Carilion Clinic's COO discusses strategy, team-building and dealing with change.
Steve Arner currently serves as president of Carilion Medical Center and COO of Carilion Clinic in Roanoke, Va. He began his career with Carilion in 1996 as a financial analyst and has since served as budget manager, human resources compensation and analytics director, hospital administrator at Carilion Stonewall Jackson Hospital, vice president of cardiothoracic and vascular services, and senior vice president at Carilion Clinic. In addition to his work at Carilion, he also worked briefly at Cigna. The son of an Army physician, he has lived in many different places, including Salt Lake City, Honolulu, Ft. Leavenworth, Kan., Frankfurt, Germany, and Rockville, Md.
Note: Interview has been lightly edited for length and clarity.
Q. What is unique about your market? What must you factor more into your strategy than you would if your 
organization were elsewhere in the country?
Steven Arner: One of the things that make us unique is that we have a fairly stable but limited population growth. However, we have significant provider competition from local, regional, and national organizations. At the same time, there is limited payer competition in our market. While we provide care in some urban markets, we also provide care to a very large rural geographic area. Carilion Medical Center is in Roanoke, Va. However, we have healthcare facilities — either hospitals or physician offices — that reach out well over 100 miles from Roanoke. This plays a significant role in our strategic planning process as we work to provide the best and most efficient care throughout our region. One outcome of this has been the establishment of almost 40 certified medical homes. We also developed an innovative, efficient regional operations center that, among other things, oversees system throughput and flow, including transportation for ambulance and air service.
We are also a significant economic driver in this region. As the largest employer in this part of Virginia, we provide many jobs in both our local and regional markets.
Q: What is your best advice for building a team?
SA: I like to make sure we are always grounded in the organizational values. At Carilion, our values are known as the five Cs: Compassion, Curiosity, Commitment, Community and Courage. Putting values first is the foundation of building a cohesive team with members working from the same understanding of what matters most.
Once you've assembled a team made up of members with diverse strengths and backgrounds, it's important to show you value each member of the team and always recognize each member's potential. Take the time to get to know everyone — not just as a member of the team but as an individual. People will be more likely to contribute to the team and the organization if they know that you value them.
Q: What is the most memorable piece of advice you have ever received?
SA: My parents instilled in me a strong work ethic. They emphasized continuous learning, asking questions and always being willing to take on new challenges.
My great uncle also made a strong impression on me by embodying these same values. As a young boy growing up on a farm, he fell in love with airplanes and his country. When World War II started, he left home as a teenager to join the Royal Air Force so that he could help the Allies and ultimately became a general in the U.S. Air Force. He taught me that if you're willing to learn and work hard and you care deeply about something, then you have the capacity to do anything.
Q: What about healthcare — either broadly or specific to your organization — has most surprised you in the past year?
SA: I think more exciting than surprising is how disruptive technology is helping to reinvent healthcare. Whether it's the role technology plays in advancing medical research or the ability for personal technologies to impact how we as individuals monitor and improve our own health, we are on the cusp of a new era in healthcare. It seems that more and more entrepreneurs, as well as healthcare organizations, are asking questions like, 'Why can't we?' and 'What if?' I'm looking forward to seeing what technology will do next to help us move forward.
Q: How do you deal with resistance to change?
SA: At Carilion, we have a very open culture of communication. Being open and transparent certainly helps, but specifically in regards to dealing with resistance, I've found it's effective to make sure people understand why we are doing things and why we need to change. Perhaps not surprisingly, my approach to change management has been heavily influenced by a pair of books I use when teaching a physician leadership class on change management: Switch: How to Change Things When Change is Hard by Chip and Dan Heath and Leading Strategic Change by Hal Gregersen and Stuart Black. Among many other things, they both emphasize helping people experience change on a small scale first and understand why change is needed.
Q: What do you most enjoy doing outside of work?
SA: My favorite thing to do is spend time with my four kids. They are all active in a variety of sports, and I really enjoy spending time at their various sporting events. We also enjoy traveling as a family — whether we are visiting the museums and skyscrapers of New York or the beaches of Florida, we love visiting different places and spending time together. My wife and I both love history, and when we travel, we love to learn about the history of places we visit.
When we aren't at a sporting event or traveling, I also love to read.