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Our Opportunity to Lead

By Alan S. Kaplan, MD, FACHE

As healthcare CEOs, the COVID-19 crisis has provided a rare opportunity—small pockets of time to think and reflect. While we’re closely monitoring our organization’s situation and huddling with local, state and national authorities, our routine of going from meeting to meeting has been upended.

As our pandemic response readiness and implementation matures, my thinking migrates toward recovery planning. As CEOs, we’re not alone in our reflections. Consultants, coaches and opportunists (this is a large category) are quick to offer advice. For me, most of this guidance is falling flat because there is no “been there, done that.” This is new territory. Unless you’re reviewing the financials that show your organization losing tens of millions of dollars each week with no accurate projections of when and if things will return to normal, conventional wisdom from the experts, such as planning for the worst during a crisis, may not be perfectly applicable.

Instead, what we need to do is be the leaders we aspired to be early on in our careers, and the leaders we have admired from our peer group and other industries. For me, it boils down to three calls to action:

Acknowledge With Candor

No sugar coating will be adequate to hide the severely damaged economy and unemployment rates that could rival the Great Depression. Internal to our organizations, we have psychologically fragile and physically exhausted physicians and staff, dire revenue projections, and strategic plans and investments that will be delayed for years. UW Health has cut our list of major initiatives in half, with more cutbacks likely as we reset strategically. It’s agonizing to curtail carefully crafted and researched projects, but it won’t be any easier in a few months. We need to acknowledge, candidly, the depth of our challenges and the sacrifices necessary to pull our organizations through the COVID-19 pandemic.

More Leadership, Less Management

Crises tend to be underled and overmanaged. It’s human nature to focus on the immediate, in-your-face issues that need tactical attention instead of looking forward toward the next round of challenges. The immediate and long-term financial situation of hospitals and health systems is the most pressing area that needs the right balance of management and leadership. Previous short- and long-term financial assumptions are now irrelevant. Annual forecasting and budgeting won’t be adequate. We’ll need to decide how many days of cash on hand is prudent versus ill-advised, and how far to cut expenses. But this may also be the nudge (or shove) required to look at our organization’s entire cost structure and calibrate it for the delivery system we knew was inevitable, but didn’t believe was imminent.

Breakthrough Behavior Changes

Healthcare providers have not always been exemplars of agility. Yet this crisis has shown that we can adapt and move quickly when we must. As leaders we’ll need to course-correct in real time, not ruminate for months. We must be proactive and responsive, both strategically and financially, at a pace that has not been typical within our industry. Initiatives that we didn’t make time for, like new care delivery and staffing models, are now imperative as we anticipate patient volume that may not return. Reverting to our old pace and settling back in could jeopardize our organizations.

We seek opportunities to lead for many reasons. For me, it is a higher calling to craft the future and to evolve our organization to a better place. No matter what drove you to become a healthcare leader, this is our time. We need to prepare, not panic. We need to take care of our medical teams and employees with greater energy than ever before. We need to navigate through the fog of this pandemic and craft a compelling future, different but just as exciting as we previously conceived. Our job has always been to create clarity in the face of headwinds and ambiguity. Now is no different except the challenges are more acute and there is more at stake. A quote from first-century Latin writer Publilius Syrus still applies today: “Anyone can hold the helm when the sea is calm.” This once-in-a-lifetime health crisis could also be our once-in-a-lifetime opportunity to lead in an environment where everything is going to change. Let’s rise above the chaos and take the helm.


Alan S. Kaplan, MD, FACHE, is CEO of UW Health, the academic health system affiliated with the University of Wisconsin, in Madison.

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