Blogs

August 8, 2012 - The Business of Healthcare

Aug 09, 2012 by Marc Strode, CEO
Folks,
I spent the last 2 days in a downtown Austin hotel conference room with about 200 folks to brainstorm, provide feedback and input and sort through the myriad of complexities regarding the changes coming next year in significant state and federal matching reimbursement for all hospitals across Texas.  Billions of $ are at stake, so everyone is at the trough.  I would much rather be back in the shop, but in times like these, it's good to be at the table and making sure that Val Verde Regional Medical Center is well-represented and engaged in the process. 

I sat at a table with admistrators from Uvalde, Kerrville, Segiun and Fredericksburg.  Unfortunately, bad news coming out of all of those camps.  Not one of those hospitals this year is offering raises or merits for any of its staff, including management.  Two of the four have laid off folks and another currently has a hiring freeze.  I know Methodist is not doing merits this year for anyone, including management, and I have heard rumors of a similar environment down the road in Eagle Pass. 

This can't be good for morale and culture in those facilities, many of which are outstanding hospitals and just as important of a player in their towns as we are in Del Rio.  Here's the good news for us.  We are doing merits this year, and we will be paying out another substantial bonus later in the fall based on our most recent fiscal year performance. 

For our management team--about 40 strong--we are doing merits a little bit differently this year.  There is more at stake, meaning there is a greater bandwidth or spread on the merits going both ways, which will be based solely on how well each manager executed their goals the past 12 months and how well they contributed to team chemistry.  On that second part, stated another way, how much of a team player they are, and/or are perceived by their peers and those they support.  We are an organization that is about accountability.  We are so fortunate to be able to afford the merit increases and able to invest back into our talent but they must be earned.  There is no payout for simply showing up.  There is no payout for only maintaining the status quo. 

This system is something I hope to roll out house-wide by 2014.  It certainly adds a degree of difficulty to the process, and you have to make sure the process is both fair and objective.  So we are cutting our teeth on 40 folks this year with the intention of getting there on 400+.  I've been in healthcare for nearly 15 years.  It's irked me to no end that you have 2 folks doing the same job, same job description.  One is a rock star and does everything every day and twice on Sunday to make the place shine.  The other person does the league minimum.  At the end of the day, getting the same merit to me is a slap in the face to the first person and certainly a disincentive to kick butt.

I have strongly--I mean strongly--encouraged everyone this summer that is in the position of doing evaluations to be honest during that process.  If someone on our team has a weakness, a shortcoming, room for improvement, etc. we are doing both the individual and the organization a huge disservice not to share that feedback.  One of leadership's job is to coach, mentor, challenge, inspire.  While we ought to be doing that all the time, 365 days a year, the evaluation process is the most formal time each anniversary to have those conversations.  It's not easy to tell someone something they don't want to hear.  If you are someone that needs to do that, I hope that you find the courage to do so.  If you are on the receiving end of that, don't take it personally.  Look at it as an opportunity to make both yourself and the team better. 

One last thread on the merits.  We are in a position to hand these out--along with the bonus checks (nearly unheard of these days for this type of program that reaches just about everyone...hip, hip, hooray VVRMC!!!) because we have had good financial success on tremendous growth the past 3 years.  We have to continue to grow.  We can do that.  You know how?  I bet most of you knows either a friend, an acquaintance or maybe even a family member who this summer has headed up to either of the SA's (Antonio or Angelo) for healthcare services.  That's what we are after.  Inevitably, some of that will always have to go up to a higher level of care, but as we expand our medical staff and as we continue to provide awesome service toward that patient experience, it will happen.  This is why it is so important for everyone to remain focused.  We can all impact that patient experience.  I promise you in this small town everyone goes back and talks about what it was like to come up to VVRMC for labs, a surgery, a trip to the ER or urgent care center, having a baby here, gett'in therapy.  You name it.  The chatter is out there and so that we can continue to grow, continue to redirect, continue to reinvest in this team and always hold ourselves accountable so that we get better that's why we do what we do.

Keep the Spirit,
Marc