Coping with change in the healthcare industry - column

Healthcare Financial Management, April, 1989 by Edward A. Kazemek

Coping with change in the healthcare industry

Coping with change has become the number one priority for most hospital executives and managers.

Wherever I go, the discussion invariably turns to the issue of adapting in order to survive the relentlessly changing healthcare industry. Many administrators and senior managers are being overwhelmed by the rapidity and intensity of change in the industry.

The most frequent comments that mark these conversations are:

"No matter what we do, we seem to be losing ground."

"I don't know which way to turn anymore."

"The fun is gone out of hospital management--I wish I were closer to retirement."

One hospital chief executive officer (CEO) suggests that for every executive who voices his or her concern about an uncertain and seemingly uncontrollable future, "there are at least 10 others who internalize their anxiety, put on a happy face for the staff, and go home to restless nights."

What can hospital executives and managers do to better cope with change and, possibly, guide the change rather than remain a victim of it? I asked this question at a recent executive forum. Some of the common themes that emerged from this discussion follow.

SHARE LEADERSHIP. Hospital executives must expand their concept of leadership to include the board of trustees, physicians, and sponsoring body. These powerful groups must become more actively involved in strategic decision making and problem solving for the institution.

Rather than keeping these groups "in their place," hospital executives must create a more active and meaningful role for them. This may require a different leadership style from those senior executives who are used to controlling involvement rather than encouraging it. As one CEO stated, "This isn't the time to play the Lone Ranger."

PROMOTE TEAMWORK. Hospital executives should adopt a teamwork management philosophy as a means of coping with change. Vice presidents, department heads, staff, and volunteers must get a clear signal that they are expected to look for ways to help one another to become more effective and efficient.

Sharing financial, market share, and other results-oriented information with management and staff is a good place to begin promoting the spirit that "we're all in this together."

NETWORK. Hospital executives should look for opportunities to share information and to learn from their peers. There is a natural tendency to withdraw or turn inward in times of stress and change. Falling into this trap will ensure a lack of innovative ideas and solutions.

Most hospital executives that I have talked with strongly support networking. Many suggest that networking should not be limited to "comfortable" peers that one sees and talks with routinely. Instead, executives should take the time to seek out new contacts who might have novel ideas or suggestions, including competitors. As one forum participant forcefully stated: "The solutions are out there. We can't afford to reinvent the wheel."

TAKE RISKS. Business as usual during times of change or crisis will usually ensure failure. Risk taking has become a new, uncomfortable management style expected of hospital executives.

Not too long ago, a hospital CEO would have been criticized by his or her board, sponsoring body, and medical staff for proposing business ventures and tactics that are now commonplace. Hospital executives must accept this dimension of their role and turn it into a strength.

KEEP PERSPECTIVE. Most hospital executives are "winners." They have worked their way up the ladder of success in their chosen field. However, the playing field has changed and will continue to change in a similar manner during the 1990s. Thus, the job may no longer be right for a number of hospital executives.

Those courageous enough to accept this possibility are proactively controlling the evolution of their careers. Things will not just happen to these people -- they will make things happen for themselves.

To keep perspective, I am reminded of an early retirement speech given by a well known hospital CEO who stated with no false sense of bravado that, "I was a successful person before I got into the healthcare field. I've been successful for over 15 years in hospital management. And, I expect to continue being successful in my next career as well."

Change is never easy to deal with. Now is the time for hospital executives and management to accept the reality of constant change so that they can guide their institutions in a more favorable direction.