One of the mentors I feel very fortunate to have had in my life was the late Richard Neustadt, a founding professor of the Kennedy School of Government at Harvard and author of the classic book Presidential Power. When I was a student at the Kennedy School in the mid-80’s, I had Dr. Neustadt for a couple of classes, got to work with him on some special projects and was part of a group of students he’d occasionally have over to his house to teach us about the subtleties of scotch whiskey.
There are a lot of insights that Dick Neustadt is remembered for but the one that is probably the most cited is that, in spite of the awesome resources at his (and, someday soon, her) command, the true power of the President of the United States is the power to persuade. To really be effective in accomplishing their agenda, the President must influence different stakeholders and constituencies to work with him or her.
Note the key preposition in that last sentence. It’s with. As an executive I was talking with recently reminded me, great leaders work with people, not through people. You may, at first, think that the dichotomy between with and through is a distinction without a difference. Not so fast, my friend. Let’s dig a little deeper on the difference between these two prepositions, with and through, and the impact they have on effective leadership.
We can start with definitions. The primary definition of with is “accompanied by.” The primary definition of through is “moving in one side and out of the other side of.” Maybe I could end this post right here. If you’re the colleague, the follower or some other stakeholder, would you rather be accompanied by or moved through one side and out the other? My guess is that for most people the answer is self-evident. You’d rather be accompanied. That’s likely at the essence of the power of persuasion that Dr. Neustadt wrote and talked about.
So, what are other markers of a leader who works with people instead of through people?
As the executive I was recently talking with told me, when you’re working with people, you start with respect for your colleagues. Unless proven otherwise, you assume that they, like you, are acting in the similar best interests of the enterprise. You assume that they’re highly motivated and qualified until proven otherwise.
You also have a focus on what they need as much as on what you need. If you only come in with what you need and what you have right and everyone else has wrong, over the long run you lose your effectiveness.
When you don’t have total control, you have to have influence. Influence – the power to persuade – takes root when you work with people rather than through them.
As CFO of one of the nation’s largest hospital management companies, Steve Filton understands the challenges hospitals face.
Mr. Filton has served as executive vice president and CFO of King of Prussia, Pa.-based Universal Health Services since 2003.
He joined the company in 1985 as director of corporate accounting and in 1991, he was promoted to vice president and controller.
Mr. Filton spoke with Becker’s about some of the challenges facing CFOs and his top cost-containment strategies.
Question: What is the greatest challenge hospital and health system CFOs faced in 2018? Do you expect this to be their biggest challenge in 2019 as well?
Steve Filton: I think effectively we’re in an environment where our payers have all concluded that costs and medical spending have to be reduced, and a lot of that burden ultimately falls on providers, like hospitals and doctors. As a [result], I think hospitals are tasked with the difficult goal of continuing to provide the highest quality care in more efficient ways. I think that was the biggest challenge last year and will be the biggest challenge this year. I think, frankly, for the foreseeable future, that’s the challenge of being a provider in today’s healthcare environment.
Q: How do you feel the CFO role has evolved in recent years?
SF: I think CFOs have a particularly challenging role in that our organizations explore the ways to deliver high quality care that’s best for our patients and try to create an environment that is satisfying for our employees. We as CFOs then say, ‘How do we accomplish these things and remain efficient and remain profitable?’ [That way organizations] can continue to do all the things we have to do as far as investing and reinvesting in the business and continuing to be competitive with our labor force and do all the things that allow us to continue to run high quality facilities, which in many cases involve significant expenditures.
Q: What are your top cost-containment strategies?
SF: I think a lot of our cost-containment strategies are focused on what I describe as driving the variability out of our business. I think so many other industries and businesses are accustomed to delivering their products and services in very standardized ways that are determined to be most efficient. I think healthcare has sort of long resisted that, and as a [result], we have lots of variability in the way that we deliver services in our various geographies. Various clinicians will deliver services differently. And I think we could benefit by following the lead of some of our peer industries and becoming much more focused on … delivering all our care and service in that standard way in accordance with best practice protocols. Driving out excess utilization and driving out rework and re-dos and errors — those things I think are a significant focus of getting the hospital industry to be more efficient and cost-efficient.
Question: During your tenure at UHS, what has been one of your proudest moments as CFO?
SF: What I take great pride in is the growth of the company. When I joined the company in the mid-1980s, it had maybe 35 [or] 40 hospitals around the country and maybe $500 million of consolidated revenues. This coming year we’ll have well over 300 domestic facilities and another 100 or so in the United Kingdom and over $11 billion of revenue. And what I’m proud of is not just the growth of the company, but … the way the company has grown and yet really adhered to its core principles. When I joined the company 30 some odd years ago, it was very committed to high quality patient care and to the satisfaction to our employees. And honestly, if anything, I think the company has recommitted itself to those core principles over the years, and to be a much bigger company [and] not have abandoned our core principles, at least for me, is a source of great pride.
Q: If you could pass along one nugget of advice to another hospital CFO, what would it be?
SF: I tell the folks who work with me and for me all the time that it’s so important to behave every day with the highest level of integrity. I think at the end of the day you can’t replace that. People, I think, will give you a lot of leeway if they trust you, if they believe that you’re behaving transparently and with great honesty. And so I encourage everyone who works for me to do that, and I certainly endeavor to try to do that as best I can. And it’s tough. There are all kinds of pressures on folks in a financial role in this sort of environment. But I think if you behave with integrity, everything else will follow from that.
You’ve probably felt the battle raging within you. To hold onto your beliefs. To boldly proclaim and do what you feel is right.
The world is crying out around you to do that what they believe to be true. All the while trying to pull you to their side and strip away your integrity.
There’s a battle happening. The battle to maintain our integrity while living in a world that beckons us with the desires of others.
While these posts received quite a bit of positive attention, there were also questions regarding the posts. Partially relating to maintaining your integrity while being told to tweet something one of these great men had said.
Instead of tweeting out quotes from Nelson Mandela or Martin Luther King Jr, it was suggested to take the quote, make it your own, and take action. Eventually changing the world because of the action you took.
This blew me away as I never equated asking someone to retweet a quote to losing their integrity. I thought it was a great way to remember these special men and to share some of their great insights.
After this was brought up, I can see how one could possibly begin to lose the fight to maintain integrity. If all we ever do is tweet good words and yet never act on them, what good are we? How are we really improving the world?
Those thoughts brings me to this post and the idea of maintaining our integrity while living a life true to ourselves.
So, what can be done to win the battle that wants us to lose our integrity?
Be true to yourself: First and foremost, be true to yourself. If someone asks you to retweet a quote or a link and you don’t feel it lives up to your standards or goals, don’t do it. Or if someone asks you to do something that goes against what you believe, tell them no and don’t do it.
This brings up memories of my middle school days. In 6th or 7th grade, my friends began to think it was fun to use profane words.
These guys would hang out behind the school whispering and sharing the bad words they’d learned.
One day a couple of these friends approached me and tried to influence me to curse with them. However, even at that age, I knew it would affect my integrity to do so.
When I refused to use the same words they used, they resorted to offering me cold, hard cash to do something against my beliefs. In the end, I knew what was right and what was wrong. I refused to do what was asked.
Don’t cave into the requests of others just because you follow them and they ask. You’ve got to stay true to your direction even if that means going against the request of someone else.
Be honest with others: I’m so glad a couple of readers brought up this issue with the request for tweets. This issue of integrity never crossed my mind when I asked others to retweet the quotes.
Rather, I was hoping it would inspire people. That they would see what great men have done and hope to do the same.
With this honest reply, I was able to see not everyone sees this in the same light. It also helped me realize people react to requests in different ways.
Honesty opens up the eyes of others and allows you to be true to yourself.
Be aware of your choices: Robert Brault once said
“You do not wake up one morning a bad person. It happens by a thousand tiny surrenders of self-respect to self-interest.”
Each choice you make has an effect on your integrity. You either make choices that add to your integrity or choices to surrender and lose the integrity you hold so dear.
Learn to examine the choices laid before you. Decide whether or not they add to your integrity. Make the choices that will make you a person of integrity.
Integrity can be an easy thing to lose. It can also be an easy thing to maintain when we’re aware of the actions we can take to keep it.
I know you want to live a life of integrity. I encourage you to do so.
Remember, be true to yourself, be honest with others, and know the choices you make affect your integrity.
Question: How do you maintain your integrity?
But because someone says truth is relative, does it make it so? No, and you know this.
Look at the grass outside of your office window. What color is it? There’s typically only two answers to this question:
The grass is green.
The grass is brown.
One is a sign of healthy grass. The other is a sign of dead grass. Yet there’s typically only two colors of grass.
Now, if you looked out your window and saw a lawn full of green grass and someone told you the grass was pink, what would you do? You’d probably laugh. I know I would.
You wouldn’t coddle the person and tell them they’re right. After laughing, you’d probably correct them. You’d tell them: Sam, the grass isn’t pink. The grass is green.
The truth is the grass is green. There’s no two ways about it.
You cannot change the fact that the grass in front of you is green. It is what it is. And grass being the color green is the truth.
You can try to twist the truth of the grass’ color as much as you would like. Your twisting of the colors wouldn’t change the truth.
But how often do we try to twist the truth when it comes to our businesses, organizations, or relationships? We try to twist the truth to what suits our desires, needs, or wants.
And still, no twisting of those truths makes our lies in business any less wrong.
There’s a reason truth matters. Truth is a guiding compass for what is right and what is wrong. You can look at the truth and know whether or not what you’re doing is right.
Truth allows you to know true north. It allows you to get to the destination you’re heading. And it helps you accomplish this with integrity.
Be careful of twisting truths to fit your narrative. It’s a dangerous path to go down.
The more you twist the truth, the more you’ll be willing to do the next wrong thing. Then the next. And then another…
But if you stay on the straight and narrow… If you’re willing to stand for truth… If you’re willing to say truth matters…
You’ll have an unshakeable character. You’ll earn the respect of others. And you’ll know you did the right thing.
I hope you’re not living in a state of relative truth. I hope and pray you’re living a life of truth.