Category Archives: Leadership Will

Is ‘toxic positivity’ a healthcare problem? One CEO thinks so.

Posted on by • Posted in Addressing Flaws, Leadership, Leadership Assessment, Leadership Commitment, Leadership Conversation, Leadership Culture, Leadership Will, Mission, Mission Statement, Relentless Interrogation, Toxic Positivity • Leave a comment
https://www.advisory.com/daily-briefing/2023/02/14/toxic-positivity?utm_source=member_db&utm_medium=email&utm_campaign=2023feb14&utm_content=member_headline_final_x_x_x_x&elq_cid=4838956&

Writing for Forbes, Sachin Jain, president and CEO of SCAN Group and Health Plan, argues that “toxic positivity,” or the idea that one should only focus on what’s going right rather than identifying and working on the underlying causes of a problem, is rampant throughout the healthcare industry and offers a few ideas on how to fix it.

Toxic positivity in healthcare

Jain writes that toxic positivity is a “somewhat understandable reaction to seemingly insurmountable obstacles, which perhaps explains toxic positivity’s ascendancy in the healthcare industry.” But now, toxic positivity is “bleeding into situations involving challenging but fully solvable problems.”

For example, Jain writes that nearly every company in the healthcare industry eventually pays a marketing agency to craft “glorious-sounding mission statements” that are then used by leaders whenever they are confronted with their shortcomings.

“Your health system just christened a new billion-dollar hospital, but is unleashing bill collectors on the indigent? Our mission is clear: Patients first!” Jain writes. “Your startup appears to be serving only the wealthiest and healthiest retirees, while pulling no cost from the healthcare system? We’re proudly committed to doing right by seniors by offering value-based care!”

Jain clarifies that he doesn’t believe all healthcare executives are cynically trying to avoid hard issues. Rather, they are “often too far removed from the front lines of the system, and even their own companies’ patient-facing operations, to witness the flaws.”

Often executives don’t notice the flaws in their health systems until a loved one needs help, Jain writes. “Only then do the industry’s leaders confront the reality that, at a person’s most vulnerable point in life, healthcare companies often treat you like a consumer … instead of just taking care of you.”

Without that reality check, it’s easy for executives to rely on their lofty mission statements and value propositions, and to “see their companies as distinct from, rather than intrinsically connected to, the industry’s biggest issues,” Jain writes.

How to fix toxic positivity

One simple intervention won’t fix toxic positivity in the healthcare industry, Jain writes, but companies can start by talking about their flaws.

“In a perfect world, the healthcare industry would commit to a culture of relentless interrogation of its flaws as a means of driving to better results,” Jain writes. Healthcare leaders need to “stop hiding behind company mission statements and ‘just-so stories’ about their impact and start speaking publicly about the steep challenges we each face as we fall short of fulfilling our specific corporate mission,” Jain adds. That means publicly addressing issues at events and discussing strategies for addressing them.

Private behavior within a company can also help reverse toxic positivity, Jain writes. Leaders should continue celebrating the accomplishments of frontline healthcare providers, but they should also “bring a critical eye to their operations and demand — not just encourage — that their colleagues help them uncover ways they can individually and collectively do better.”

That means asking questions like, “If our organization disappeared tomorrow and people were forced to find their healthcare insurance or services or devices elsewhere, would anyone be truly worse off and why?” Jain writes. If your company doesn’t have an answer for that, then you should work harder to increase your replacement value and drive competitive differentiation.

Addressing toxic positivity also means addressing the flaws in value-based care and having “honest, authentic conversations about what works and what doesn’t and why,” Jain writes. “About whether companies that proclaim to improve care are merely benefitting from arbitrage opportunities in reimbursement systems or are actually, meaningfully improving service to patients.”

Executives need to stop treating the healthcare industry like all other industries and “call BS on the idea that it’s somehow okay to be financially successful without making an actual difference in anyone’s lives,” Jain writes.

The healthcare industry needs to welcome thoughtful, critical, and reflective voices to every table, Jain writes. “Because nothing — absolutely nothing — will actually get better without them.” 

Former patient kills his surgeon and three others at a Tulsa hospital

Posted on by • Posted in Employee Safety, Gun Control, Gun Related Deaths, Gun Violence, Health System, Hospital, Hospital Industry, Leadership, Leadership Cares, Leadership Commitment, Leadership Culture, Leadership Values, Leadership Will, Patient Safety • Leave a comment

https://mailchi.mp/31b9e4f5100d/the-weekly-gist-june-03-2022?e=d1e747d2d8

On Wednesday afternoon, an aggrieved patient shot and killed four people, including his orthopedic surgeon and another doctor, at a Saint Francis Hospital outpatient clinic, before killing himself. The gunman, who blamed his surgeon for ongoing pain after a recent back surgery, reportedly purchased his AR-15-style rifle only hours before the mass shooting, which also injured 10 others. The same day as this horrific attack, an inmate receiving care at Miami Valley Hospital in Dayton, OH shot and killed a security guard, and then himself.

The Gist: On the heels of the horrendous mass shootings in Buffalo and Uvalde, we find ourselves grappling with yet more senseless gun violence. Last week, we called on health system leaders to play a greater role in calling for gun law reforms. This week’s events show they must also ensure that their providers, team members, and patients are safe. 

Of course, that’s a tall order, as hospital campuses are open for public access, and strive to be convenient and welcoming to patients. Most health systems already staff armed security guards or police officers, have a limited number of unlocked entrances, and provide active shooter training for staff.

This week’s events remind us that our healthcare workers are not just on the front lines of dealing with the horrific outcomes of gun violence, but may find themselves in the crosshairs—adding to already rising levels of workplace violence sparked by the pandemic.

Something must change.

Gun violence, the leading cause of death among US children, claims more victims

Posted on by • Posted in Child Gun Deaths, Core Values, Courage, Course of Action, Cowardice, Gun Control, Gun Related Deaths, Gun Violence, Health Policy, Leadership, Leadership Cares, Leadership Culture, Leadership Integrity, Leadership Values, Leadership Will, Public Health, Public Health Crisis, Public Inaction, Public Opinion, Public Perception, Public Safety, Public Schools, State of the Union • Leave a comment

https://mailchi.mp/d73a73774303/the-weekly-gist-may-27-2022?e=d1e747d2d8

Only 10 days after a racially motivated mass shooting that killed 10 in a Buffalo, NY grocery store, 19 children and two teachers were murdered on Tuesday at an elementary school in Uvalde, TX. The Uvalde shooting was the 27th school shooting, and one of over 212 mass shootings, that have occurred this year alone.

Firearms recently overtook car accidents as the leading cause of childhood deaths in the US, and more than 45,000 Americans die from gun violence each year. 

The Gist: Gun violence is, and has long been, a serious public health crisis in this country. It is both important to remember, yet difficult for some to accept, that many mass shootings are preventable. 

Health systems, as stewards of health in their communities, can play a central role in preventing gun violence at its source, both by bolstering mental health services and advocating for the needed legislative actions—supported by a strong majority of American voters—to stem this public health crisis. 

As Northwell Health CEO Michael Dowling said this week, “Our job is to save lives and prevent people from illness and death. Gun violence is not an issue on the outside—it’s a central public health issue for us. Every single hospital leader in the United States should be standing up and screaming about what an abomination this is. If you were hesitant about getting involved the day before…May 24 should have changed your perspective. It’s time.”

 The MacArthur Tenets

Posted on by • Posted in Character, Confidence, Courage, Encouragement, Evolution, Inspiration, Leadership, Leadership Culture, Leadership Inspiration, Leadership Integrity, Leadership Listens, Leadership Messaging, Leadership Presence, Leadership Respect, Leadership Values, Leadership Will, Personal Welfare, Temper • Leave a comment

https://www.leadershipnow.com/macarthurprinciples.html

Douglas MacArthur was one of the finest military leaders the United States ever produced. John Gardner, in his book On Leadership described him as a brilliant strategist, a farsighted administrator, and flamboyant to his fingertips. MacArthur’s discipline and principled leadership transcended the military. He was an effective general, statesman, administrator and corporate leader.

William Addleman Ganoe recalled in his 1962 book, MacArthur Close-up: An Unauthorized Portrait, his service to MacArthur at West Point. During World War II, he created a list of questions with General Jacob Devers, they called The MacArthur Tenets. They reflect the people-management traits he had observed in MacArthur. Widely applicable, he wrote, “I found all those who had no troubles from their charges, from General Sun Tzu in China long ago to George Eastman of Kodak fame, followed the same pattern almost to the letter.”

  Do I heckle my subordinates or strengthen and encourage them?

  Do I use moral courage in getting rid of subordinates who have proven themselves beyond doubt to be unfit?

  Have I done all in my power by encouragement, incentive and spur to salvage the weak and erring?

  Do I know by NAME and CHARACTER a maximum number of subordinates for whom I am responsible? Do I know them intimately?

  Am I thoroughly familiar with the technique, necessities, objectives and administration of my job?

  Do I lose my temper at individuals?

  Do I act in such a way as to make my subordinates WANT to follow me?

  Do I delegate tasks that should be mine?

  Do I arrogate everything to myself and delegate nothing?

  Do I develop my subordinates by placing on each one as much responsibility as he can stand?

  Am I interested in the personal welfare of each of my subordinates, as if he were a member of my family?

  Have I the calmness of voice and manner to inspire confidence, or am I inclined to irascibility and excitability?

  Am I a constant example to my subordinates in character, dress, deportment and courtesy?

  Am I inclined to be nice to my superiors and mean to my subordinates?

  Is my door open to my subordinates?

  Do I think more of POSITION than JOB?

  Do I correct a subordinate in the presence of others?

Can we take the long view on physician strategy? 

Posted on by • Posted in Consumer Focus, Consumer-Centric, Leadership, Leadership Flexibility, Leadership Implementation, Leadership Physician Alignment, Leadership Vision, Leadership Will, Pandemic, Physician Leadership, Physician Strategy, Strategic Alignment, Strategy, Transformation • Leave a comment

https://mailchi.mp/d57e5f7ea9f1/the-weekly-gist-january-21-2022?e=d1e747d2d8

Editor's note: Taking the long view | Campaign US

It feels like a precarious moment in health systems’ relationships with their doctors. The pandemic has accelerated market forces already at play: mounting burnout, the retirement of Baby Boomer doctors, pressure to grow virtual care, and competition from well-funded insurers, investors and disruptors looking to build their own clinical workforces.

Many health systems have focused system strategy around deepening consumer relationships and loyalty, and quite often we’re told that physicians are roadblocks to consumer-centric offerings (problematic since doctors hold the deepest relationships with a health system’s patients).

When debriefing with a CEO after a health system board meeting, we pointed out the contrast between the strategic level of discussion of most of the meeting with the more granular dialogue around physicians, which focused on the response to a private equity overture to a local, nine-doctor orthopedics practice. It struck us that if this level of scrutiny was applied to other areas, the board would be weighing in on menu changes in food services or selecting throughput metrics for hospital operating rooms. 
 
The CEO acknowledged that while he and a small group of physician leaders have tried to focus on a long-term physician network strategy, “it has been impossible to move beyond putting out the ‘fire of the week’—when it comes to doctors, things that should be small decisions rise to crisis level, and that makes it impossible to play the long game.”

It’s obvious why this happens: decisions involving a small number of doctors can have big implications for short-term, fee-for-service profits, and for the personal incomes of the physicians involved. But if health systems are to achieve ambitious goals, they must find a way to play the long game with their doctors, enfranchising them as partners in creating strategy, and making (and following through on) tough decisions. If physician and system leaders don’t have the fortitude to do this, they’ll continue to find that doctors are a roadblock to transformation.

More hospitals poised to require COVID-19 vaccines

Posted on by • Posted in Asymptomatic Transmission, Coronavirus, Coronavirus Delta Variant, Coronavirus Mutation, Do No Harm, Employee Mandate, Ethics, Evidence-Based Care, Health Policy, Health System, Hospital, Hospital Industry, Infection Control, Infection Control Plan, Infectious Virus, Leadership, Leadership Cares, Leadership Culture, Leadership Integrity, Leadership Intent, Leadership Legacy, Leadership Listens, Leadership Plan, Leadership Trust, Leadership Vision, Leadership Will, Medical Ethics, Pandemic, Public Health, Public Opinion, Public Perception, Public Safety, Quality of Care, Social Distancing, Vaccination, Vaccine, Vaccine Hesitancy Rate, Vaccine Mandate, Vaccine Safety, Vaccine Skepticism • Leave a comment
https://www.healthcaredive.com/news/more-hospitals-poised-to-require-covid-19-vaccines/602457/?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202021-06-28%20Healthcare%20Dive%20%5Bissue:35120%5D&utm_term=Healthcare%20Dive

It’s “a trickle that will become a torrent,” Ashish Jha, dean at Brown University’s School of Public Health, tweeted.

More hospitals are likely to require employees receive a COVID-19 vaccine, experts said, to further protect the sick and vulnerable patients who rely on them for care.

A Houston-area hospital captured headlines after taking a firm stance on requiring vaccines that prevent severe illness of the coronavirus, which has killed more than 600,000 in the U.S. and ravaged the economy.

Houston Methodist employees who refused the vaccine were either terminated or resigned. A judge earlier this month sided with the hospital and tossed out an employee lawsuit that was seeking to block the mandated inoculation. The ruling may give other hospitals the green light to require the jab, and as more facilities put a similar policy in place, others are likely to follow, experts said.

It’s “a trickle that will become a torrent,” Ashish Jha, professor and dean at Brown University’s School of Public Health, posted Thursday on Twitter.

3 large health systems in Massachusetts to require all workers to be vaccinated.

Given the critical need to protect vulnerable patients, its critical all hospitals do this.

Leading systems will do it soon.

Laggards will get there eventually.

Joining the growing tide of vaccine mandates are a variety of systems and hospitals, including Mass General Brigham in Boston, BJC Healthcare in St. Louis and Inova Health System in Virginia.

Some of the nation’s largest health systems have yet to mandate the shot, including Kaiser Permanente and CommonSpirit Health.

“Vaccination will only be required for Kaiser Permanente employees if a state or county where we operate mandates the vaccine for health care workers,” the company said in an email.

The American Hospital Association continues to hear that a growing number of its members are requiring the vaccine, with some exemptions. However, many member hospitals are waiting until the FDA grants full approval, a time when more safety and efficacy data will be made available.

“Getting vaccinated is especially critical for health care professionals because they work with patients with underlying health conditions whose immune systems may be compromised,” AHA, which has not taken on stance on the requirement, said in a statement.

The mandates raise ethical questions, some say, pointing to the profession’s promise to “do no harm.”

Arthur Caplan, head of medical ethics at New York University School of Medicine, said the codes of ethics that doctors and nurses says to put patients first, do no harm and protect the vulnerable.

“Of course they should be vaccinated,” he said. “If they don’t want to get vaccinated, I think they’re in the wrong profession.”

The Equal Employment Opportunity Commission said employment law does not prohibit employers from requiring the jab, essentially giving the green light to employers to put incentives and requirements in place for their workers. The EEOC is the federal agency tasked with ensuring that workplaces do not discriminate.

Some states are going against the tide and signing legislation that bars vaccine mandates, including Florida. The city of San Francisco will require hospital employees and workers in high-risk settings to get the vaccine. San Francisco, like other employers and universities, will require all city workers get inoculated.

The differing policy stances across the country creates additional hurdles for corporations with a large footprint.