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20 January, 2014 Posted by John G. Self Posted in Healthcare, Leadership
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What Is The Hardest Business In The World To Manage?

Posted January 20th, 2014 | Author: John G. Self

A recent study determined that the hardest businesses in the world to manage are hospitals — 20 percent tougher than any other enterprise. For health system and hospital CEOs, those results amount to nothing more than a blinding flash of the obvious.

iStock_000023234972XSmallWhile I do not know the source of the study, a colleague mentioned it during an interview and the findings are certainly consistent with Peter Drucker’s assessment — that hospitals are among the most complex of human organizations ever created by man.

Talking about achieving leadership excellence during a period of mounting turmoil, when survival is the watchword for many Chief Executive Officers, seems a little out of sync. But in fact, there is no better time to revisit this issue.

The vast majority of hospital CEOs lead community-based hospitals, from small critical access facilities in rural areas, to large regional referral medical centers in the most populated centers of America. These are important assets and the residents of the communities they serve depend on them for healthcare. The thought of “just surviving” seems inadequate, so woefully less than what the residents want and need.

As CEOs think about managing in these often confusing times, they need to zero in on the legacy they will leave behind. No, not their personal legacy, but that of the organization they run. Will it be a health system or a hospital that “just survived,” scrambling to remain relevant, or will it be a vibrant, innovative health care center that takes pride in safely delivering sick and well care in a way that lowers cost, improves quality and satisfies their customers? 

For CEOs, this is a solemn and challenging responsibility. Their actions, and the decisions of their Boards over these next five to seven critical years, could well determine whether the community has access to an animated responsive healthcare operation, or whether they just get by and patients are forced to go elsewhere for more sophisticated types of diagnostic technology and treatment. A successful healthcare organization is essential to the well-being of the residents it serves as well as a critical cornerstone of the community’s economic development.

Some communities which, in the late 70s, 80s and 90s turned this valuable community asset over to investor-owned hospital corporations to ensure the legacy of their hospital through better management and access to capital, are in for a real shock as the major companies like HCA, Community Hospital Systems (CHS) and LifePoint begin making strategic divestitures of their marginal performers as shrinking Medicare and commercial reimbursements, and continuing declines in inpatient admissions, hit profits and stirs the pot of unrest on Wall Street which is addicted to growth in earnings, not just profits.

The not-for-profit community systems that many investor-owned hospital executives derided as ineffective may ultimately prove to be preservers of this community legacy.

One thing is certain, if you are a healthcare executive and you do not like change or the pressure of unbelievable challenges, this will not be an enjoyable time. A new career may be in order.

© 2017 John Gregory Self

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