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It is not what you did yesterday or today, but what you will do tomorrow.

push to improveThis is the battle cry for healthcare’s push to improve, to do it better, safer and cheaper.  Get used to it.  This will be one of many relentless pressures in the lives of healthcare executives for many years to come.

For some leaders, those who lack the patience, skill or intelligence, or those who  work for someone inflicted with these deficiencies, this will be anything but an inspirational experience.

There are far too many executives who, under the guise of being straight forward or direct, will employ a  noisy “take no prisoners” approach. All they seem to care about is hitting their budget numbers, primarily financial, not the squishy quality and safety stuff. After all, the penalties for less than stellar quality of care or patient satisfaction ratings are not so great that the Wall Street investors will even notice. At least not yet.

For years, a sizable number of healthcare executives have enjoyed reasonably long and successful careers as mediocre leaders. They have come to believe, mistakenly so, that the relentless driving of people to exceed the budget makes them a great leader.  Well, not exactly.  It may qualify them as a good CEO, but remember, that is just a title.  People do not gladly follow titles.

In years past it was easier to dictate and control our businesses than to inspire our employees but regulatory and financial reforms are changing all that. Leaders throwing people under the bus to save themselves will not produce sustainable results.

As I think about this still sizable and challenged group, I wonder: when did leadership become about self-preservation versus putting our patients, our employees and our communities ahead of our self interest?

“In tough times, I made the hard decisions!”  That is what some CEOs like to brag about when they line up for their annual bonuses after laying off employees and whipping into submission those who are left.  In many cases spreading the financial pain of necessary expense reductions among all employees, including the CEO, could have resulted in even greater savings. That sounds and feels more like true leadership to me.

It is kind of ironic that the phrase “we have to make hard choices” is the same one politicians use with their core voters when they start cutting government spending,  typically beginning with the least among us in society.

Perhaps if we made the right decisions to begin with, we wouldn’t have to make those hard decisions that hurt our people and destroy morale.