Editor’s Note:  David C. Pate, MD, JD, FACP, FACHE, is the Chief Executive Officer of St. Luke’s Health System, the market leader in Boise Idaho.   

David C. Pate, MD, JD, FACP, FACHEDr. Pate is a graduate of Rice University with a degree in Biochemistry.  He earned his Doctor of Medicine from Baylor College of Medicine.  Following graduation he entered the private practice of Internal Medicine before pursuing a law degree from the University of Houston in 1996.  

Prior to being named as CEO of St. Luke’s Health System in Boise, Dr. Pate’s executive responsibilities included serving as Senior Vice President and Chief Medical Officer at St. Luke’s Episcopal Health System in Houston and as Chief Executive Officer of that organization’s flagship hospital in the Texas Medical Center.  

He regularly writes an insightful blog on a range of subjects, from leadership to population health management. The blog appears of the System’s web site.


In my pre-Thanksgiving blog, Can You Build and Lead Teams?, I asked for readers to provide me their thoughts on this important subject.  Dr. Pate’s response, I believe, is a great, real-world exclamation point. In other words, spot on!

Thank you David for your continued inspiration.

My secrets to building and leading a team are:

  1. Hire right.  You (John) have written extensively about this and I agree with your advice, so I will not go into this further.
  2. Develop your trust bank with the team and add to it whenever you can – the team won’t follow you if they don’t trust you.  You have to be a role model, your acts must be consistent with your words, and you must treat people fairly.  If you don’t, people see through you and won’t trust you.  You especially have to act consistent with the values of the organization.
  3. Ask for their advice, and if you don’t take it, explain why.  Oftentimes, the most difficult decisions I have to make are when my team is divided.  I convene them, listen to all arguments, then tell them when I will make a decision by, make the decision by that deadline and then explain the basis for my decision, including that there was no right or wrong answer, how grateful I was to have their input so that I could make the best decision possible, what my decision was, and why.  This lets the team know I appreciate them, I heard them, and I carefully considered their input and I respect them enough to explain my decision to them.  It also can serve as a coaching event to help them in their own decision making.
  4. Spend time with them.  Just like a marriage, you have to spend quality time and make the effort to know them, listen to them, and understand them.  That is why I always make time for leadership retreats.  Even at a time when things were very busy and many of my team wanted to have the time back for their work, I remained committed to these retreats, and afterwards, these same executives admitted that it had been time well spent.
  5. Provide honest and clear feedback.  During their annual performance reviews, I give each executive a 2-3 page letter.  I start off by telling them how much I appreciate them.  I list out the things that I think were significant accomplishments and strengths of their leadership competencies.  I also conclude with a list of constructive criticism, opportunities for improvement, and things that I would like to see them focus on for the upcoming year.  On the other hand, when I have met to counsel an executive who will not be able to remain with the organization unless his/her performance turns around, I meet with that person to personally review everything, but because I know the person will hear and retain very little of what I tell them, I also give them a letter in which I specifically list out the problem behaviors and what it will take by when in order to improve the performance sufficiently that they can keep their job.  I also include things that I or the organization are willing to do to support them.  Not only does this promote effective communication, but it adds to the trust bank (I have never had an employee I have terminated sue the organization) and it provides a nice record.  I have found that even my best performers don’t fully trust the wonderful things said about them during the performance appraisal if there is not something pointed out that they can do to improve.
  6. Recognize accomplishments.  I spend time to make sure I personally thank my team members for special accomplishments.
  7. Know them personally.  It is important to understand what is going on in their life, who their family is, and what is important to them.  Recognizing that they are special people worth knowing, and not just employees adds to their engagement and their willingness to follow you when the times are tough.