Dirty Words

At some point in their education, all aspiring reporters learn about journalism's "seven dirty words." These terms (not printable here) are guaranteed to offend, ostracize, and get you fined—or, as comedian George Carlin said, they will "infect your soul, curve your spine, and keep the country from winning the war."

The world of healthcare leadership has a dirty word of its own. It's a word that can propel leaders to the top of their organizations—only to knock them back down. It can drive people to cheat, lie, and steal. On a smaller scale, it can even kill team spirit, zap loyalty, stunt growth, and trigger resignations. But it's also one of the words I hear most often: "I."

Sit in on any senior-level meeting, and you're likely hear a lot of "I." Managers will say, "I've implemented a new system" or "I've launched a campaign" or "I analyzed the process." But how often have they actually done any of those things? Many leaders use the word "I" to describe every success and offer "he/she/they" only when it comes to explaining failure.

I met George Masi, executive vice president and chief operating officer of Harris County Hospital District in Houston, at the annual American College of Healthcare Executives conference this spring. As I've written before, Masi's an expert on leadership—both good and bad. In the days following Hurricane Katrina, Masi's organization treated thousands of displaced patients in a virtual hospital in Houston's Astrodome. Hard times are the ultimate test of leadership, Masi said—and what separates the "I" sayers from the "we."

"I'm very suspicious when I hear leadership speak about 'I'," Masi told us. "These people won't be the ones to help you in times of adversity."

As Masi explained, leadership is all about relationships—with unions, nurses, boards, physicians, patients, the media, and the community. Good leaders don't go it alone. They know it's not about them, it's about the organization. And to this end, they build on the work that others have done before them. They recognize that a project might outlast their tenure, so they pass their knowledge on and they credit others' knowledge.

At most organizations, aspiring leaders learn early on that saying "I" is what gets them noticed. Senior executives may need to gently retrain them to say "we." Most of all, leaders need to make sure they're not guilty of overusing that one-letter word themselves. Because as every parent knows, it's the dirty words that are most likely to be picked up and repeated.