Mr. Freeburg, thank you so much for taking the time out of your busy day to meet with me. The first things I would like to talk about are what you consider to be your daily job requirements and change. Please, tell me a little bit about what a “typical day” is like in the healthcare / hospital setting as CEO.
It’s busy. I recently moved within Baptist Health South Florida from Miami to Tavernier, which is in the Florida Keys. My new mantra is “I work in paradise, but it is still work.” A typical day for me generally starts around 8:30 when I come into the office and start looking at e-mails. I’ll get, on average, about 150 e-mails a day. I’ve learned to go through those pretty quickly. If they require some type of response from me, I’ll flag them and get back to them a little later in the day when time permits. And then there are always phone calls — from employees, from the leadership team, from the patients and visitors. These calls usually have to do with some variation of a billing issue, a patient care issue, a physician issue, or even some type of personnel issue. Then, there are always meetings.
Every day I have meetings set up with employees or physicians. At least one day a week, I have a meeting in Miami with the CEOs from the other hospitals. Recently, however, let’s say within the last 4 to 5 months, my focus has been on physician contracts. Patients are our “customers,” and I believe it’s good practice to talk directly with your customers to get feedback on your services.
This has taken up quite a bit of my time – between conference calls with physicians and the legal staff in Miami to hammer out the details of the contracts. Also included in a typical day is rounding, which is getting out of my office and talking with employees, physicians and sometimes with patients. Patients are our “customers,” and I believe it’s good practice to talk directly with your customers to get feedback on your services.
How have you managed to remain successful, in light of all the changes going on in healthcare these days and also ensure that your employees continue to provide superior customer service to their patients?
First of all, working for an organization like Baptist Health of South Florida really has a huge impact on how we, as an organization, approach change. Since we are a large organization, we want to present the same face to everybody, to our vendors, to our patients, to our physicians and our employees. We don’t want one hospital to do it one way and another do it another way. We try to standardize, but we understand that some things must be modified to fit the character of a particular hospital. Baptist Health has the infrastructure to help us with change. For instance, if I were at a stand-alone hospital down here trying to deal with the intricacies of the new healthcare plan, it would be much more difficult than it would be if I were not part of a large organization.
So, it appears the support is there, with key leaders working together and being consistent?
Yes, I think one of the key indicators is when you have satisfied patients, physicians, and employees. We work very hard at providing excellent service to everyone who comes to the hospital.
As the CEO, how do you manage the impact of these changing circumstances on your employees, patients, and other healthcare workers?
I’ve been in healthcare administration for 24 years and every day is different. In addition to the external influences of change (i.e., the new healthcare plan), things are always changing internally. For example, our nurses are always looking to improve the processes involved in delivering patient care. We look at improving processes throughout the hospital. The purpose is to improve customer service and enhance the customer’s experience with us. …changes don’t have to be massive, but every day there should be little ways we improve ourselves.Most people probably don’t think of a hospital as providing customer service. However, in reality, we often provide the most personal level of care and services to the people who come to our hospital. I believe that continually looking for ways to improve the customer’s experience is something any organization must do if they wish to be successful. The changes don’t have to be massive, but every day there should be little ways we improve ourselves.
Overall then, what is most challenging to you today- considering the current healthcare setting? What I’m asking here is a little more focused as to the “most significant” challenge.
Being in a rural community presents its unique set of challenges. Let me explain. We are located in the Florida Keys, which is a rural community. However, the northern tip of the Keys is only 15 miles from Miami. Tavernier, where this hospital is located, is in the Upper Keys and about a two hour drive to Miami. That means we compete, at some level, with big city hospitals. We are challenged to be as good – if not better than – hospitals much larger than we are. Because of that, we place tremendous importance on excelling not only in customer service, as I mentioned before, but in quality as measured by government agencies.
As you can imagine, the government measures all sorts of things in healthcare. For example, one agency measures if we provide detailed discharge instructions or give aspirin to someone having a heart attack. Another agency measures if our nurses listened carefully to you and if our doctors explained your medical condition in a way you understand. We watch our scores constantly. If we slip even a little, we put together a performance improvement team to bring that score back up. Because we often have a low number of patients – we are only a 25-bed hospital – if we have only one unhappy patient or we make a mistake such as not giving that aspirin, our scores can drop drastically. It’s a challenge not to take our focus off excellent patient care every minute of every day.
It doesn’t matter if an organization is in healthcare, manufacturing, or the hotel industry, the focus must always be on the customer. It must be on providing an experience that will make them want to come back to your facility or want to recommend you to their family and friends. And, by the way, the government does measure whether our patients would recommend our hospital to family and friends.
The next section has to do with Human Capital, basically the “people” of the organization. Now, setting aside some of the most commonly desired traits employers usually look for when hiring employees, such as adequate communication skills, professionalism, and the like, what could you identify as the top two most important qualities in a job applicant that you believe would lead the hospital into the future?
First of all, he or she has to be a positive, “can-do” type of person. Because of the ongoing changes, because of the challenge of dealing with people, the patients, families, physicians, and colleagues, it has got to be a “can-do” type of attitude. …he or she has to be a positive, “can-do” type of person.The second thing is an attitude of “whatever it takes.” In a small facility like this, we all wear a lot of hats; the managers and leadership team here have to do a lot more than they would have to do in a much larger facility where they might have an assistant manager or additional assistance. So, I look for a “whatever it takes” type of attitude and not someone who might respond with “it’s not my job…”
After working with new hires in the past, what have you discovered to be the most overinflated, or exaggerated; in other words, pseudo-ideal qualities- whereas later on you would find out that that was the “let-down” of your expectations for him or her?
Often in an interview, a candidate will say they have a “can-do” attitude; that they’re willing to do whatever it takes to get the job done. But when faced with the demands of a hospital, which operates 24/7, 365 days a year and never closes, I find some people misplace their “can-do” attitude between the job interview and their first day on the job. They misplaced the strong work ethic they touted during the interview process. They forget we’re 24/7 and begin to think of their position as a Monday through Friday, 9-5 type of job. For example, they aren’t willing to take call when there’s a patient who needs their expertise. Because we are such a small facility, we don’t have much duplication of expertise and that can create issues sometimes. However, fortunately, that displaced “can-do” attitude isn’t our biggest issue.
Regarding leadership, how would you describe yourself as a leader and what traits do you think are necessary for a leader to possess?
I think relationships are the foundation of leadership and you must have a different type of relationship with different people. For example, my relationship with our physicians is more collegial than my relationship with the laboratory staff. My relationship with my senior leadership team is more collaborative then my relationship with front line supervisors. My relationship with top performers is friendlier than my relationship with medium or low performers.
It’s a matter of finding the right tone, the right rhythm that draws out the best from everyone in the relationship- Myself included. As for my own style, I like to practice a collaborative type of leadership. I like to listen. I consider myself a good listener. Although I like to get input from other people who often may know more about what is going on with regard to whatever the decision is about, I don’t believe in consensus management. It’s a matter of finding the right tone, the right rhythm that draws out the best from everyone in the relationship- Myself includedYou can’t have everybody around a table agree; there are times that you have to agree to disagree and somebody has to make the decision. As the CEO, if it gets to that level, then I have to be able to make that decision. So I do believe that it is important to gather as much information and data from the people who really know, the people who practice what they do every day, but somebody has to be able to take that input and make a final decision. A lot of times that has to be me.
What has been your most challenging leadership decision in the past year?
I must say that it almost always comes down to one type of people-related issue. Since human nature is the way it is, people’s behavior can vary so dramatically, issues can become way too difficult and the end result can be “all screwed up.” Dealing with these issues is usually very time-consuming.
Probably my most difficult decision to date was whether to continue the employment of a particular physician. Unfortunately, he has been rather disruptive to our nursing staff and to other physicians. His contract was set to expire, and I had to determine if his continued employment was appropriate. From a business perspective, he was one of our busiest doctors, but his behavior was causing many other problems. I decided, after a meaningful conversation with him and many other people, to renew his contract with some very specific behavioral expectations.
Who has been your biggest influence, with regards to leadership and why?
I would say Wayne Brackin. He was my mentor at South Miami Hospital for 15 years. He was the CEO of South Miami when I was there. Now he is the COO of all of Baptist Health South Florida. Tony Dungy, in his book, has been very influential, regarding “Quiet Strength.” Another influence was my Dad, who has been deceased for many years. Growing up, my Dad taught me a lot about relationships and their importance to being a successful leader.
Do you hold yourself to a particular productivity requirement, and if so, could you explain the nature of it?
I understand how productivity is measured differently depending on what industry you are in. My productivity, I would say, is gauged based on hospital performance. Employee satisfaction, patient satisfaction, and physician satisfaction are the three main areas; and of course the profitability, or at least our bottom line, which is another area we monitor. Also, in recent years, CMS (the Federal agency for Medicare), has incorporated their own version of patient satisfaction survey and quality measures. Every hospital is judged by them based on these standards, so this is another benchmark that we use to determine our “productivity.”
Do you expect your senior leadership team to meet a particular benchmark on a daily, weekly, or monthly basis? I understand that this may tie in directly to the surveys you just mentioned, and so forth.
Yes, they are evaluated on the same benchmarks as I am. In addition to monitoring our survey results, we monitor our progress based on the implementation of our strategic plan. I also ask our leaders to recognize employees for a job well done. We place a great deal of importance on recognition, because recognition usually leads to happier employees, which ultimately cascades over to happier, more satisfied patients. I believe that through employee recognition, we demonstrate to employees how much we appreciate the work they have performed. If employees aren’t acknowledged for the work they do, they feel undervalued.
The recognition doesn’t have to be elaborate. It can be as simple as a verbal thank you. Here at Mariners, we’re big on recognizing people by having a cake party. Unfortunately, employee recognition is often one of those things that, before you know it, time goes by and people haven’t been recognized for their high performance and service excellence. Therefore, we do monitor how well we’re doing in recognizing our employees, and do it as often as we can.
How would you say you influence your senior leadership team and staff to be productive- to be able to perform at the level you desire?
I think over time you begin to develop an expectation of success. If what you are monitoring falls below your expectations, you have to communicate and make sure they understand why we are doing something. Too often, I think we (management in general) give the “what” and don’t explain the “why.” I think a sound explanation is helpful in bringing somebody back into focus and back on track to what they are supposed to be doing.
What leadership strategies, over the span of your 24 years in healthcare administration, have you found “not” to be successful for you in your line of work, and why?
I’m not a micromanager, and I don’t think that micromanagement works real well. I think micromanagement does more harm than good.My philosophy is to hire the best person for the job. Then, empower them to do that job. My philosophy is to hire the best person for the job. Then, empower them to do that job. If you micromanage, you risk disempowering employees. You risk eroding employees’ confidence in themselves. You end up hurting performance rather than letting people do the job they were hired to do. I find giving employees autonomy enables them to perform their jobs well and comfortably.
Final thoughts. We’ve covered your general daily job requirements to get a feel for what exactly it is you do as the CEO of a hospital, Human Capital regarding the people of the organization, Leadership regarding yourself, and then Productivity regarding expectations. Are there any final thoughts? If there was one solid piece of advice you could offer to leaders in your community what would that be?
The most important decision you make is – which candidate should I hire. Not hiring the right person will come back to haunt you. If the person doesn’t fit the culture of your organization or if that “can-do” attitude we talked about earlier disappears, life can be miserable for you. Hiring the right person can be difficult. Because, as you know, when people are interviewing, they can put on a whole different façade. Unfortunately with some candidates it’s not until they start working that you see what you’re really getting.
Yes, I agree, that is exactly why I asked that question earlier regarding what you’ve come to discover about those you’ve hired in the past. Sometimes, it is so much harder to tell than others…
Then, you have to deal with it. If you don’t end up hiring the right person then you end up dealing with that person a lot, a lot. Those few that become less then ideal employees or managers, seem to consume more of our attention as leaders. The Pareto principle, or 80-20 rule, applies to employees. You can spend 80% of your time on the 20% of employees who were bad hires. Even if it’s just one person who wasn’t the right hire to begin with, the problem gets worse and worse. The longer they are with you, the problems associated with the bad hire require more and more of management’s time. Whereas if that person weren’t here, management may be cleared to focus on what’s really important. That, I think, again, is the most important thing, who you hire…
Mr. Freeburg, I can’t express how much I really appreciate your time today. Your Executive Insights are very much valued and thank you for your continued leadership in our South Florida community!