“My Boss, Ms. Healthcare: Leadership in Action”


Posted by Jacob Victory

I embrace the theory that leadership is an action-step. And I also think that bosses are an interesting species. It is sometimes hard not to notice themes when colleagues and friends who work in pharmaceutical firms, nursing homes, home health care agencies, hospitals, health care law or managed care organizations describe their bosses. “I need a leader, not a boss!” proclaims one close friend. “She’s a busy regulatory expert who can’t operationalize anything,” says one colleague. Another quips, “I can’t find him. He’s always focused on preparing board documents and is not interested in the day-to-day details.” Yet another smirks, “My boss is so overwhelmed putting out fires and worrying about reimbursement cuts that she rarely provides any direction—so I make the decisions that she needs to make for me!”

One synthesized it succinctly: “Healthcare has too many busy leaders who are focused on changing regulations or survival.” Indeed, healthcare insurance coverage, utilization, care delivery and reimbursement structures are evolving (I won’t use the word “changing”). As a service industry, healthcare is solely about people helping people. What help do our leaders need to manage their people, who can then help others to make this industry churn?

Since most of us work in the health care industry, let’s for a moment assume that we all share the same boss. We’ll call her “Ms. Healthcare” (I say “Ms” strictly based on personal experience, as I’ve had 11 bosses in my career thus far and nine have been women). Ms. Healthcare walks into her office every morning and faces: 1) Clinical staff shortages; 2) Changing regulations; 3) Chronically ill patients who need more coordinated care; 4) Reimbursement that increasingly does not cover expenditures; 5) An inquisitive board who seeks solutions; and 6) Management staff who fear self-implosion if they receive another project to manage—without resources. Let’s also assume that Ms. Healthcare has developed a short-attention span, is anxious, doesn’t espouse project management, and is continually faced with the same six issues I list above.  And with phone calls and meetings that clog her calendar all day, it can seem like it’s an endless cycle. (Luckily, patients continue to be served.)

Ms. Healthcare, being of awesome power and might, feels she can conquer everything. She is bright, hard-working and dedicated. Indeed, Ms. Healthcare has a lot to offer. She is continually chipping away at ensuring efficiencies, new care models, staff development and patient care. I’ve learned a lot from Ms. Healthcare, too. She’s taught me to think at a high-level, that building relationships are key and to have high expectations of myself and others. But let’s consider some easy leadership tips I’ve learned in my own experiences leading people, programs and projects and what I’ve observed in the experiences of others that she can follow to make her day even more productive. If I was her coach, I’d advise her to:

1.  Go to your computer. Find the delete key. Cancel 50% of your meetings. You don’t need them.

2.  Get a pen. Make a list. Prioritize your objectives. Do we really need all those projects completed simultaneously?

3.  Grab the phone. Call your direct reports. Check-in. Do you know how much a “How’s it going?” can re-energize your staff? And how much thinking has been done on staff development and succession planning?

4.  Find a clinician. Ask him what he needs. Are you prepared for what he might say?

5. Call a politician. Invite them to take a tango lesson with you. Could you dare your government to seek your input?

Now, you may think that the five points above are droll or too simplistic. My next five blog postings will address each respective tip in a bit more detail.  Blog postings thereafter will address the other healthcare issues that Ms. Healthcare faces. Leadership is indeed a verb, an action-step. I firmly believe that it can be easy only if its simplest tasks are mastered.

Jacob Victory, an NYU-Wagner alum, is the Vice President of Performance Management Projects at the Visiting Nurse Service of New York. Jacob spends his days getting excited about initiatives that aim to reform and restructure health care.  He’s held strategic planning, clinical operations and performance improvement roles at academic medical centers, in home health care and at medical schools. Jacob also exercises the right side of his brain. Besides drawing flow charts and crunching numbers all day, he makes a mean pot of stew and does abstract paintings, often interpreting faces he finds intriguing.


The Hook


Posted by Jacob Victory

I recently bought a pair of trousers. The cloth was fancy, the pleats were perfection and the pants actually had lining. “Swanky,” I thought to myself, and I got excited about the discounted price; so I bought it—without trying it on because I’m a lazy shopper and found my size quickly. Excited about the purchase, I didn’t think about the pants until I had to wear it a couple of days later.  Yet, my enthusiasm waned; when I slipped on the trousers I had a wrestling match with the pants hook in order to button the pants. It did not hook properly and despite my strong intentions, multiple attempts and raised eyebrows, the hook won and I gave up. Defeated, I slipped into an older pair, grabbed my keys and took the train to have breakfast with one of my mentors.

On the train ride to work after my breakfast—elated at having had an hour’s worth of advice, encouragement, playful banter and savory hash-browns—my mind obsessed about the pants hook.  While I dislike purchasing clothes, I had found a great pair of fitted and expensive (albeit discounted) trousers. But that blasted hook prevented me from wearing it. Annoyed, my mind reflected back to my breakfast conversations and I was thankful that I had one mentor who, despite his modest rolodex and retirement from health care 10 years ago, understood me, listened to the questions I asked, and offered his years of experience, observations, and input on how I should focus on what I seek, delegate the rest, and look forward to all that a successful professional and social life has to offer. “He’s got me hooked on every word he says,” I recall thinking. And, just as the train conductor announced my stop, it struck me that “hook” was the morning’s theme.

On one hand, I had a fancy pair of trousers with the perfect cut and material but it was useless to me because I could not hook it up properly. On the other hand, I had a modest man of modest means offering me a tanker’s weight in wisdom & encouragement—and had me hooked for more. I believe in mentorship. If you’re a looking for a mentor, here are eight points to consider:

1.       Seek mentors who listen more than they speak. They are often the wisest.

2.       Do not solely focus on seeking the most powerful, well-liked or well-positioned person you can find. The best advice or opportunity is not always offered by those in “high” places.

3.       Once you identify someone, never ever (ever) ask, “Will you be my mentor?” It can be off-putting and tainted with obligation. Instead, consider asking them out for coffee or a phone-chat by asking: 1) “There is an issue on which I would love your advice,” or 2) “I’d love to hear about your background and thoughts on (insert topic here).” Anyone who allocates their time and lavishes advice on you will, in time, become your mentor.

4.       Find that “hook,” or that connection or particular commonality that bolsters your relationship.

5.       Carve out time to build a relationship, as this is 90% of the task.

6.       Consider their time valuable.

7.       Realize that some people are not inclined to teach, to give advice or lend their time. If you receive a polite “no,” thank them anyway and move on.

8.       Lastly: enjoy it, as feedback is a gift.

Jacob Victory, an NYU-Wagner alum, is the Vice President of Performance Management Projects at the Visiting Nurse Service of New York. Jacob spends his days getting excited about initiatives that aim to reform and restructure health care.  He’s held strategic planning, clinical operations and performance improvement roles at academic medical centers, in home health care and at medical schools. Jacob also exercises the right side of his brain. Besides drawing flow charts and crunching numbers all day, he makes a mean pot of stew and does abstract paintings, often interpreting faces he finds intriguing.