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The Best Leaders Know When to Get Out of the Way

 |  By Philip Betbeze  
   September 17, 2010

This month's cover story in HealthLeaders magazine is an interesting one. Yes, I wrote it, but you should read it anyway. It's interesting because I was stunned by how much simplicity there is in running a super-complex organization like a hospital or health system. At least that's what my self-deprecating sources would like you to think. I think it's much more complicated than they let on.

In fact, I know different. I can't think of a more uncertain time in the industry for people in those positions, and I know many of you, their peers, would agree with me. Yet they have faith that their management style and that surrounding themselves with talented people will be the broad strategy that will lead to ultimate success—defined by quality healthcare delivered to the community at a reasonable price, first of all, and also defined by a thriving nonprofit business. Yes, I said it. Healthcare is a business even if most healthcare organizations would prefer I didn't call it that. For them, calling it a business is based on what they feel is the public perception. Calling nonprofit healthcare a business is, for many healthcare executives, akin to violating Google's purported mantra, "don't be evil."

I get it. But if you can't run a successful business in nonprofit healthcare today, you'll soon be out of a job—and the community might be out of a hospital. That's how quickly things are changing as prices for healthcare zoom into the stratosphere and government tries to do something about it.

What I learned reporting this story is that to run a successful business, today's successful healthcare CEO can't do it by executive fiat. Thankfully, it's getting harder to find despot CEOs in healthcare anymore. He or she also can't do it by stifling innovation. Many of the most successful CEOs have people they trust in positions of delegated power. Today's top CEOs are less interested in how their deputies get it done than they are in getting it done. That means CEOs meet frequently with them to dial up strategic goals, and then they leave them alone to do the job the best way they see fit.

They also don't mind respectful disagreement. Steve Johnson, CEO of Susquehanna Health in Williamsport, PA, for example, values teamwork above all other attributes on his leadership team.

"What I'm looking for are individually talented people who have a strong experience background, but who are very good at working together," he says. "If I can't have someone with both, I'll default to a better team player."

That means finding a delicate balance of often-competing personality traits, he says. Team players can be short on the innovation front. High achievers can be impossible to work with.

"Are they candid with each other in constructive way? People who avoid conflict don't do well, and people who are lightning rods aren't solid either," he says.

So to me, that's the most important job of the CEO in healthcare these days. That is, hire talented people, and mostly, get out of the way, but know when to make that essential decision among lieutenants who may have disagreements. It's a fine balance. It's not for the timid, and it's not for the autocrats either.

If you ever played organized sports, you know what I mean. What's common about the CEOs I interviewed for this story is common among most good coaches. Their players will run through a wall for them not because of the many aspects of their life and work that the leader could potentially control, but because their leader stands behind them when they make a decision and they respect what he stands for.

We could use more people like this in healthcare, so I'm glad to see the good guys succeed.

Philip Betbeze is the senior leadership editor at HealthLeaders.

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