Yakima (Wash.) Valley Memorial Hospital was founded in 1950, which means Rick Linneweh is only the second person to lead this 226-bed hospital as CEO. He calls the hospital a "rare bird" since it's an independent, non-profit, standalone facility. Some community hospitals mull over the doom and gloom of healthcare reform, but Mr. Linneweh wants no part in that. Healthcare reform has left Yakima rejuvenated, and the hospital is eagerly strategizing its options for accountable care organizations and other collaborative networks, showing community hospitals don't have to cower in the face of change.
"We believe that delivery reform is in front of us, because payment reform won't go away, so we've been actively involved in the movement towards integrated networks and eventually towards an ACO," Mr. Linneweh says. "In that sense, the small community hospital can be a test tube for how healthcare reform works in rural America." Mr. Linneweh discussed other milestones of his career and lessons he's learned since 1977.
Question: When you first assumed your position, was there anything that initially took you by surprise?
Mr. Linneweh: I took over an organization that did not know who owed us money, or to whom we owed money. I took it over and if I look back candidly, I can't believe how long I was underwater. After the first six months, I thought I would see the surface of the water. Then in another six months I thought I'd see the surface. So it took a couple of years for me to see the surface and get the hang of this.
The hospital was [on the verge of] being extinct. It took a lot of time, effort, energy and family sacrifice to make it to where we are today. The role of CEO has no definition to it. It is what you make it out to be. I've absolutely loved what I've been doing for that past 35 years. I can count on one hand the number of times I've questioned why I'm here. I'm constantly learning. There might be four or five things I want to get done in a day, but no one day is ever the same.
Q: How has healthcare reform affected your role?
Mr. Linneweh: I came into this world out of graduate school as the administrator of an acute-care hospital. Then I transitioned to become the leader of a vertically-integrated organization when, about 30 years ago, we decided we'd move into extensive pre-acute and post-acute care services. That also meant the inclusion of physician practices as part of a vertical integration. Now I'm spending the last years of my career intimately involved with physician activities. A mentor told me a long time ago that my relationships with physicians would be the key to everything that happens, and he was right.
Q: How have your professional relationships evolved over the past 35 years?
Mr. Linneweh: Relationships are built upon trust. Trust happens over time and that time allows an individual to demonstrate consistency, predictability and reliability. Over the time I've been here, I've been able to demonstrate that so physicians are comfortable in a candid relationship. When I've talked to them about being "physician-driven," that's a very honest statement and one that will be followed. I will literally share the reigns with them.
Physicians move into a community to stay there for a long time, so the organization that moves people in and out is always going to be at a disadvantage. Physicians want consistency. I think in the 35 years I've been here, some other hospitals have gone through about 16 different CEOs.
Q: Are there any mistakes that resulted in memorable lessons when you first started out?
Mr. Linneweh: I came out of grad school feeling like a hot shot. I had a lot of opinions and I offered those opinions when no one asked me about them. I had to learn the hard way. The most important part of conversations is asking questions. That's completely changed the way I interrelate with individuals. I am the "question man." Yeah, you may have opinions, but until someone asks you for them — continue asking questions.
Q: What, if anything, gets you stirred up about healthcare today? What tends to spark a reaction?
Mr. Linneweh: I love where we're at right now. Yeah, I'm at that point where I'm thinking about retirement, but I've been waiting around since the 1960s for some kind of reform. Our system is broken. This whole discussion happening around healthcare delivery reform is absolutely invigorating. It's causing creativity and collaboration like I've never seen before. It's energizing! I look at retirement and want to say, 'Not while this is going on.' We're having some good success and fun in the near term, and I frankly think the whole idea of accountable care organizations and clinical networks — from our standpoint — is going to be the strategy for Memorial to stay independent.
Q: CEOs often comment that their job can be quite lonely. Have you experienced this at all? If so, how do you overcome it?
Mr. Linneweh: Is it a lonely job? Oh, heavens yes it is. Unless you're part of a system where you can spend time talking to colleagues in non-competitive environments. But those of us in independent environments — you do find it lonely. A lot of this has to do with temperament. I get my energy from going off to a quiet room to think. I find it energizing to be alone. But I think the CEO almost requires an individual who is comfortable being by themselves.
Q: What approaches do you take when it comes to working with your senior management team? Do you have any informal "rules" or codes of conduct in how you work together?
Mr. Linneweh: I'm an optimist. I'm a truster. Yes, I've been stung by trusting, but overwhelmingly I've found that trusting has taken me a long way. The two litmus tests I have for people who work with me are, first, I need to know how they make decisions. Second, I need to know what their judgment is like.
I think of [my relationships as] a space craft up in the stratosphere. You know how people used to walk in space? They were always tied to a spacecraft by a tether. Whenever I'm starting a new work relationship, I start with a short tether until I know their decision-making and judgment. As I spend time with them, the tether gets longer and longer, until now some people have jetpacks on their back and just check in and then zip back out to space on their own.
I have a group I've worked with for decades. One of my senior VPs who recently retired had worked with me for 30 years. A current senior VP and I have worked together for 22 years. I'm a piece of the puzzle with indents here and protrusions there, and I look for people who will fit my puzzle piece. They'll fill in for some of my inadequacies so we as a pair make for something better. It's always been a case of looking for pieces that not only fit me, but also the people who work with me.
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"We believe that delivery reform is in front of us, because payment reform won't go away, so we've been actively involved in the movement towards integrated networks and eventually towards an ACO," Mr. Linneweh says. "In that sense, the small community hospital can be a test tube for how healthcare reform works in rural America." Mr. Linneweh discussed other milestones of his career and lessons he's learned since 1977.
Question: When you first assumed your position, was there anything that initially took you by surprise?
Mr. Linneweh: I took over an organization that did not know who owed us money, or to whom we owed money. I took it over and if I look back candidly, I can't believe how long I was underwater. After the first six months, I thought I would see the surface of the water. Then in another six months I thought I'd see the surface. So it took a couple of years for me to see the surface and get the hang of this.
The hospital was [on the verge of] being extinct. It took a lot of time, effort, energy and family sacrifice to make it to where we are today. The role of CEO has no definition to it. It is what you make it out to be. I've absolutely loved what I've been doing for that past 35 years. I can count on one hand the number of times I've questioned why I'm here. I'm constantly learning. There might be four or five things I want to get done in a day, but no one day is ever the same.
Q: How has healthcare reform affected your role?
Mr. Linneweh: I came into this world out of graduate school as the administrator of an acute-care hospital. Then I transitioned to become the leader of a vertically-integrated organization when, about 30 years ago, we decided we'd move into extensive pre-acute and post-acute care services. That also meant the inclusion of physician practices as part of a vertical integration. Now I'm spending the last years of my career intimately involved with physician activities. A mentor told me a long time ago that my relationships with physicians would be the key to everything that happens, and he was right.
Q: How have your professional relationships evolved over the past 35 years?
Mr. Linneweh: Relationships are built upon trust. Trust happens over time and that time allows an individual to demonstrate consistency, predictability and reliability. Over the time I've been here, I've been able to demonstrate that so physicians are comfortable in a candid relationship. When I've talked to them about being "physician-driven," that's a very honest statement and one that will be followed. I will literally share the reigns with them.
Physicians move into a community to stay there for a long time, so the organization that moves people in and out is always going to be at a disadvantage. Physicians want consistency. I think in the 35 years I've been here, some other hospitals have gone through about 16 different CEOs.
Q: Are there any mistakes that resulted in memorable lessons when you first started out?
Mr. Linneweh: I came out of grad school feeling like a hot shot. I had a lot of opinions and I offered those opinions when no one asked me about them. I had to learn the hard way. The most important part of conversations is asking questions. That's completely changed the way I interrelate with individuals. I am the "question man." Yeah, you may have opinions, but until someone asks you for them — continue asking questions.
Q: What, if anything, gets you stirred up about healthcare today? What tends to spark a reaction?
Mr. Linneweh: I love where we're at right now. Yeah, I'm at that point where I'm thinking about retirement, but I've been waiting around since the 1960s for some kind of reform. Our system is broken. This whole discussion happening around healthcare delivery reform is absolutely invigorating. It's causing creativity and collaboration like I've never seen before. It's energizing! I look at retirement and want to say, 'Not while this is going on.' We're having some good success and fun in the near term, and I frankly think the whole idea of accountable care organizations and clinical networks — from our standpoint — is going to be the strategy for Memorial to stay independent.
Q: CEOs often comment that their job can be quite lonely. Have you experienced this at all? If so, how do you overcome it?
Mr. Linneweh: Is it a lonely job? Oh, heavens yes it is. Unless you're part of a system where you can spend time talking to colleagues in non-competitive environments. But those of us in independent environments — you do find it lonely. A lot of this has to do with temperament. I get my energy from going off to a quiet room to think. I find it energizing to be alone. But I think the CEO almost requires an individual who is comfortable being by themselves.
Q: What approaches do you take when it comes to working with your senior management team? Do you have any informal "rules" or codes of conduct in how you work together?
Mr. Linneweh: I'm an optimist. I'm a truster. Yes, I've been stung by trusting, but overwhelmingly I've found that trusting has taken me a long way. The two litmus tests I have for people who work with me are, first, I need to know how they make decisions. Second, I need to know what their judgment is like.
I think of [my relationships as] a space craft up in the stratosphere. You know how people used to walk in space? They were always tied to a spacecraft by a tether. Whenever I'm starting a new work relationship, I start with a short tether until I know their decision-making and judgment. As I spend time with them, the tether gets longer and longer, until now some people have jetpacks on their back and just check in and then zip back out to space on their own.
I have a group I've worked with for decades. One of my senior VPs who recently retired had worked with me for 30 years. A current senior VP and I have worked together for 22 years. I'm a piece of the puzzle with indents here and protrusions there, and I look for people who will fit my puzzle piece. They'll fill in for some of my inadequacies so we as a pair make for something better. It's always been a case of looking for pieces that not only fit me, but also the people who work with me.
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