Are hospitals and health systems inherently toxic, or do healthcare executives occasionally fail to embrace collaborative leadership strategies? According to two healthcare academics, it's a little of both.
At the American College of Healthcare Executives' 56th Congress on Healthcare Leadership in Chicago, Ken Cohn, MD, a board-certified general surgeon and CEO of Healthcare Collaboration, and Leonard Friedman, PhD, professor in the Department of Health Services Management and Leadership at The George Washington University, explained that in order for hospitals and health systems to succeed in today's hostile times, leaders will have to resort to less finger-pointing and engage in active dialogue across all organizational sectors.
How are healthcare organizations described?
Dr. Friedman explained that most hospitals and healthcare organizations are described with five modifiers: They are job generators, havens of healing, major sources of revenue, vanguards of technology and sources of stress.
Yet, when the audience of roughly 50 healthcare executives was asked if they thought "emotionally supportive" could be another modifier, only a few people raised their hands.
"There's something that doesn't quite connect there," Dr. Friedman said. "But healthcare organizations are fundamentally unhealthy places to work."
Why healthcare organizations can be emotionally unhealthy
There are several factors that contribute to fractured and emotionally unstable healthcare organizations. Dr. Friedman listed four in particular: workforce shortages (such as with primary care physicians and nurses), professional hierarchies/personal egos, the vulnerable nature of healthcare delivery and the concept that there is too much to do and too little time.
"When you talk to people on the frontlines of healthcare, they are working as hard as they possibly can, but we're asking them to do more," Dr. Friedman said. "And Rich Umbdenstock, president of the American Hospital Association, recently said that doing more with less is an unsustainable strategy."
The first step for today's healthcare administrators to conquer these factors is rather simple, said Drs. Cohn and Friedman: Acknowledge that "blamestorming," or finger-pointing, is not a positive way to resolve tough issues, and attempt to understand why employees show certain emotions in specific scenarios.
"I know this is going to sound groundbreaking, but healthcare organizations are populated with carbon-based life forms who possess a full plate of emotions," Dr. Friedman said. "All of us possess these emotions. Some of us do a little bit better job of keeping them under wraps, some of us don't. But at the end of the day, we're not robots. Maybe we need to embrace our humanness and emotions to find a way to make that work for us."
Case study
Dr. Cohn, who specializes in hospital-physician relationships, then outlined a case study in which a rift between a hospital CEO in California and a group of physicians caused turmoil — and the eventual termination of the CEO.
After the CEO had turned the local community hospital into a highly regarded tertiary care center, he eventually replaced the chairman of radiology, effectively severing decades of close ties with the hospital's radiologists. Later, the administration refused to acknowledge the newly elected chief of staff due to perceived conflicts of interest. Several skirmishes later, the CEO was quoted as saying, "This [situation] is about avaricious, dissident physicians trying to destroy my hospital." Physicians, and even hospital staff, said the hospital culture had deteriorated into a level of "DEFCON 5."
The major lessons learned? Blamestorming created irreparable damage to the hospital's relationships and reputation, thus leading to the CEO leaving, and the community consequently felt the negative ripple effects of the fallout.
"We need to learn how to build a culture that makes it safe to reflect and learn in a setting characterized by disruptive change," Dr. Cohn said. "We need to understand the role of both visionary leadership from the CEO and bottom-up innovation in facilitating healthcare transformation."
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