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NEW ORLEANS, Louisiana – Dan is a talented CEO. His specialization is in the rural community hospital segment. He has enjoyed success but his average tenure has been less than four years. Over the last 10 years, he has held 4 different jobs.

Dan believes the frequency of his turnovers is because he has not been afraid to make tough choices to improve hospital performance. Moreover, his success has attracted the notice of recruiters who are only too happy to move him.

Community involvementDivorced with no children, he works long hours and many weekends. When he is not working, he likes to travel to a neighboring city where he enjoys three of his passions – fine dining, live music and professional sporting events. For Dan, community events and volunteerism are just not that important. A self-described agnostic, he does not see any value in going to church. When he is in town, Dan either goes to the office or, on Sundays, stays home with a pot of coffee, the newspapers and his reading file from work.

Dan’s current board is pleased with the progress the hospital is making. They are unified in their belief that a vibrant community hospital is essential to their community’s long-term economic growth. Indeed, Dan has been successful restoring the organization to financial health but they are growing uneasy with the increasing number of negative comments that are being made about their CEO. Many of the comments are misguided or inaccurate – typical of small town gossip – but the fervor and increasing frequency of the complaints is disconcerting. Most of the board members own small local businesses and they do not want to alienate their customers by seeming to ignore their complaints and accusations, regardless of their accuracy.

In a meeting with Dan, the board chairman praised the young CEO for his stellar performance in enhancing operations and improving the finances. But he cautioned Dan about the need to take steps to improve his visibility in the community, and to engage with the residents outside the hospital. “Dan, I believe the number of these complaints are growing because people are reacting to misguided claims about some of your decisions. They do not know you so the rumors and negatives are defining your image. Residents tend to believe what they are told by some of our former employees, a couple of the older physicians and family members. This is not an issue we can ignore any longer. ”

Dan pushed back. He argued that his lack of community involvement actually protected him from getting needlessly involved in the local petty politics that would make things worse. “I am paying someone to improve our public relations image and she is obviously failing us so I will make a change there this week. I will speak to those physicians and I will counsel any current employees who may be spreading negative information to be more positive or I will get rid of them, too. They are going to screw everything up.”

The board chair left the meeting a frustrated man. He reported to his colleagues that Dan did not seem to understand what the importance of his involvement in the community meant to the overall success of the hospital.

Six weeks later, ironically on a stormy Thursday night, the Board voted not to renew Dan’s contract. They appointed the CNO to serve as the interim CEO while they searched for Dan’s replacement.

Dan was shocked. As the board discussed the motion not to renew his employment contract, Dan’s defense was loaded with incredulity – that he performed well, he accomplished what they had requested and that his style of community interaction, or lack thereof, should not be a factor.

They liked Dan, but they could no longer ignore the community dissatisfaction. It was not good for the hospital, it was not good for their businesses. Painfully, they recognized they had not done everything they could have done to help Dan change, but now things had gone too far.

“If the community knew Dan the way we know him, none of this would have happened,” the chairman declared as he adjourned the meeting. “He is a nice person doing the right thing but he upset too many apple carts.”

There are six simple rules that successful rural community hospitals know. The basis for each of these guidelines is that a CEO who is active in the community, who is confident, politically and socially savvy and accessible and who is willing to personally engage his customers, is less likely to fail for the reasons that sank Dan’s otherwise successful tenure.

Each town has its own customs and traditions. Be smart, be respectful.

  1. Church – This may seem politically incorrect, and in the end everyone makes their own choices, but much of what happens socially in a small town is centered on church attendance, especially if you belong to one of the denominations that is prominent in the community. Attend, but do not rush to become a leader. In most small churches there is a certain hierarchy. You will be asked to volunteer but until then be content with attending services, educational programs and fundraisers.
  2. Service Clubs – Like church, this can be dicey. Join the club that is most active in the community. Attend, be supportive and then wait for the openings to volunteer your time and talents.
  3. Weekly Coffee Group – In many towns, influential community leaders meet for coffee at least one day a week. These tend to be tight-knit groups and outsiders are not always welcomed with open arms. Find out where the best group meets, and if it is in a restaurant or coffee shop, try to stop by for coffee, be friendly, shake hands and then sit by yourself or leave. Wait to be asked to join them.
  4. High school and youth league sports – In many states, Friday night football is king. Be a visible supporter for some, if not all, of the home games. Be a regular at other sports events as well, especially the ones that count. You can even look at getting a custom made sports shirt from companies such as Imprint to throw your support behind the teams.
  1. Track your visibility – There is nothing wrong with having outside interests that take you out of town, but monitor the frequency of your trips. Do not become an inadvertent absentee CEO.
  2. Have regular lunches, or meetings, with the key business leaders in town – bank president(s), school superintendent, the Mayor, the County Judge and other key community stakeholders.

Remember, hospital CEOs, like local bankers, pastors and elected leaders, walk within a bright spotlight. Be ever mindful of your presence – how others in the community really see you.