After 18 years as the CEO of The Permanente Medical Group, based in Oakland, Calif., overseeing 22 Kaiser Permanente hospitals, Robert Pearl, MD, knows a thing or two about what business skills hospital C-suite leaders need to excel in their positions.
Dr. Pearl, a professor at Stanford (Calif.) University, spoke with Becker's about the traits of great hospital leaders, operational challenges and the best piece of advice he has ever received.
Question: What skills are needed to turn a good hospital leader into a great hospital leader?
Dr. Robert Pearl: Three skills: emotional intelligence, communication excellence and strategic thinking and a willingness to take risks.
- Emotional intelligence. You'll never be able to make improvements without doctors trusting you, and they'll never trust you unless you can see and respect how they view patient care.
- Communication excellence. Every new great idea generates concerns, confusion, questions and distrust. One to one communication is the only way to overcome all.
- Strategic thinking and a willingness to take risks. At the start of major change, leaders need to be able to see the threats, and they often are blind. But they also need to move forward despite them, and that takes courage.
Q: Aside from the qualified healthcare worker shortage, what is the biggest challenge facing hospital leaders today?
RP: Again, a few things.
- Physician burnout leading to difficulty making the operational improvements needed.
- Resistance to operational improvements that require closure of small, inefficient (and often redundant) services in hospital systems.
- Public perception that hospitals are merging for monopolistic reasons, raising prices and leaving patient needs behind.
Q: What's the best piece of advice you've ever received?
RP: Doors open and doors close — if you don't jump through, you may never have another chance. When the CEO role in Kaiser Permanente opened up, I didn't initially want the job. I took it because it was a unique opportunity — and I've never regretted doing so. Communicate again and again and again. It takes 17 times for a person to learn a new word in a foreign language and it takes 17 times for people to understand a major change.
Q: Anything else on your mind?
RP: When faced with a question of whether your organization is moving too fast or too slow, always speed up. Kaiser put an EHR into practice before others and became the leader in NCQA-measured quality. We committed to same-day access for all problems, including the most routine, and became the J.D. Power market leader. And, we decided to reduce costs through preventing and avoiding complications from chronic diseases and lowered our prices 15 percent below the competition. The result of all three was growing market share from 34 to 46 percent.