Integrity Matters Most in a Leader!

https://www.linkedin.com/pulse/integrity-matters-most-leader-brigette-hyacinth/

In every aspect of our lives we depend on the integrity of others, and others do the same with us. That’s why it’s such a big deal when we discover someone we trust hasn’t been truthful or hasn’t been playing by the rules.

Although integrity is one of the most essential and admired leadership traits, in today’s world it seems to be lacking. What you see in leaders is not often what you get.

Here are 7 masks some leaders wear:

1. Orator (The Two Face mask) – Double tongued are they. They can sound so persuasive and so sincere. Fervent lips which sound so eloquent can hide true character. Behind the dazzling mask lies their real intentions of deception. Erroneous communications are a big cause of lack of perceived trustworthiness in bosses. Politicians are notorious and highly populate this category. However, their actions always expose them. We don’t take them at face value because we don’t know which face they have on.

2. Advocate (The 3 Musketeers mask)- “One for all and one for one.” They are all for me, myself and I. The love of power is their main motivator. They outwardly proclaim they are people focused, and their priority is with the team but behind closed doors they are self- seeking. Therefore when the opportunity is presented to prove it they cannot. They will do anything to make themselves look good, or maintain their status quo even at the expense of the team.

3. Philanthropist (The Robin Hood mask) – They give with the right hand but secretly take back with the left hand. Under this disguise these type of leaders give openly so others can think highly of them. If there was no fanfare they would not support charitable initiatives. Former Tyco International Ltd. Chairman Dennis Kozlowski improperly used company funds to promote himself as a generous benefactor. He committed more than $100 million of the conglomerate’s money to good causes however, his own foundation gave little to charity. He was accused of stealing $134 million from the company and served 8 years in prison.

4. Obdurate (The Iron Man mask) – They scarcely show their true feelings or human side. They think they need to have this public tough image. Marissa Mayer, former CEO of Yahoo came across as cold and disconnected to her employees. Her policies (maternity leave and long-term telecommuting) caused outrage. Adopting this persona alienates and pushes people away. By not showing any vulnerability, such leaders do not develop deep meaningful connections or build relationships with their team.

5. Meek (The Mister Fantastic mask) – They appear so humble and act down to earth when in fact they have an entitlement and superiority complex. However, their true colors are revealed in unguarded moments. I remember once working late and overhearing a manager speaking with a supervisor. He didn’t realize I was there and openly spoke to her. As I sat there I couldn’t believe that this is the person I thought I knew. When he came out of his office and saw me by my desk, he seemed really disoriented and shocked and asked if I had overheard him. Well, my whole perception of him changed from that day.

6. Proficient – (The Phantom of the Opera mask) – Some leaders conceal imperfections in favor of a polished image. The demands or expectations that society creates leaves them feeling mediocre and inadequate. They are uncomfortable in their own skin so they try to measure up and may even employ unethical methods to fit in. Lying on his resume cost former Bausch & Lomb CEO Ronald Zarrella $1.1 million in bonus after it was revealed he did not have an MBA as recorded. Company officials declined to accept his resignation. He remained in his role for another six years before retiring in 2008. Ironically, he probably didn’t need that degree. His prior job experiences were almost certainly enough. Still, like so many people, he seemed to have yearned for a status symbol.

7. Conformist – (The Shape-Shifter mask) – In this case, top management puts pressure on these types of managers to change their principles. Their style may not fit in with the changing culture. There is a shift between their preferred style of behavior and what the company wants. They play it safe to preserve their position and privileges. They just follow orders and exude no loyalty to employees. It’s demotivating working for a manager who does not stand up for their team. If you make a mistake they quickly turn into judge, jury and executioner. It’s hard to feel passion for a job when you experience this.

In the era of social media, where leaders’ personal and professional lives are often transparently intertwined, the mask eventually becomes apparent. Trust once lost is often hard to regain. Integrity requires humble introspection.

It requires you do what is right – not what is easy. Our actions must mirror our words in all facets of life. It all starts with keeping your word, making fair decisions, communicating honestly, taking responsibility, treating others with dignity and respect and giving credit where it’s due. There are many things you can lack and still steer clear of danger. Integrity isn’t one of them. If you don’t have integrity, people will not trust, believe or follow you. If you don’t have integrity, you have nothing.

 

 

 

ELITE HOSPITALS PLUNGE INTO UNPROVEN STEM CELL TREATMENTS

https://www.healthleadersmedia.com/clinical-care/elite-hospitals-plunge-unproven-stem-cell-treatments?utm_source=silverpop&utm_medium=email&utm_campaign=ENL_190402_LDR_BRIEFING%20(1)&spMailingID=15395736&spUserID=MTY3ODg4NTg1MzQ4S0&spJobID=1620119090&spReportId=MTYyMDExOTA5MAS2

Hospitals say they’re providing options to patients who have exhausted standard treatments. But critics suggest the hospitals are exploiting desperate patients and profiting from trendy but unproven treatments.

The online video seems to promise everything an arthritis patient could want.

The six-minute segment mimics a morning talk show, using a polished TV host to interview guests around a coffee table. Dr. Adam Pourcho extols the benefits of stem cells and “regenerative medicine” for healing joints without surgery. Pourcho, a sports medicine specialist, says he has used platelet injections to treat his own knee pain, as well as a tendon injury in his elbow. Extending his arm, he says, “It’s completely healed.”

Brendan Hyland, a gym teacher and track coach, describes withstanding intense heel pain for 18 months before seeing Pourcho. Four months after the injections, he says, he was pain-free and has since gone on a 40-mile hike.

“I don’t have any pain that stops me from doing anything I want,” Hyland says.

The video’s cheerleading tone mimics the infomercials used to promote stem cell clinics, several of which have recently gotten into hot water with federal regulators, said Dr. Paul Knoepfler, a professor of cell biology and human anatomy at the University of California-Davis School of Medicine. But the marketing video wasn’t filmed by a little-known operator.

It was sponsored by Swedish Medical Center, the largest nonprofit health provider in the Seattle area.

Swedish is one of a growing number of respected hospitals and health systems — including the Mayo Clinic, the Cleveland Clinicand the University of Miami — that have entered the lucrative business of stem cells and related therapies, including platelet injections. Typical treatments involve injecting patients’ joints with their own fat or bone marrow cells, or with extracts of platelets, the cell fragments known for their role in clotting blood. Many patients seek out regenerative medicine to stave off surgery, even though the evidence supporting these experimental therapies is thin at best, Knoepfler said.

Hospitals say they’re providing options to patients who have exhausted standard treatments. But critics suggest the hospitals are exploiting desperate patients and profiting from trendy but unproven treatments.

The Food and Drug Administration is attempting to shut down clinics that hawk unapproved stem cell therapies, which have been linked to several cases of blindness and at least 12 serious infections. Although doctors usually need preapproval to treat patients with human cells, the FDA has carved out a handful of exceptions, as long as the cells meet certain criteria, said Barbara Binzak Blumenfeld, an attorney who specializes in food and drug law at Buchanan Ingersoll & Rooney in Washington.

Hospitals like Mayo are careful to follow these criteria, to avoid running afoul of the FDA, said Dr. Shane Shapiro, program director for the Regenerative Medicine Therapeutics Suites at Mayo Clinic’s campus in Florida.

‘EXPENSIVE PLACEBOS’

While hospital-based stem cell treatments may be legal, there’s no strong evidence they work, said Leigh Turner, an associate professor at the University of Minnesota’s Center for Bioethics who has published a series of articles describing the size and dynamics of the stem cell market.

“FDA approval isn’t needed and physicians can claim they aren’t violating federal regulations,” Turner said. “But just because something is legal doesn’t make it ethical.”

For doctors and hospitals, stem cells are easy money, Turner said. Patients typically pay more than $700 a treatment for platelets and up to $5,000 for fat and bone marrow injections. As a bonus, doctors don’t have to wrangle with insurance companies, which view the procedures as experimental and largely don’t cover them.

“It’s an out-of-pocket, cash-on-the-barrel economy,” Turner said. Across the country, “clinicians at elite medical facilities are lining their pockets by providing expensive placebos.”

Some patient advocates worry that hospitals are more interested in capturing a slice of the stem-cell market than in proving their treatments actually work.

“It’s lucrative. It’s easy to do. All these reputable institutions, they don’t want to miss out on the business,” said Dr. James Rickert, president of the Society for Patient Centered Orthopedics, which advocates for high-quality care. “It preys on people’s desperation.”

In a joint statement, Pourcho and Swedish defended the online video.

“The terminology was kept simple and with analogies that the lay person would understand,” according to the statement. “As with any treatment that we provide, we encourage patients to research and consider all potential treatment options before deciding on what is best for them.”

But Knoepfler said the guests on the video make several “unbelievable” claims.

At one point, Dr. Pourcho says that platelets release growth factorsthat tell the brain which types of stem cells to send to the site of an injury. According to Pourcho, these instructions make sure that tissues are repaired with the appropriate type of cell, and “so you don’t get, say, eyeball in your hand.”

Knoepfler, who has studied stem cell biology for two decades, said he has never heard of “any possibility of growing eyeball or other random tissues in your hand.” Knoepfler, who wrote about the video in February on his blog, The Niche, said, “There’s no way that the adult brain could send that kind of stem cells anywhere in the body.”

The marketing video debuted in July on KING-TV, a Seattle station, as part of a local lifestyles show called “New Day Northwest.” Although much of the show is produced by the KING 5 news team, some segments — like Pourcho’s interview — are sponsored by local advertisers, said Jim Rose, president and general manager of KING 5 Media Group.

After being contacted by KHN, Rose asked Swedish to remove the video from YouTube because it wasn’t labeled as sponsored content. Omitting that label could allow the video to be confused with news programming. The video now appears only on the KING-TV website, where Swedish is labeled as the sponsor.

“The goal is to clearly inform viewers of paid content so they can distinguish editorial and news content from paid material,” Rose said. “We value the public’s trust.”

INCREASING SCRUTINY

Federal authorities have recently begun cracking down on doctors who make unproven claims or sell unapproved stem cell products.

In October, the Federal Trade Commission fined stem cell clinics millions of dollars for deceptive advertising, noting that the companies claimed to be able to treat or cure autism, Parkinson’s disease and other serious diseases.

In a recent interview Scott Gottlieb, the FDA commissioner, said the agency will continue to go after what he called “bad actors.”

With more than 700 stem cell clinics in operation, the FDA is first targeting those posing the biggest threat, such as doctors who inject stem cells directly into the eye or brain.

“There are clearly bad actors who are well over the line and who are creating significant risks for patients,” Gottlieb said.

Gottlieb, set to leave office April 5, said he’s also concerned about the financial exploitation of patients in pain.

“There’s economic harm here, where products are being promoted that aren’t providing any proven benefits and where patients are paying out-of-pocket,” Gottlieb said.

Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said there is a broad “spectrum” of stem cell providers, ranging from university scientists leading rigorous clinical trials to doctors who promise stem cells are “for just about anything.” Hospitals operate somewhere in the middle, Marks said.

“The good news is that they’re somewhat closer to the most rigorous academics,” he said.

The Mayo Clinic’s regenerative medicine program, for example, focuses conditions such as arthritis, where injections pose few serious risks, even if that’s not yet the standard of care, Shapiro said.

Rickert said it’s easy to see why hospitals are eager to get in the game.

The market for arthritis treatment is huge and growing. At least 30 million Americans have the most common form of arthritis, with diagnoses expected to soar as the population ages. Platelet injections for arthritis generated more than $93 million in revenue in 2015, according to an article last year in The Journal of Knee Surgery.

“We have patients in our offices demanding these treatments,” Shapiro said. “If they don’t get them from us, they will get them somewhere else.”

Doctors at the Mayo Clinic try to provide stem cell treatments and similar therapies responsibly, Shapiro said. In a paper published this year, Shapiro described the hospital’s consultation service, in which doctors explain patients’ options and clear up misconceptions about what stem cells and other injections can do. Doctors can refer patients to treatment or clinical trials.

“Most of the patients do not get a regenerative [stem cell] procedure,” Shapiro said. “They don’t get it because after we have a frank conversation, they decide, ‘Maybe it’s not for me.'”

LOTS OF HYPE, LITTLE PROOF

Although some hospitals boast of high success rates for their stem cell procedures, published research often paints a different story.

The Mayo Clinic website says that 40 to 70% of patients “find some level of pain relief.” Atlanta-based Emory Healthcare claims that 75 to 80% of patients “have had significant pain relief and improved function.” In the Swedish video, Pourcho claims “we can treat really any tendon or any joint” with PRP.

The strongest evidence for PRP is in pain relief for arthritic knees and tennis elbow, where it appears to be safe and perhaps helpful, said Dr. Nicolas Piuzzi, an orthopedic surgeon at the Cleveland Clinic.

But PRP hasn’t been proven to help every part of the body, he said.

PRP has been linked to serious complications when injected to treat patellar tendinitis, an injury to the tendon connecting the kneecap to the shinbone. In a 2013 paper, researchers described the cases of three patients whose pain got dramatically worse after PRP injections. One patient lost bone and underwent surgery to repair the damage.

“People will say, ‘If you inject PRP, you will return to sports faster,'” said Dr. Freddie Fu, chairman of orthopedic surgery at the University of Pittsburgh Medical Center. “But that hasn’t been proven.”

2017 study of PRP found it relieved knee pain slightly better than injections of hyaluronic acid. But that’s nothing to brag about, Rickert said, given that hyaluronic acid therapy doesn’t work, either. While some PRP studies have shown more positive results, Rickert notes that most were so small or poorly designed that their results aren’t reliable.

In its 2013 guidelines for knee arthritis, the American Academy of Orthopaedic Surgeons said it is “unable to recommend for or against” PRP.

“PRP is sort of a ‘buyer beware’ situation,” said Dr. William Li, president and CEO of the Angiogenesis Foundation, whose research focuses on blood vessel formation. “It’s the poor man’s approach to biotechnology.”

Tests of other stem cell injections also have failed to live up to expectations.

Shapiro published a rigorously designed study last year in Cartilage, a medical journal, that found bone marrow injections were no better at relieving knee pain than saltwater injections. Rickert noted that patients who are in pain often get relief from placebos. The more invasive the procedure, the stronger the placebo effect, he said, perhaps because patients become invested in the idea that an intervention will really help. Even saltwater injections help 70% of patients, Fu said.

A 2016 review in the Journal of Bone and Joint Surgery concluded that “the value and effective use of cell therapy in orthopaedics remain unclear.” The following year, a review in the British Journal of Sports Medicine concluded, “We do not recommend stem cell therapy” for knee arthritis.

Shapiro said hospitals and health plans are right to be cautious.

“The insurance companies don’t pay for fat grafting or bone-marrow aspiration, and rightly so,” Shapiro said. “That’s because we don’t have enough evidence.”

Rickert, an orthopedist in Bedford, Ind., said fat, bone marrow and platelet injections should be offered only through clinical trials, which carefully evaluate experimental treatments. Patients shouldn’t be charged for these services until they’ve been tested and shown to work.

Orthopedists — surgeons who specialize in bones and muscles — have a history of performing unproven procedures, including spinal fusion, surgery for rotator cuff disease and arthroscopy for worn-out knees, Turner said. Recently, studies have shown them to be no more effective than placebos.

MISLEADING MARKETING

Some argue that joint injections shouldn’t be marketed as stem cell treatments at all.

Piuzzi said he prefers to call the injections “orthobiologics,”noting that platelets are not even cells, let alone stem cells. The number of stem cells in fat and bone marrow injections is extremely small, he said. In fat tissue, only about 1 in 2,000 cells is a stem cell, according to a March paper in The Bone & Joint Journal. Stem cells are even rarer in bone marrow, where 1 in 10,000 to 20,000 cells is a stem cell.

Patients are attracted to regenerative medicine because they assume it will regrow their lost cartilage, Piuzzi said. There’s no solid evidence that the commercial injections used today spur tissue growth, Piuzzi said. Although doctors hope that platelets will release anti-inflammatory substances, which could theoretically help calm an inflamed joint, they don’t know why some patients who receive platelet injections feel better, but others don’t.

So, it comes as no surprise that many patients have trouble sorting through the hype.

Florida resident Kathy Walsh, 61, said she wasted nearly $10,000 on stem cell and platelet injections at a Miami clinic, hoping to avoid knee replacement surgery.

When Walsh heard about a doctor in Miami claiming to regenerate knee cartilage with stem cells, “it seemed like an answer to a prayer,” said Walsh, of Stuart, Fla. “You’re so much in pain and so frustrated that you cling to every bit of hope you can get, even if it does cost you a lot of money.”

The injections eased her pain for only a few months. Eventually, she had both knees replaced. She has been nearly pain-free ever since. “My only regret,” she said, “is that I wasted so much time and money.”

 

 

 

Do Ethics Really Make You a Better Leader in Business?

http://www.leadershipdigital.com/edition/daily-leadership-innovation-2019-03-29?open-article-id=10125816&article-title=do-ethics-really-make-you-a-better-leader-in-business-&blog-domain=leadershipnow.com&blog-title=leading-blog

Do Ethics Really Make You a Better Leader

ETHICS IS NOT a word used very often behind the walls of companies and organizations. Many companies have a set of values and company policies. However, very few companies educate leaders about ethics and encourage leaders to discuss ethics with their teams. 

Ethics are usually an afterthought, taken seriously only after an event that causes a business or team to fall apart. If understood and put into practice by a dedicated leader, ethics have the potential to turn stagnant, declining teams into productive and engaged ones. Ethics enable new teams to continue to grow, sustain, and thrive as the individuals and the business evolve.

Ethics are the foundation for peace and progress. Don’t we all crave both peace and progress at work? Ethics are timeless principles for behavior toward ourselves and others that translate to specific actions.

Ethics are what fuel personal growth and make large-scale collaborative efforts work. The lack of clarity about what ethics are and what ethics really involve in action is the primary barrier for many leaders in practicing ethics at work. Here is how an understanding and intentional practice of ethics at work make leaders, and therefore businesses, stronger and more successful.

Truthfulness over time opens and repairs communication lines.

Ethics prize the principle of truthfulness. Though it seems straightforward, it often takes courage to truly be truthful with team members and peers. Leaders that practice truthfulness with team members build genuine trust over time. Leaders that practice truthful, transparent communication build a team culture of interpersonal respect and alignment.

A practice for cultivating trust is to have regular one-on-one meetings with team members. In your one-on-one meetings, leave technology and distractions behind. Give your team members dedicated focus, ask if they have questions, and give them positive and constructive feedback. Leaders develop trust through transparent and genuine communication. Teams united in honesty and truthful communications move forward as a cohesive unit. 

Opportunities for individual development fuel collective progress.

Leaders that understand and practice ethics at work are also better at motivating and empowering individuals in order to fuel collective progress. Another foundational ethical principle is the concept of non-stealing. In workplaces, non-stealing goes far beyond just stealing of physical possessions. Non-stealing in leadership involves not stealing (but instead giving) opportunities, knowledge, and acknowledgment to team members.

Leaders can practice the ethical practice of non-stealing by giving knowledge, skills, and opportunities to team members enable progress. In one-on-one meetings, share your skills and knowledge with team members. Mentor them as they work through a special project or assignment on their own. When individuals are given opportunities to grow individually, they are more dedicated and skilled contributors. Leaders that practice non-stealing understand that individual peace and progress must happen for each team member in order for the whole to move forward.

Non-attachment enables creative problem solving and the generation of new ideas.

Leaders often find themselves stuck, leading a stagnant team because they are attached to their ways or outdated beliefs. Beliefs about what is right or beliefs about people’s limitations often hold back the team from progressing. Leaders who are not open to new ideas and feedback compromise the collective progress of the team.

Non-attachment is practiced by letting go of your outdated beliefs about people, ways, results, or status. New ideas and suggestions that team members bring to the table are often the answers to proactively solving or avoiding problems. Don’t hold firm beliefs about the way things should be, how far someone should progress, or the exact way results should turn out. Allow space for limitless possibility and evolution to happen. Invite and evaluate new ideas and suggestions with an open mind. This practice enables collective progress. 

Positive communication and mindfulness foster focus and protect valuable energy.

Finally, ethical leaders are masters of cultivating the conditions for collaboration. In dynamic, fast-paced business environments, leaders and teams often find themselves rushing and producing work full of errors. People burn out quickly after long days of exhausting meetings. Small disagreements or misalignments turn into political issues. Arguments deter focus and negatively impact productivity and engagement. Ethical leaders know how to practice control of energy in order to cultivate focus and ease for their team. 

Control of energy involves communicating with a positive tone. Even when giving constructive feedback, ethical leaders start with a positive affirmation and use a tone of equanimity throughout the conversation. This is a sustainable rather than a short-sighted approach. This control of energy helps to cultivate calm and protect the energy of the team and themselves. Control of energy also involves taking constructive rest breaks often to restore and rejuvenate. A walk outside, away from the screen and often chaotic work environment can do wonders to reset your mind and body. Lead by example and encourage your team members to do the same. 

Ethics are the foundation for strong leadership and collaboration.

When understood and put into practice at work, ethics have the potential to fuel productivity and motivation. Ethical leaders cultivate focus, trust, and connection, which are key ingredients for successful leadership. Leaders that practice ethics in action find that the principles reach far beyond company walls and add value to their lives outside of work as well. Ethics are universal and add value to our work and life.

How can you put ethics into practice to strengthen your leadership? Many leaders don’t realize that diverse teams often have very different individual perceptions of what ethics look like in practice. Teams need to learn a collective language for ethics in order for ethics to be accessible instead of vague. Leaders can lead by example by putting ethics into.

 

 

 

 

The Benefits of a High Trust Environment

The Benefits of a High Trust Environment

Image result for high trust environment

The advantages of working in a high trust environment are evident to everyone from the CEO to the shop floor, from suppliers to customers, and even the competition. Building and maintaining trust within any organization pays off with many benefits.

Here are 12 benefits of working in a high trust culture:

1. Problems are easier to solve – because the energy is on the real problem, and people are not afraid to suggest creative solutions.
2. Focus is on the mission – rather than interpersonal protection.
3. Efficient Communication – less need to “spin” information.
4. Less unrest – little need for damage control.
5. Passion for the work – that is obvious to customers.
6. A real environment – no need to play head games.
7. People respect each other – less bickering and wasting time.
8. Fewer distractions – things get done right the first time.
9. Leaders allowed to be human – can make a mistake and not get derailed.
10. Developing people – emphasis on being the best possible.
11. Reinforcement works better – because it is not perceived as manipulative.
12. People enjoy work – the atmosphere is light and sometimes even fun.

With advantages like these, it is not hard to figure out why high trust groups out perform low trust organizations dramatically. There have been many studies that indicate the leverage you get with a high trust group over a low trust one is at least three times. That is why it is common for groups to more than double productivity in less that a year if the leaders know how to build trust.

There are dozens of leadership behaviors that will develop higher trust. An example would be to do what you say (“walk your talk”). I believe the most powerful leadership behavior that will develop higher trust is to create a safe environment. My quote for this phenomenon is “The absence of fear is the incubator of trust.”

Creating a culture of low fear is not rocket science at all. Leaders simply need to make people understand that they will not be put down for sharing their opinions as long as it is done in an appropriate way and time. I call this action “reinforcing candor,” because the person needs to feel welcome to share a contrary view without fear. Leaders who can accomplish this kind of culture will have the advantages listed above.
Work to consistently build, maintain, and repair trust in your organization. I believe the leverage in doing so is the most significant path to greatness in any organization.

 

 

Universal Health Services finance chief Steve Filton on cost containment and challenges hospital CFOs face

https://www.beckershospitalreview.com/finance/universal-health-services-finance-chief-steve-filton-on-cost-containment-and-challenges-hospital-cfos-face.html?origin=cfoe&utm_source=cfoe

Image result for cfo challenges

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.

 

 

 

Three Tricky Questions About Trust

Three Tricky Questions About Trust

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I am intentionally breaking into my series on Body Language to write about my core material on trust because a new Podcast Interview has just been released that contains some vital information about trust. The interview is with Andrew Brady, CEO of the XLR8 Team and author of an upcoming book, “For the ƎVO⅃ution of Business.”

In my leadership classes, I often like to pose 3 challenging questions about the nature of trust.

As people grapple with the questions, it helps them sort out for themselves a deeper meaning of the words and how they might be applied in their own world. The three questions are:

• What is the relationship between trust and vulnerability?
• Can you trust someone you fear?
• Can you respect someone you do not trust, and can you trust someone you do not respect?

I have spent a lot of time bouncing these questions around in my head. I am not convinced that I have found the correct answers (or even that correct answers exist). I have had to clarify in my own mind the exact meanings of the words trust, vulnerability, fear, and respect.

Before you read this article further, stop here and ponder the three questions for yourself. See if you can come to some answers that might be operational for you.

Thinking about these concepts, makes them become more powerful for us. I urge you to pose the three questions (without giving your own answers) to people in your work group. Then have a quality discussion about the possible answers. You will find it is a refreshing and deep conversation to have.
Here are my answers (subject to change in the future as I grow in understanding):

1. What is the relationship between trust and vulnerability?

Trust implies vulnerability. When you trust another person, there is always a chance that the person will disappoint you. Ironically, it is the extension of your trust that drives a reciprocal enhancement of the other person’s trust in you. If you are a leader and you want people in your organization to trust you more, one way to achieve that is to show more trust in them.

That is a very challenging concept for many managers and leaders. They sincerely want to gain more trust, but find it hard to extend higher trust to others. As Abraham Lincoln once said, “It is better to trust and be disappointed every once in a while than to not trust and be miserable all the time.”

2. Can you trust someone you fear?

Fear and trust are nearly opposites. I believe trust cannot kindle in an organization when there is fear, so one way to gain more trust is to create an environment with less fear. In the vast majority of cases, trust and lack of fear go together.

The question I posed is whether trust and fear can ever exist at the same time. I think it is possible to trust someone you fear. That thought is derived from how I define trust.

My favorite definition is that if I trust you, I believe you will always do what you believe is in my best interest – even if I don’t appreciate it at the time. Based on that logic, I can trust someone even if I am afraid of what she might do as long as I believe she is acting in my best interest.

For example, I may be afraid of my boss because I believe she is going to give me a demotion and suggest I get some training on how to get along with people better. I am afraid of her because of the action she will take, while on some level I am trusting her to do what she believes is right for me.

Let’s look at another example. Suppose your supervisor is a bully who yells at people when they do not do things to his standards. You do not appreciate the abuse and are fearful every time you interact with him. You do trust him because he has kept the company afloat during some difficult times and has never missed a payroll, but you do not like his tactics.

3. Can you respect someone you do not trust & can you trust someone you do not respect?

This one gets pretty complicated. In most situations trust and respect go hand in hand. That is easy to explain and understand. But is it possible to conjure up a situation where you can respect someone you do not yet trust? Sure, we do this all the time.

We respect people for the things they have achieved or the position they have reached. We respect many people we have not even met. For example, I respect Nelson Mandela, but I have no basis yet to trust him, even though I have a predisposition to trust him based on his reputation.

Another example is a new boss. I respect her for the position and the ability to hold a job that has the power to offer me employment. I probably do not trust her immediately. I will wait to see if my respect forms the foundation on which trust grows based on her actions over time.

If someone has let me down in the past, and I have lost respect for that person, then there is no basis for trust at all. This goes to the second part of the question: Can you trust someone you do not respect?

I find it difficult to think of a single example where I can trust someone that I do not respect. That is because respect is the basis on which trust is built. If I do not respect an individual, I believe it is impossible for me to trust her. Therefore, respect becomes an enabler of trust, and trust is the higher order phenomenon. You first have to respect a person, then go to work on building trust.

People use the words trust, fear, respect, and vulnerability freely every day. It is rare that they stop and think about the relationships between the concepts. Thinking about and discussing these ideas ensures that communication has a common ground for understanding, so take some time in your work group to wrestle with these questions.