Stress, Focus Buoy Healthcare Leaders

This article appears in the December 2011 issue of HealthLeaders magazine.

In our 2011 Industry Survey, 32% of leaders said they are very satisfied in their job, which is down from 42% in 2009 and 38% in 2010. While the overall satisfaction rate (combining satisfied and very satisfied) remains greater than 80% (it was 81% in 2011, 86% in 2010, and 87% in 2009), what do you think accounts for this lessening in intensity of satisfaction, and do you expect that to continue?   

J. Scott Graham,
CEO, Coulee Medical Center, Grand Coulee, WA

I have been in this position just over a year, and I’d be in that 32% who are very satisfied. But I think I understand why it is on the wane. A lot of it has to do with the external pressures out there that have continued to mount over the past several years. We are one of the most highly regulated industries out there, and that makes it extremely challenging to stay on top of all of that.

So people want the greatest amount of service for the least expense and, like in any industry, that is going to put on some pressure to be more competitive and efficient, and that is going to increase the stress levels.


Jeffrey E. Thompson, MD
CEO, Gundersen Lutheran, La Crosse, WI

“I am not terribly surprised by it. I believe there are a lot of stressors going on in healthcare in general and in the environment around us. Stress brings out the good and the bad. If your organization is struggling, it will make it look worse. If your organization is really functioning well, the stress tends to allow your organization to shine.

A problem that I see a number of people having is they get paralyzed because of the huge uncertainty in the government, the insurance environment, and in the community. There are so many things up in the air. You need to look past all the things that could go in a different direction and ask, “What are the things we need to accomplish, and what are the precious few things that we really need to execute that are going to be good in all of those environments?” Regardless of whether fee-for-service hangs around or ACOs rally and charge down the road in the next year or two, an organization that can prove its quality, that has palpably better service and lower cost than its competitors, is going to do well.

People get nervous, and with good reason, because it is not clear where it is going to go. But that should not paralyze you into inaction. You can still make a plan for it.

George Kyriacou
President and ceo, Hanover (PA) Hospital

A factor that may be more unique to smaller hospitals than larger hospitals is one that I have been dealing with: a real aversion on the part of both independent medical staff and some boards to take risks.
As a small independent hospital that wants to stay independent, we need to be at the leading edge—not the bleeding edge—of implementing new strategies, rather than on the second or third run when the opportunity may not be so great.

There is a tremendous amount of fear and a desire or belief that if we hold off, this is just a fad that will pass. I don’t believe that is the case.

It is understandable, but a small organization has to be fast moving and nimble to survive as an independent entity in today’s world of constantly aggregating models. If you aren’t willing to take risks and spend money to achieve financial advantage down the road, then you are going to be in a slow death spiral and in a position to be gobbled up by one of the big entities just because you couldn’t keep up with the world today.


Kimberly Bordenkircher, RN, BSN, MBA, FACHE
CEO, Henry County Hospital, Napoleon, OH

Where we are: We are on the edge of what I call transformational change. The decrease in satisfaction will continue until we successfully navigate through that second order of change. The environment and the pace of change is unrelenting.

Where we were: A decade ago when I was in this role, there would be big initiatives coming down the pike and you’d have an opportunity to prepare for them and implement them and sit back and see if
they worked or not. You had some time before each big initiative. That is not the case anymore. The change never stops.

Where we are heading: We are preparing for a future that, to some extent, is completely unknown. We know that healthcare reform is coming. Exactly what that means and what it is going to look like we aren’t sure of, but we have to position our organization so we can survive and hopefully thrive during the change. It is hard to stay focused on what is really important.

Where to focus: What works for me is that in spite of all the regulation and healthcare reform, I try to keep my eye on what is important, and that is the patient. I try to connect all the initiatives and activity back to what is important for patients. Then I work really hard to keep my staff connected to that.

This article appears in the December 2011 issue of HealthLeaders magazine.