CHICAGO (March 23, 2009) – As the American College of Healthcare Executives (ACHE) convenes its annual education Congress today, the military is out in force. These healthcare executives from the military’s highly regarded Medical Service Corp (MSC) run our Army, Navy and Air Force hospitals and ambulatory clinics at bases throughout the U.S. and around the world.
They are gathering with thousands of their civilian counterparts for four days of intense education covering topics such as quality, patient safety and satisfaction, physician-hospital alignment challenges, regulatory compliance, finance and even reimbursement. Military officers attend the same classes with their civilian counterparts because there are so many similarities between the two types of healthcare operations. Yes, there are some differences but those are far fewer – and minor in scope – than most civilian healthcare CEOs or their recruiters would imagine.
In addition to attending the myriad of educational sessions, many of the military personnel are here for career networking. Dozens are preparing to transition to, hopefully, a similar role in a civilian healthcare sector.
These officers are some of our best and brightest. They know how to lead. They know how to execute and produce anticipated results. They know how to work with physicians, manage to budget and compete for revenue. They have the same education and professional credentials as their civilian colleagues. Many have had the opportunity to pursue additional degrees and in-depth training programs to sharpen their leadership skills, their analytical ability, or to master the latest thinking concerning health system design and delivery.
The military does NOT cut corners when it comes to investing and developing their leaders.
Why, then, are these proven leaders not viewed as a choice “catch” for the executive teams of healthcare organizations in the U.S.?
The answer is that they face a wall – a formidable barrier — built of years of accumulated myths, a lack of understanding of how military hospitals operate, or, often, even a preference for “safe” candidates, those candidates whose background and career path is like their own.
Some of these myths include:
1. Most military officers hold, on average, four jobs in their first seven years following retirement.
Yes, a study reported these results. However, those numbers are significantly skewed by including the officers from combat and support divisions where the command structure and leadership style are, in actuality, markedly different from the MSC, according to former officers I have interviewed and who have successfully completed the transition.
2. The military’s leadership structure, the privileges and the forced respect of commanders creates unreasonable expectations that are incompatible in the civilian workplace.
This myth usually draws the biggest smiles – even some hearty laughs – from military healthcare executives. On average, 65-70 percent of all employees at military healthcare installations in the U.S. and overseas are civilians. That fact alone illustrates why there is much less of the formal military culture in their hospitals – less saluting and less commanding personnel to perform.
3. MSC executives have a captive workforce that is compelled to follow orders. This makes running a military hospital much easier than a civilian facility.
This, too, is incorrect (See number 2 above). MSC civilian employees need and want the same type of inspiration, coaching, mentoring, and encouragement as their counterparts in civilian hospitals. Issuing commands, shouting orders, dictating performance, or other types of command behavior that is more evident in combat units does not work in military hospitals, Walter Reed included.
4. Military healthcare executives do not understand civilian labor relations issues.
Not true. Surprisingly, the civilian workforce at military hospitals in the U.S. and at many bases around the world, are unionized. Colleague and friend, Col Tom Driskill (retired), who was Chief of Staff at Walter Reed and Trippler Army Hospital in Honolulu, among others, said that labor negotiations in the military could be every bit as tough as those in a civilian closed shop union environment. Officers who do not maintain effective labor relations will have a tough time meeting their performance targets, and this could materially affect their career outlook.
5.The military does not hold its hospital executives to the same standard of accountability.
This myth is wildly off target. MSC officers know that they might survive one bad performance review, but not two. Two poor performance reviews typically means you will not advance to the next rank. In the military if you do not advance, you retire, you are asked to leave or you are forced out. If you do not qualify for retirement at that point, you will lose everything that you have invested in your career investment.
The military’s culture on accountability is tough. It is unforgiving. And it is very different from the civilian hospital culture where the “up or out” mentality does not exist. While this can potentially create transition problems for some officers, this can be handled through an effective “onboarding” program.
Are there bad leaders in the MSC? Yes, as is certainly the case within civilian healthcare organizations. Nonetheless, civilian leaders need to take a hard and long look at the MSC’s deep pool of talent. They will find great leaders with solid work experience who can and will deliver exceptional value.
They are, after all, among our best and brightest with solid work experience.