The Best in Bosses

My last musing, "Jerk Alert," was about bad bosses and the damage they can do to an organization.  And, Lord knows, there are plenty of bad bosses to go around.  

But I've been fortunate in my career to have had many great bosses...guys and gals who led by example, were firm but fair, who inspired and thereby inspired me to lead others.  What leadership characteristics did they have in common?

Bill Morrison graduated from Johns Hopkins University, Baltimore MD in 1949, Rex Hospital, completed a Hospital Administration Residency, Raleigh, NC in 1951. He was the first administrator for New Hanover Hospital.  For over twenty-one years, Bill energetically and strategically paved the way for what is now New Hanover Regional Healthcare System in coastal North Carolina. Along the way, he earned the respect of health care administrators, physicians, community leaders, politicians, and representatives from a variety of organizations. Bill established the first hospital Quality Assurance Department in North Carolina; established the first Neonatal Intensive Care Unit east of Raleigh. He pioneered Ambulatory Surgery and Same Day Surgery, enabling patients to arrive, have their surgery and return home in the same day, thus reducing patient care expenses.

Bill was a strong believer in teamwork and the value of a diversified hospital work force. He was a strong employee advocate and implemented a wage and salary system to ensure equitable pay practices. In fact, his first recommendation to the Board of Trustees was to raise the salaries of the registered nurses to a competitive amount. 

In 1987, Bill hired me as the first administrator of the newest hospital in the growing New Hanover system, The Oaks Psychiatric Hospital.  I had experience in psychology and outpatient clinics but had never run a freestanding psychiatric hospital.  In that calm Morrison way all of us remember, Bill said, "You'll do fine.  I won't let you fail."  I worked for Bill for 8 years, up to his retirement.  Bill formed a consulting firm and hired me as his psychiatric hospital consultant.  We worked with a number of hospitals in North Carolina and won awards from the North Carolina Hospital Association.

Here's what I remember about Bill:

"Take Risks to Get Rewards."  From Day 1, Bill encourage me to make BIG decisions, take chances, roll the dice.  Not carelessly, but calculated risks for specific rewards.  And you know what?  We we right most of the time.  We grew from 17 beds to 40 then to 62, we added outpatient services.  We had the first partial hospital in eastern N.C.

"Support Failure."  When I did fail or make the wrong decision, all Bill would say -- usually with a wry smile -- was "Well, that didn't work."  And we'd move on.  His willingness to support subordinates through failures led us to make stronger and bolder moves.

 "Three Questions."  One day I was sitting in Bill's office and our Chief of Staff had just quit. What should we do now?  Bill said something that has always stayed with me:  "Bob, whenever there is a major shake-up in an organization, your staff will have 3 questions.  Interestingly, they are always the exact same 3 questions:  'What about me?' 'What about me?' And oh, by the way, 'What about me?'  He taught me the importance of seeing the organization through the eyes of individual staff members and paying attention to what they need.

"Give Away the Credit."  Bill was an expert at recognizing people and their accomplishments...even when the accomplishment was his.  He made people feel 10 feet tall.  He was humble about his own achievements and lavish with his praise.  I didn't learn of many of his national awards and accomplishments until I read his obituary in 2011.

"Remember Your Ball Boys."  One day at Management Team, the housekeeping came into the Board Room to empty the trash.  When she left, Bill looked around the table and said "Who knows that young lady's name?"  No one did.  He said:  "She knows everyone of your names. She's part of our team.  You should know her name, too."  And I made sure I did, her name was Delores.
  
"Martinis."  During one of our first consulting engagements, Bill and I found ourselves staying in a little rural motel in eastern N.C., in a town of no more than 4,000 people.  Bill invited me to his room for "happy hour" and produced a portable bar with a bottle of vodka, two glasses and an eyedropper of vermouth.  He explained that no matter where in the world you found yourself, as long as you had vodka, a glass and an eyedropper of vermouth, all you need was ice and you were "in business." To this day, every time I have a martini, I raise the glass to my friend and mentor, Bill Morrison.

Jim Johnson actually hired me away from The Oaks and New Hanover Regional.  I had moved up the food chain after Bill's retirement and was now the Senior Administrator of the Specialty Hospital Division of the regional system, overseeing psych and rehab hospitals and various hospital departments.  But I wanted more.  I wanted to be a Chief Executive Officer, in charge of my own hospital.  

Jim had worked his way up from hospital CFO to hospital CEO and, when I met him, was the corporate Senior Vice President of Operations for the Charter Medical Corporation, at the time the largest for-profit psychiatric hospital company in the world.  And although I didn't have any for-profit hospital experience, he was willing to give me a chance and hired me to be the CEO of the Charter Cypress Behavioral Health System of Lafayette LA, a 2-hospital system.  

 

Here's what I learned from Jim:

 

"Firm But Fair."  Jim could be a tough leader.  He was demanding.  He was decisive.  He had high expectations.  But he was never unfair.  He told me what he expected, asked me if I could do it, then held me accountable.  I learned quickly to meet those expectations.

"You Manage What You Measure."  I learned that daily "Flash" (operations) meetings with my management team were critical.  We reviewed the previous 24 hours, metrics, staffing, admissions, discharges and projected the next 24 hours.  We measured everything and made daily adjustments to operations.  You can't wait until the financials come out to make changes, you make them every day.

 "Speed + Execution = Results."  My first week on the job, Jim asked me if I knew what my budgeted staffing ratio was.  I was proud to say I did.  Then he asked me what my census was.  I told him.  Given the staffing ratio and the census, did I know how many staff I could have?  I gave him the number.  (3 right answers in a row!  I'm on a roll!)  Then he asked me how many staff I actually had on payroll that day.  I told him...and the number was 14 staff members higher than the ratio allowed.  "What are you waiting for?," he asked.  It's a question he still asks me occasionally.  It is shorthand for "You know what needs to be done.  Do it."

"Get Your Hands Dirty."  This is another favorite Jim-ism.  It means:  "Get out of the office.  Walk the halls.  Talk to patients.  Work directly with your managers.  Hold everyone accountable." 

 
"Every Once In Awhile You Have to Throw a Dead Body Into the Hall."  I had a CFO who wasn't doing his job.  I liked the guy and so I minimized the size of the problem.  The problem got worse.  Eventually, it caught Jim's attention.  "Fire him.  If you know he's a screw-up, so does everyone else on your team.  He's hurting the hospital and he's hurting your leadership.  Set an example.  Throw a dead body in the hall."  

"Whether It's Your Fault or Not, It's Your Fault."  As a CEO, you are ultimately responsible for everything that happens in the hospital.  24 hours a day.  365 days a year.  Accept the responsibility, but in doing so, you have to work to build an organization that works as well when you're gone as when you're there.  Build a management team and staff who also accept that responsibility.  

"Do or Do Not.  There is No 'Try.'"  Actually, Yoda said that in Star Wars, but Jim had a version of it.  "Can you get your staffing in line?," he'd say. "I'll try," I'd say.  He'd say:  "Don't try.  Do it." Speed + Execution, ya know?

Jim and I had a good run with Charter Medical.  Years later, the company went under and Jim started his own psychiatric consulting and management firm, The Cawley Johnson Group (http://cawleyjohnson.com/).  I was pleased that he brought me in to manage a hospital for him in Indiana and I'm still working with him, now leading a psychiatric hospital in Georgia for CJG.    

 

These are just two of the great leaders I've been privileged to work with.  Two completely different styles, but common threads, I think: 

 

INDEPENDENCE:  Both of them clearly defined their expectations of me in specific but broad terms, e.g., "Meet your budget", but allowed me to determine how to achieve those goals.  General Patton once said, "Tell your leaders what you expect but not how to do it.  They'll surprise you with their ingenuity."

 

ACCOUNTABILITY:  But independence goes hand in hand with accountability.  If I have the freedom to determine the game plan, I must accept responsibility for the outcome.

 

VISION:  Bill once told me the job of a CEO is to "put your feet up on the desk and dream the big dream."  Think in terms of where you want your hospital to be in 3 to 5 years, have that vision in your head all the time and make decision that are consistent with achieving that dream.

 

DECISIVENESS:  Being a leader in healthcare these days means you have to make big, bold, decisive decisions and drive them to the goal line.  Not making a decision is a decision in and of itself.  Don't be afraid to fail. Throw a body in the hall. Bill once told me, "There is magic in boldness."  I think I know what he meant.  

 

PEOPLE, DATA & THINGS:  While I was the Administrator at The Oaks, I also taught Vocational Psychology at UNC-Wilmington.  One of the theories in vocational psychology is that jobs can be categorized in terms of the amount of time & emphasis the job places on people vs data vs things.  What I learned from Bill and Jim is that a successful leader has to know his data and be able to manage things, but never forget healthcare is people-driven and, ultimately, you are only as good as the team you build.  Praise in public, criticize in private.  Celebrate success.  Reward excellence.  Give credit freely.  Thank people for their efforts.