What I Learned: Lessons from a leader in healthcare

From the implementation of the Affordable Care Act to the rapid advancements in medicine and technology, healthcare is clearly in a state of flux. Yet some essentials in the field remain timeless—with leadership ranking as one of the most important. 

One person who has seen many transformations, and provided peerless guidance through it all, is Salvador Esparza. An executive with more than 25 years’ experience, Esparza has served in senior management for major healthcare institutions throughout California and is an assistant professor of Health Administration at Cal State Northridge. He also sits on the Curriculum Advisory Committee of the Patient Advocacy Certificate Program at UCLA Extension. 

Here, Esparza shares four tips about leadership in the healthcare field. 

The patient’s needs must be the primary concern. Esparza said that for too long, healthcare was very provider-centric. “Decisions were often made based on the best interest of providers—whether for economic, convenience or ego reasons,” he said. “I’m sad to say that I still see some of these behaviors today, though rarely. Things dramatically changed for many organizations when the Institute of Medicine report ‘Too Err is Human’ [released in 1999] exposed the weaknesses in our health delivery systems and caused deep soul-searching.” 

Effective leadership does what’s best for the whole organization. Esparza identifies two types of leaders that concern him: “First are the ones who want to create a purely ‘clan culture’—that is, the relationships within the organization take precedence over individual effectiveness.”

As a result, a leader may take too long to pull the trigger on terminating an ineffective employee. “It takes courage to do what is best for the patient and the organization,” Esparza said. 

On the other end of the spectrum, some bosses scream and yell, pound the table, or use profane language.

“They create a culture of fear, falsely believing that this somehow will get things done,” Esparza said. “It may in the short run, but in the long run, it creates an environment where people will look for the first opportunity to leave. Everyone deserves to be treated with respect and dignity. It’s better to light a fire within people than to light a fire under people—but it takes effort.”

Every healthcare organization needs good leader-managers. “It’s said that good managers know how to do things right and good leaders know the right thing to do,” Esparza said. “These are very different things and ideally, we should look for both of these traits in every supervisor, manager, director, vice president and chief executive we hire.”

With reimbursement models changing and challenging the industry, “everybody must have these two competencies in place for effective execution of the strategic goals and objectives, especially if the organization wants to survive in this turbulent environment.”

Employees are assets, not commodities. While it may seem tempting to view workers as commodities, this means that the organization hires people based on price rather than on competency, Esparza said.

“Like anything else, you get what you pay for,” he said. “But when employees are viewed as assets—human capital—the organization places value on their contribution to the financial [bottom line] as well as quality-of-care performance. It’s essential we embrace this mindset about employees. At no time in the history of healthcare delivery systems is this more important than now.”

Lou Carlozo for UCLA Extension

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