn't really think of it that way.
You know,
there's plenty of other places they can goget contracted out there in high demand.
But the hospital CEO signsthose contracts.
If they're going to work at the hospital,and I
(15:43):
she gaspedwhen she realized, who she had barked at.
And it was pretty abrupt, I'll be honest.
And so, she just apologizedand apologized again, and I said, no, no,
don't worry about it. I'm sorry,I was in your space.
I was just trying to be helpful.
but I can see how,I may have been, in your way and she said,
“No, no, no, I'm so sorry.
I assumed you were the medical student,and I didn't know.” And anyway,
(16:05):
I left and didn't think more about it.
Well, I went back and rounded in the areaabout a week later,
and that anesthesiologist saw me again
and said,I am so sorry for what happened last week.
And I said, you know, it's totally fine.
She said, “So, can I do anything for you?”And I said, “yes,
if you don't mind,would it be okay if I gave you a hug?”
(16:28):
And she said, oh, please, please.
Well, I gave her a hug and the whole thingjust dissipated because she could see
that I had absolutely no badfeelings about it whatsoever.
And my intent was to put her at ease.
and I tried that to have people at easein their jobs and feeling good
about what they do.
(16:49):
I think that was sucha great example of a CEO or an executive
who wants to really understandtheir people
and who cares about their people and caresabout the individual circumstances
and the individualthings that are happening.
I can only imagine being her,you know, freaking out.
Like, I can't believe I did this,
you know, of course it was the CEO,not the medical student.
(17:11):
And just letting that be on my mindfor that entire week
and for you to see her,that you can offer her a hug.
I can't even imagine just how the reliefshe felt, like you explained.
And I think that's very humbleand that's very understanding.
That's such a great example of a great CEOwho cares about their employees
and really wants to develop that trust.
(17:32):
Thank you.
I think the other piece of that is
if you are needingto deliver a tough message,
but the majority of the timeyou're delivering praise and kindness,
people will sit up and pay pretty closeattention when your tone shifts versus
if you're already in the negative toneall of the time, then it's easy to dismiss
and miss something because, oh, he'sjust ornery today or whatever.
(17:55):
But when it's at a placethat that is not your usual tone,
people will pay attentionwhen things need to be said.
Did you ever have an experiencewhen either changing hospitals
or going to new medical facilitywhere you could see the morale was low
or the there was some distrustbetween the physicians and nurses
(18:16):
compared to the CEOs and executivesand how that changed
as you started administering that kindnessand trust to your employees?
Okay. So, yeah,something that comes to mind for sure.
When I was a brand new CEO,
I had a large behavioral health unit and,one of them was an acute unit.
So out of 88 behavioral health units,one of these was a particularly,
(18:38):
I think, difficult placefor some people to go and be.
And I wanted the staff to know
that I cared about the difficult workthat they were doing in their in the acute
unit and helping peoplewho really needed their help.
And I wanted them to understand
that I was not going to be a strangerto the unit.
And I went on the unit, unannounced often
(18:59):
and said hello to patientsand talked to the staff members.
And, one of the staff members commented,
it's been yearssince we've seen a CEO round in here.
And I thought,first of all, that's too bad.
Understandable, because there's a wholelot more to the medical center
then that unitand they can spend their time elsewhere.
But I wanted thatthat particular group of employees
(19:21):
to know that I cared and understoodthe difficult job that they were doing.
They felt that.
And, we had some hard workto do in that unit.
And all the behavioral health unitsof the course of the next several years.
We brought in a new director.
We brought an all new psychiatrist.
We created a reallythe first of its kind that I knew of,
kind of a hospitalist, inpatient programfor psychiatry, years ago.
(19:46):
I think it's a little more commonnow, but, all of that,
I think, was facilitated by the employeesjust seeing me there.
And then they became supportiveof the changes that needed to be made,
because they knew I cared about themand the work that they were doing.
You chose to go to the hard placeand put your time and attention
on those people,rather than, let's make the easy thing
(20:06):
shine and let's just let the hard thingskind of fade.
I love that you said that you want them toknow you care about their difficult work
because, a lot of timesyou see the service level work
or we see the best of the work
or the easiest part of the workor the joyful moments.
But wanting to care about those difficultparts of work is,
a really big deal,especially to the employees.
(20:26):
It means so much more to us as humanswhen someone cares about the hard stuff
than the shiny, great, wonderful stuffabout what we do or who we are.
That was awesome, I love it.
Yeah, great.
Thank you.
I personally enjoyed this and I startedwhen I was the chief operating officer.
I got in scrubs and would go, outwith the environmental service staff
(20:47):
and I would, purposefully ask to go
clean areas, that it would be looked uponas a little bit
odd for a, chief operating officerto be there and cleaning.
So I would scrub toilets.
I would be doing floors.
And the signal there was
nobody is too importantto do any work in this facility.
(21:09):
We are all here to take care of patients.
And indeed, it got the attentionI hope for.
People would take pictures
and say, well, this is funny,we've never seen this before.
So clearly the company was paying me
to do a job that often was at a deskor in relationships,
(21:30):
you know, making deals and doing contractsand doing all kinds of things
that were not related to cleaningbecause we had staff to do that.
But part of my jobI felt like was to curate,
upliftand maintain a culture of excellence.
And I believed that
that excellence began with peopletaking pride in the work that they did.
I never wanted to hear somebody say,when I asked a job, what do you do here?
(21:54):
If they would say, I'm just,followed by their job titles, I'd stop
and we'd have a conversation.
And so I'm just a registrar and I wouldsay, oh, no, you're not just a registrar.
Do you know how important your job is?
You're the first impression ofthe hospital or the patients that come in
and you know, when they comein, they're coming in worried about
(22:16):
a couple of things.
One is the diagnosis that they mayor may not know they have.
And number twois the worry about that diagnosis.
They may or may not know they have.
Everybody carries that worry.
And when you smile at a patient,
even if you think you'rejust registering them, but you say,
welcome to our hospitaland thank you so much for coming.
(22:39):
We're going to take great care of you.
And you may think that you're justregistering them and taking a payment,
but you're doing so much more than that.
You're setting up the whole care paradigmas I used to call it.
And what you're doing isyou're making it easier for everybody
that comes after you.
If you've made a good first impression,
they will give grace to everybodyafter that, if things get a little messy
(23:02):
But if you start off
with a down impression,everybody's digging their way out of it.
So your job is not just a register.
And that would be a conversationI would have.
I would have a similar conversationwith anybody
that was just an environmental serviceworker.
No. Your job is to keep things clean.
Infection control.
If we don't have that, what would happen?
you know, just dietaryand the list goes on and on.
(23:23):
Everybody was important.
So I'm hearing a lot of disruptivebehaviors, positive disruptive behaviors.
Right.
that are disrupting patterns,expectations, and sending very purposeful
communication to the entire organizationthat people come first.
the CEO doesn't even come firstabove anybody else.
(23:45):
That's a pretty revolutionarystyle of leadership.
that takes a lot of dedication
to making people, again,feel loved, heard, and valued.
I keep coming back to that, but that'swhat I'm hearing from your message
here is that that is a strong pieceof your leadership style.
Have you met resistance to that?
(24:05):
Have you met people being like, “whatare you doing?”
Or “that's not appropriate”or “you shouldn't”?
I mean, I couldI could see a lot of executives
maybe having an impulse to do that,but second guessing that and being like,
that's going to make me look weakor that's going to make me,
not look like an authorityor have people respect me or
take me seriously,especially since you're saying you kind of
in your younger years were consideredlike a Doogie Howser vibe, right?
(24:30):
That would bea real concern of an executive.
But you just blew right past it.
Towards something else.
Since you're you're also dothe professor thing as well as the CEO
and the startup thingall of the same time.
Say you had a student
that was in a similar situation,but was really struggling with feeling
the expectationfill normal CEO expectations and roles.
(24:51):
What would you counsel them?
What would you say?
I would tell them to get out and serve.
You can't possibly manage your reputationas well as other people can.
So you solidify your relationshipswith other people
by helping them feel valued and loved,and they'll have your back.
So if if there's a group of peoplethat are trash
talking to you or undermining you,
which is common in any largeorganization, things get political.
(25:14):
People want power or where they perceivethat there is power.
They want to tear it down.
Whether people are exercising the power
justly or unjustly,it's just part of the way that it is.
And if you have people that are alignedwith you, they'll take care of you
so that you can get your job doneand move an organization forward.
I think fulfilling your job
(25:36):
is getting everybodyaligned in lockstep to move
as fast as you can go, to get the resultsthat the organization needs to have
and in a for profit hospital environment,it was to take care of the patients
and to earn a profitwhile you're doing it.
And those two things to be congruentand to work
well,you have to have an efficient operation.
(25:57):
And that means that youyou can't over hire people.
So one of the things that I respectedand grew to really appreciate about HCA
was that they did not, lay people offvery often.
You would see a lot of other organizationsmay hire and hire, and then one day
they're surprised and then they have tojust do a big reduction in force.
(26:18):
And I thought that was a major disservice
to peoplethat could have been recruited in
and brought their familiesfrom far and wide.
And then just,oh, sorry, we're laying you off.
That's a terrible thing to do.
So having fiscal restrainton hiring people on the front door
and only hiringnecessarily is actually a kind thing,
(26:41):
even though some of our people feltvery stretched.
Often they were very stretched.
But what made it okay that they werestretched was understanding.
I'm really important here,and I'm needed and I'm valued.
If they didn't feel that when they'refeeling stretched at the same time
and they're dissatisfied, they're gone,and then you've got a turnover problem
(27:02):
and then you're recruiting inand you're almost never able to catch up.
those become self-perpetuating problemswhen you if you gain
a reputationas being a difficult place to work.
Have you ever found a situationwhere you took someone
and you could see that they were eithercausing problems
within a teamor the organization or otherwise,
(27:23):
and were able to change the paradigmor change what was happening,
to turn themfrom kind of a liability into an asset.
Quint Studer who is a great patientexperience guru we'll call him.
He wrotea book called Hardwiring Excellence.
And I implemented a lot of things,at one of my hospitals
(27:44):
from his Hardwiring Excellence book,as a lot of executives did.
And that was really tryingto turn some of those low performers
into the middle performersand then the middles to high performers.
And to accomplish that,you actually had to label them.
You really had to sit down and say,okay, where are people ranking?
And so then you could put togetherkind of a targeted list.
(28:07):
This person is not doing real well.
And then you formulate a learning capsulearound them to help
teach them and bring them up.
And if they're not responding, then,I believe it's the words of Disney, “You
invite them to seek their happinesselsewhere.” and we definitely had that.
We had both of those scenariosthat happened where we were able to move
(28:28):
people up, by mentoring themand helping them and helping them
to realize that that they were neededand that they were important.
And then also, we did definitelyhave occasions where we we let people go.
But I will say thisabout the letting people go.
I had, a mentor one time who saidthey should always know it's coming.
(28:49):
It should never be a surprise.
And that hit me,
in a way that says, yeah,that that is correct.
That's the kind of thing to do.
And that'swhat progressive discipline is all about.
And it actually works.
Usually people will decide, oh,I got to fix this problem or
(29:09):
yeah, I'm not going toI'll just wait for them to make it happen.
But they've been told all along,you know, this means this.
Don't do this.
If you do this again,
there's the door and this it's often overmonths and it's painful
and it takes a lot of time,but it's very worth the process.
If you had to share what you experienced
(29:30):
as one of the biggest pain pointsas a CEO.
And then if you have potential lessonsthat you learned from those
to overcome those,that would be excellent to hear as well.
This may not be applicable to everybody,but some of the most difficult
pain points are thingsthat you really can't do much about.
And then it's how do you live with itwhen you have no control over it?
(29:52):
And, and in hospitals and health care,
it's a strange thing to have no controlor little, little control
over seasonality, over federal government,
control, in certain ways that,that makes the job very difficult.
There is one studythat the American Hospital Association
(30:13):
did that said, for every hospitaladmission,
that comes in the door,that patient already has $1,200
worth of cost associatedwith the regulation to take care of them.
And, you know, in the United States,we don't take regulations off the books
very easily.We just adamant pile things on and on.
And so the poor administrators in healthcare today just have books and books
(30:38):
full of things that they're expectedto be managing and in control of.
And so one of the most difficultaspects of the job was you would have
an agenda set up for the day and you go,this looks like a pretty good day.
I'm going to do this, this, this, thisand this and all the things that,
that I would like to doto advance the culture forward.
And you'd get a call and,you know, some inspector was here for this
(31:00):
and somebody was there for that,and you had to deal with this fire
and put that out.
And it was just managing the unexpectedday after day after day.
And so that
became for me, how do you psychologically
deal with the unexpected all the time,and how do you get good at that?
And because I'm like on onepersonality test, I took the big five.
(31:23):
And you're probably familiar with I'm 94%extroverted, so if it didn't work for me
to process these things internally,I would just, you know, ruminate about it.
So I realized that I need a very good teamabout me,
and I had to touch basewith them every day
and go over everythingand who's got everything
and who's got this unexpected problemand where is it?
(31:46):
What are we doing with it?
And then just taking the timeto talk and discuss.
That was sometimes a challengewith some of the more introverted folks
who just wanted to be leftalone to do their job.
I got it,but I needed to process and talk about it.
So we had to balance that, right?
I think we're built as humansto need people,
even introvertedpeople have to externalize
(32:07):
in some way, shape or formand having someone who is a good mirror
or whether that's a team member, a coachor whoever, can make all the difference.
That's a really great lesson to learnhow to use your team.
to both communicate what's going on.
So you're enhancing communicationwhile also taking your own
need into account of needingto externalize our ideas.
So that's really kind of a cool solutionof hitting all those things at once.
(32:31):
Yeah.
He also made a really good point about
understanding things about yourselfand who are you authentically.
so you can find all the strengths in that.
And then understanding,okay, not everyone works that way.
So how you can work with differentpersonalities too is really important.
You are a university professor.
You're taskedwith taking the up and coming generation
(32:53):
and turning them into the leaderthat you have learned to become,
and hopefully even surpassingwhat you're able to do
So if you had to share a could put into
the mindof every future executive, on the planet,
some key lessons, then you could just say,here's my gift to you.
(33:14):
You now know this.
What would those lessons be?
I mean, I'm sure there's many,but if you had to choose 1 or 2,
what would you say.
Because I have the opportunityand privilege to teach health
care leadership in particular, it'san understanding of the industry
that I try and impart with the students.
This entails the knowledge that I havethat working in health
(33:36):
care is a sacred privilege,and I use that terminology.
The word sacred is a heavy term, butif you're working in hospitals, as I did,
it doesn'ttake much to stop and think about the kind
of a different daythat is the day of your customer.
If you think of them as a customer.
that's a very different day.
(33:56):
Nobody woke up, and said, gee,I want to be admitted to a hospital today.
Yeah.
It's just I mean, unless unless you are,you know,
really excitedbecause you're expecting a baby,
but even then, you know, hey,this is going to be a little bit painful
or a lot painful or a lot unexpected or,you know,
(34:17):
there's still a lot of anxietyeven surrounding the joyous event.
Yeah.
So you have people entering the worldand people exiting the world
in your place of business,and it is your business
to take care of that and make surethat there's a lot of dignity,
and that people are well taken care of.
So it is a sacred privilege.It's a sacred trust.
(34:39):
And not everybodyshould be doing health care.
But the people that do do it,
they need to make sure that they're upfor that challenge.
And so that's one of the thingsI try and impart with my students.
And then I get to teach, just general
organizational behavioras well in leadership courses.
And then I often talk about making surethat we take care of people,
(35:00):
that regardless of whatever industryyou're in, whatever
you're doing, if you're leading people,you're affecting lives.
And that that doesn't stop at 5:00.
What you did that day impacts
not just the employee,but it impacts family.
It impacts a whole lot of other peopleand other relationships.
So are you elevating?
(35:21):
Let's hope you're elevatingand making the world a better place.
As soon as you have any input or power,make sure you're wielding it for good.
I would have to guess thateven if you were in the tech industry
or you were in something purelywhere most are there just to make money,
I have a hard timebelieving that you still wouldn't
make it about lifting people's lives
and feeling like it is a sacred trustto make people's lives better.
(35:44):
I think that's a core value that seemsto be shining through what you do.
So yeah, no, it is a real honorand privilege to be able
to, to talk with you today.
It's been my honor and privilegeit has been awesome.
Thank you for for taking the timeto talk to me.
Everyone,we look forward to seeing you next time.
(36:04):
After this, we'll share with yousome mini workshops where we break down
some of the things Dana shared with ustoday.
Put some practical daily tips of howyou can put these things into practice,
and we look forward to followingand seeing all these wonderful people
you're mentoring upto change the whole health care business.
So thank you for doing that. Thank you.
(36:27):
Thank you.
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