Difficult Conversations Podcast
Lessons I Learned as an ICU Physician
Episode 160 | November 30, 2021
Leadership From The Boardroom
Chairman and CEO of Stuart Levine and Associates
Welcome to Difficult Conversations with Dr. Anthony Orsini. Today, my guest is Stuart Levine, who is the Chairman of the Board and CEO for STUART LEVINE & ASSOCIATES. He was the former CEO of Dale Carnegie & Associates. Stuart is an international best-selling author of three books, The Six Fundamentals of Success and Cut to the Chase, and the co-author of the international bestseller The Leader in You. Stuart has been delivering speeches around the globe for over twenty years on the subjects of leadership, change management, and organizational transformation. He is a sought-after commentator on TV, print, and social media. Stuart also has extensive experience in healthcare leadership and his experience in business and healthcare make him uniquely qualified to speak to us today about these important topics.
Stuart talks about different types of leadership, why command and control didn’t work then, and doesn’t work now. Dr. Orsini brings up a talk he recently did on physician burnout. Stuart shares his thoughts on bringing back autonomy to the doctors and why it’s so important to keep physicians in the loop of the business of healthcare. Stuart tells us about one of the key components that does not get enough attention, and that is “we share learning together.” He elaborates on the one thing his experience in healthcare taught him which is perspective and shares a touching story that truly elevated him as a human being. Dr. Orsini sheds light on the importance of how the human connection improves healthcare, and Stuart touches on understanding cultural issues and why data is so important. Find out Stuart’s perspective on leaders and why the most important thing in leadership is communication. We hear some great advice if you’re interviewing someone for a job and how you can tell if a person is willing to learn. If you enjoyed this podcast, please go ahead and hit subscribe on your favorite podcast platform.
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Stuart Levine (1s):
Once you get past, oh, called the halo of a Harvard education, you still need to talk about the core issue, which is healing. And I, for one, feel very strongly that there is a correlation between my body healing and the person who’s touching me, that clinician, the doctor, and believing that he or she has my best interest at heart. And that’s the joie de vivre, that’s the healing quotient that doesn’t get enough conversation because people sometimes demean it and say, well, that’s a soft skill. Oh contraire, I do not believe that. I think that’s the differentiator. So if you’re interviewing and you’re the person doing that, I think punching the ticket for a great education, we all recognize is very important.
Stuart Levine (50s):
But then asking questions that are experiential. Tell me about the people you have developed professionally. And by the way, tell me about what you do in the community.
Announcer (1m 1s):
Welcome to Difficult Conversations: Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Dr. Orsini is a practicing physician and president and CEO of the Orsini Way. As a frequent keynote speaker and author, Dr. Orsini has been training healthcare professionals and business leaders, how to navigate through the most difficult dialogues. Each week you will hear inspiring interviews with experts in their field who tell their story and provide practical advice on how to effectively communicate. Whether you are a doctor faced with giving a patient bad news, a business leader who wants to get the most out of his or her team members or someone who just wants to learn to communicate better this is the podcast for you.
Dr. Anthony Orsini (1m 46s):
Well, welcome to another episode of Difficult Conversations: lessons I learned as an ICU physician. This is Dr. Anthony Orsini, and I will be your host again today. Today we have another amazing guest to add to our already great lineup of previous guests. Today our guest is Stuart Levine. Stuart is the chairman of the board and CEO for Stuart Levine and associates. He has significant board and executive leadership experience across multiple disciplines, including financial services, technology, and healthcare. He was the former CEO for Dale Carnegie and associates, which operated in 72 countries. Stuart is an international best-selling author of three books, The Six Fundamentals of Success, which we’ll talk about today, cut to the chase.
Dr. Anthony Orsini (2m 31s):
And he’s also the co-author of Simon and Shuster’s international bestseller “The Leader in You”. Collectively, these books have sold over 1 million copies and are published in 37 languages. Mr. Levine has been delivering speeches around the globe for over 20 years on the subjects of leadership change management and organizational transformation. He’s a monthly contributor for Forbes as well as many other publications, and as a sought after commentator on TV, print and social media. He’s appeared numerous times on top rate at global television programs, such as NBC’s today, show ABC’s world news, Bloomberg, Fox news, and many others.
Dr. Anthony Orsini (3m 13s):
Stuart also has extensive experience in healthcare leadership. He previously served as lead director, Gentiva health services and vice chairman, Northwell health and director for many years. I’m excited to have him as my guest today because I feel that his experience in business and healthcare make him uniquely qualified to speak to us about leadership and the business of healthcare. Well, thank you Stuart for coming on today. I really appreciate this. I know you are a very busy man right now.
Stuart Levine (3m 42s):
Thank you very much, Doc. It’s good to be with you to talk about issues that are things that you and myself think about every day because they impact on the quality of people’s lives. So I’m delighted to be with you today to discuss some of these important local foundational leadership issues.
Dr. Anthony Orsini (4m 1s):
So exciting is that what the premise of this podcast for the last year, almost a year and a half now has really been of course, about communication, but how communication is so important in business and communication in healthcare as well, and how the breakdown of communication to really destroy both the company and a patient-doctor relationship and your experience in healthcare, as well as in business really makes me very excited because I think what we’re going to talk about later is really the business of healthcare. But before we start, I think it’s always a good idea to get the audience, to get to know you. So tell us how STUART LEVINE from long island, New York arrived at the pinnacle of your career, which is coming on my podcast today.
Stuart Levine (4m 46s):
I think most importantly, I grew up in a little town called Bethpage. And one thing about Bethpage was without regard to ethnicity or background, and we all share some common values. So you worked hard and you were straight up with people and you moved ahead. And so for me, that Bethpage foundation of values really became critical. And I think it’s critical to anybody’s success in the future. So I attribute a lot of my success to that foundation. And from there was fortunate to have different turns in my career and always learned into those lean and learn into those experiences. If you will.
Dr. Anthony Orsini (5m 27s):
So big family, little family, how did you end up going into business? What was the driving force of all that?
Stuart Levine (5m 33s):
So I was a school teacher. I started my professional career as a teacher to at the first mandatory environmental education program. Ecology in the state of New York. Was elected to the New York state assembly when I was 24 years old, had the high privilege of serving in the assembly with then governor Nelson Rockefeller in that iteration in my life was a Republican, and we had that little Watergate thing, which historically you may remember and was defeated. And at 26 thought my life was over. Went into business and then eventually joined the Dale Carnegie organization and had the high privilege of becoming the first chief executive office or the global corporation.
Stuart Levine (6m 16s):
But in that part of my life, Tony, I had to learn how to turn a corporation around without an infusion of capital and what I learned through a really studying it. And that’s a tough thing to do in a family owned business was the importance of strategic communication. And so I will call it engaging the hearts and minds of our people throughout the world, building a staff and doing it in a collegial way, a collaborative way became a critical learning for me. Well based I would say on data. And so that became, I will call it a pivot in my career because there, I had very few capital resources, had a lot of human resources, but had to through the establishment of standards globally of instruction and curriculum development move an organization forward.
Stuart Levine (7m 6s):
And that’s where strategic communication first came into my mind concurrent. And I think appropriate where you and your audience today when my wife and myself settled in a little town called Locust Valley on the north shore of Long Island, I was asked by my internist to join the Glen Cove hospital board Glen Cove was about, a 200 bed community hospital. And you know, when your doctor is putting it through the rigors of an annual inspection, it’s tough to say no. I joined the Glen Cove board and saw some things from a quality point of view that I just couldn’t understand. And that really started my next pivot and to healthcare.
Stuart Levine (7m 48s):
When I was in the assembly, I served on the standing committee of a health, but being on the Glen Cove board really got me into a certain venues that were very interesting and formative to my thinking.
Dr. Anthony Orsini (7m 59s):
Let’s start, unpacking a few things that you said. You, you talked about when you went to Dale Carnegie, how important collegial communication was. Things are very different in business now than they were many years ago. Where now we talk about the culture of the boardroom. We talk about the culture, servant leadership. It’s very big in healthcare as well. Cause we kind of, I think healthcare just lags behind business about a decade, but we’re there now the worker for today, especially in millennials, I talked to James Orsini about this awhile ago, there are different. And the days of the hardcore, you know, put your nose to the grind or do what you’re told they don’t work anymore. Right? I had Kristen Baird on a few weeks ago and talked about nursing turnover and people who leave their jobs, not because of the money they leave their jobs because of their boss.
Dr. Anthony Orsini (8m 45s):
It sounds like you were way ahead of that curve. And can you comment about the different types of leadership and why that doesn’t didn’t work then? And it doesn’t work now.
Stuart Levine (8m 53s):
I think I’ll call it the command and control, this is a very important distinction in my mind, where I would turn to you and say, even though you’re a distinguished doctor, I’d say, doc, you do it my way or it’s the highway. There are still organizations that we see today that function that way. You are not going to engage a workforce today and you couldn’t back then. It was a different venue, a different way of communicating with people, but command and control. In my view that never worked. Engaging people based on the following. The premise is that leaders serve. We all serve somebody or something. And making sure we have common ground on values because absent values people don’t have a common ground to have I’ll call it the requisite character to make good decisions and self-confidence becomes very important.
Stuart Levine (9m 44s):
So for me, that process starts with identifying what my personal values are and what the organization, and that’s the beginning of an engagement. So as an example at Glen Cove hospital, when it became clear to me that the quality of care that we were providing in the community was not where we aspired it to be. The first time we tried to merge with them was sure it failed. And the chairman of the board at that point turned to me. And this is a very important lesson. I think for everybody who’s listening, who wants to understand the mystery? There’s no mystery, it’s hard work and it’s preparation. Every time any of us go to a meeting. In this case, the Glen Cove board, I was very prepared.
Stuart Levine (10m 26s):
I didn’t just ruffle through my papers. I worked in advance. I understood the minutes. I understood what the body was trying to get to and what the strategy was. And then we formed up a conversation about, well, look, what is community health in this little Glen Cove community and build some energy on the board to agree, to move forward with a merger based on clinical outcomes for the, our families and ourselves. So it became personal and then to the community, so leaders serve and they listen. And then when you collect data, it’s really tough doc, to refute data. In this case, I’ll give you an example of quality outcomes.
Stuart Levine (11m 6s):
So we could say, Hey, look, here’s what it looks like from a quality outcome point of view in the community at Glen Cove. At Dale Carnegie, we could say, hey, look, here’s what our customers are saying about us. And by the way, currently, typically here’s where the world is going. And once you agree on values, which gets trust, and then you get an agreement on data that is collected by an independent source, then you can move ahead in an intelligent way or preparation values, and then build the communication that becomes, I think, the basis for a movement forward.
Dr. Anthony Orsini (11m 44s):
It’s interesting. You talk about command and control. And I mentioned that I think healthcare is about 10 years back and we are amazing guests like Claude, Silver. And I mentioned before, we talked about servant leadership. I last week I did a we’re taping this in early September. Last week, I did a conference on physician burnout and physicians is extremely high. There’s a great documentary put out by the number of medical doctors who are committing suicide right now. It’s actually an epidemic. And one of the top things that people talk about as the cause of physician burnout and suicide is lack of autonomy and how right now physicians are feeling like they’re caught in that command and control.
Dr. Anthony Orsini (12m 26s):
That many physicians, 30 years ago, they had their own practices. They were very autonomous. They walked into their office and they were the boss and everybody loved them. And this was their thing. And it failed or succeeded because of them. They find themselves in the year, 2021, maybe a decade behind business where administrators are now telling them, this is what you should do, and you’ll do this and it’s command and control. Exactly. I love that term. How do we get to that point where we can bring that autonomy back to the doctors and when you were on the board, how important is it that you keep the physicians in that loop of the business of healthcare?
Stuart Levine (13m 6s):
Well, number one, I think from a board point of view, it’s about asserting respect because those clinicians who you just referred to who are burning out, who are committing suicide and having difficult times, they’re not feeling the respect from the board and the senior leadership, because it becomes a very tough business and you and myself understand what that implies. But I will tell you that it’s interesting to watch what’s going on in the pandemic because the real shift is something that we predicted years ago on artificial intelligence. And now we say as an example, the only way to deliver efficient healthcare is through telemedicine.
Stuart Levine (13m 48s):
And we haven’t spent enough time with then I’ll call it rank and file. I’m talking about respected clinicians who are really academically sound and sharing with them as a single practitioner, as a practitioner group saying, Hey, look, docs. We’re going to use this technology because right now it’s unsafe for you. It’s unsafe for your staff. It’s unsafe for the patient to come into your office. And by the way, we respect so much what you do for the physicians who were feeling, I will call it unattached and not linked into the mission, there’s not enough conversation, honestly, about the mission of why you’re here, why you train so hard, be a doctor and clinician.
Stuart Levine (14m 31s):
And I think it starts at the top. It starts with the board as an example at Gentiva health services where I was the lead director and something that struck me early there, Tony was here we had 5,000 nurses throughout the country delivering home healthcare. And I was struck by the fact that on the board, we did not have a committee. We didn’t have access to regular data on quality outcomes. And then there are ways to recognize you as clinician to say, Hey, gee, whiz. That was a great thing you did for that patient and are very comp follow-up over procedure and so forth. So I think number one at the board level, it’s making sure that the data is part of the CEO’s dashboard.
Stuart Levine (15m 12s):
And we, as board members should ask for that and where appropriate form committees, because then we have insights and can recognize people. And listen, I think part of my responsibility as a director, I’ll take Gentiva and then I’ll give you the Northwell. So at Gentiva, I thought it was my responsibility to go with nurses to see what we were doing in the field. And when I asked the board to join me there, weren’t a lot of, it was kind of like crickets. Nobody was, is jumping at the opportunity, but I have to say that by going out and making field visits and thanking people for their service really kind of ripples through the organization.
Stuart Levine (15m 56s):
And currently, as an example at Northwell work, the CEO, Michael Dowling has done recognizing the pain all of us are going through and the changes because of the pandemic, every two or three weeks, he makes the portal open for a 45 minute conversation through the infectious disease people to give us information. And by the way, features one or two physicians who are doing something interesting in the whole mix of research, again, throwing his arm out around people to recognize people. So what do we do as directors? It gives us a chance to say, thank you. We respect your work.
Stuart Levine (16m 36s):
And particularly in a board when you’re going through a cultural transformation, if you do not have physicians sitting at that table, and if you do not have research and data that says, okay, doc, here’s what we heard from 350 physicians, then it’s, you know, five people in a room, somewhere making a decision that’s not based on logic and it’s awfully difficult. This is not PR by the way, a lot of people impugn the integrity of communication. It’s not PR it’s about human beings, interacting with each other. And the same way you, as a physician, as a doctor has protocols that are defined for the safety of an outcome.
Stuart Levine (17m 21s):
There should be the same type of discipline around collecting data for the safety of an outcome so that we will understand that she was okay, 350 physicians said the following, and maybe we need to listen to them and then have a couple of doctors around the table to interpret with us. So I think the board’s got to particular in healthcare and people that understand the importance of the clinical side of the business. If you will.
Dr. Anthony Orsini (17m 47s):
You raised an important point there, there’s something about, I think it’s referred to as ground intelligence in the army and let’s draw a parallel again between business and medicine. Again, I had a guest on Mike Abrashoff, Captain Mike Abrashoff was an ex Navy captain who wrote an amazing book called “The best damn ship in the Navy” and he took the worship in the Navy and made it into the best in one year. And the way he did that was by speaking to every single sailor that was on his ship. And every sailor had to come up with at least one idea on how to improve the ship. And he tells a great story of one sailor who was very reluctant to say anything finally said to the captain, do you know why we paint the ship every year?
Dr. Anthony Orsini (18m 32s):
And the captain said, I have no idea. He says, we paint the ship because rust from the bolts leaks onto the ship it’s saltwater. And so he said, okay. And he said, anybody ever hear of stainless steel? And so that young soldier was responsible for changing the whole Navy protocol for putting the guns, et cetera. I think what you were hinting on there is that it’s really important for a business person to go to that team leader. And maybe you can comment more about how important that is to say, you know, I came up with this idea from this tower. Does that make any sense to you? Because sometimes looking from 30,000 feet above is not the same as actually being on the ground.
Stuart Levine (19m 13s):
It’s an excellent conversation. So is what it looks like to me from the board. Here’s what it looks like in business. So I became chairman at north shore LIJ of the ambulatory surge committee quality committee with ambulatory surgery, which fundamentally at that time were represented the underserved population. But what I did with the committee is I invited the committee to go on class trips once a quarter to visit an ambulatory surge site. So, which I have to say was the most incredible learning experience for me, for my colleagues. And it gave us a chance to say thank you to those clinical people, the physicians and teams in those units, and really understand the needs of the communities we were serving by physically going there, those class trips, it turned out to be monumental in moving quality in ambulatory surge discussions, much higher on the food chain, a dashboard, if you will.
Stuart Levine (20m 14s):
So sometimes leadership means you have to do something a little different and it was different. And I wish I could tell you, 100% of lay people who serve on the board, jumped on that bus with us and had box lunches, but you know what, first there were two or three by the time that my tenure three or four years later, we probably had 10 people that would jump on board, but here’s one of the key components that does not get enough attention. And that is, we shared all learning together. And by sharing, learning together, I’m talking to clinical professional staff, the board members on the staff, people who accompanied us, we got to common ground and a common understanding of what our mission was and what our purpose was, which is so important when you’re dealing with somebody’s life.
Stuart Levine (20m 58s):
You know, when you talk about the business of healthcare, every once in a while, I get a Twitch, because at the end of the day, I’ve served the on you know, family owned businesses that manufacture guitar strings. Well, if we miss manufacturer a guitar strings, we’re not going to kill somebody. They won’t be an adverse outcome. In healthcare, you know, the dirty truth that I do. And that is that the Institute of medicine now projects over 160,000 people per annum die in hospitals because of errors, medical errors. That’s a huge problem. And if you really get under the hood there, Tony, at which I’m sure you have, that breakdown comes in communication for one person, a physician, a nurse handing off information to the next person down the line.
Stuart Levine (21m 48s):
And a person gets a thousand milligrams as opposed to a hundred or falls off a gurney because somebody forgot to strap that trick, you know, all those stories. So the point is learning together, understanding the import, and now, you know, serving on a Sentinel event committee at the system gives you more penetrating advice because you’re dealing with the human element. And so that’s why I went to talk to me about the business of healthcare. I really do wins because I see a patient’s face. I see how difficult this environment is. You asked me earlier about my family. I’m blessed. I have a wonderful son, a daughter, and now three grandchildren phenomenal.
Stuart Levine (22m 28s):
But the one thing my experience in healthcare taught me is perspective. And I want to spend a second talking to you about that. I feel very strongly about this. And then thinking back to our conversation, when I was kind of, I guess, the CEO at Dale Carnegie, and, you know, during the day you get involved in all kinds of intense business conversations, your head’s gonna explode and you start to feel, oh my God, the world is coming in on me. And I came into the hospital one night for a meeting. And as I kind of moved through the halls pretty fast, I had a penetrating lesson on perspective. I don’t know where I saw a mother and father whose face was green with fear.
Stuart Levine (23m 8s):
And there was a doctor pushing a very small incubator and I could see a little baby in there. And I knew where they were going. They were going to an x-ray suite. Okay. And I looked at that for a microsecond. So as not to be intrusive, but it was the most penetrating lesson for me and life as a father, as a community member board member. And as I’ll call it a business leader, that perspective, it never went out of my mind because it brought me to the mission. And if you think I have problems, what those poor people were going through that night, I have no idea what the outcome was. That was not my purpose, but instructionally.
Stuart Levine (23m 50s):
And what that did for me as a human being, that perspective is why I encourage people to get involved in healthcare. Because that perspective, I really believe elevated me as a human being.
Dr. Anthony Orsini (24m 3s):
It’s a great point. You know, my Ted talk, “how the human connection improves healthcare” talks about the noise that physicians hear all the time, but, you know, see more patients business of healthcare don’t order too many tests, or you’re ordering too little tests and how that leads to burnout, but also leads to 80. You mentioned a malpractice and medical areas. 81% of malpractice lawsuits are due to communication errors. And those are communication errors, not between doctors and nurses only, but between patients and doctors. Where a patient misunderstands a doctor or a, patient’s afraid to ask a question of a doctor. My premise is that one of the cures for healthcare right now is for physicians and patients to both understand that there’s all this noise out there, right?
Dr. Anthony Orsini (24m 51s):
With this business and medicine and all that. But when you are in a room together, when you’re sitting with that mother and father, as you know, I’m a neonatologist. So I deal with parents with sick babies all the time. When you’re in the room with a patient, it’s all gone, it’s you and me looking in each other’s eyes. It’s me saying, I know I have 30 patients in the waiting room, but right now this is the only person. And I can tell you, Stuart, from my teaching, with the Orsini Way and other workshops that I give your doctors all the time, come to me and say, that thought makes me sane. Because physicians and people who volunteer like you in the end, they all want the same thing.
Dr. Anthony Orsini (25m 34s):
They want to help. They’re healers, they’re compassionate people. And you just have to say, okay, I’m shutting this door and whatever’s going on out there. I’m going to forget. And that’s what we call the compassion of medicine. And I think that’s what you’re alluding to with all this. So that’s just, you know, this, my own add to what you just said, I think is very powerful that that really affected you when you saw that mother and father, but at their child, when you’re on that boardroom, you don’t forget that. Right. That’s in the end, you have to say, okay, that’s true. But I’m going to remember the eyes of those parents.
Stuart Levine (26m 7s):
I think that the soul, which is what we’re talking about right now of the patient and their wellbeing becomes critical to the conversation in healthcare. And when you drift too far away. And that’s why I encouraged directors to go out and make visits with home health care people, to see if in fact, that’s your business, you can’t possibly understand what those numbers imply unless you physically see it and digest it as a human being. And so for me, that becomes part of the responsibility of as a director. And I will tell you today, we know that there is a battle for talent.
Stuart Levine (26m 48s):
That might sound like some rhetoric, but it’s true. People really have a very important decision to make. Whether in fact, they are going to work at your institution or somebody else’s a or B. And the fact of the matter is that if you have a recognized excellent culture, and that’s something you can’t buy with advertising space, that’s over a cup of coffee, one person behind your back and my back saying, yeah, this is a terrific organization. That culture becomes a strategic weapon, particularly going forward in the next number of years. And so for me, understanding cultural issues, understanding, and on a healthcare board, when you ask what is our employee turnover number, and let’s understand it and let’s get under the hood so we can understand whether we can remediate those issues or not.
Stuart Levine (27m 42s):
And sometimes you can, but it’s a strategic weapon. And that’s why you see certain institutions are having, I’ll call it a better run than others in a tight employee-centered environment and understanding how to engage people. You can’t tell me, you trust me unless you share data. And the reason why that’s a critical factor. And so, you know, going back to the Dale Carnegie experience and bringing into healthcare as command and control, you know, in my early days as CEO, they brought me in a manual to a management training program and they said, so what color do you think the binder should be?
Stuart Levine (28m 22s):
And I looked at the guy and I said, what are you talking about? He said, well, you know, typically the CEO makes that decision. I said, not anymore. I said you need to come back here within a short period of time and present me with some data as to what our class members and our prospective customers think the color and the typeset should be. It doesn’t matter what I think it matters what our customers think. And that becomes a lot of people. Again, it’s rhetoric the voice of the customer. Now you have to have real data. You have to build the bridge to those customers. And then that has to impact. And then by the way, have the courage to share it with the people you work with.
Stuart Levine (29m 6s):
In that case, we moved it from the binder to a discussion about the course design. We commissioned global research and we formed a cross-functional team of 18 people, including franchisees and regular staff, people like myself and so forth. We moved product construction from 18 months to about 90 days because we had everybody in the room. We were able to accelerate through every barrier. It’s that type of thinking. I wouldn’t encourage in healthcare. We can bring people together and say, okay, here’s the case. Here’s what happened on that patient outcome. And I want to touch on one other thing that you said triggered in my mind that Tony about patients, a number of years ago, I had the privilege of being on the foundation who worked for the internists and the United States was a big foundation board.
Stuart Levine (29m 54s):
I was the only suit. And what struck me was data that was presented one day about the high level of people who were illiterate. They looked like you and me, Tony, they looked as good as you. And they sounded good. But when they were leaving the institution and people gave them a piece of paper were follow-up protocols. They couldn’t read it and they couldn’t execute against it. So again, back to the point, you said you need to close the door. You need to look at a person. So as you, as the dark, the need to say, do you understand what’s on this paper? And here’s what you can do to help yourself self-heal.
Stuart Levine (30m 35s):
Cause I think that’s a future trend in healthcare. That illiteracy data is still out there and making sure that in the current world that we care for people, there’s no doubt in my mind, but what does that care imply? And sometimes taking five minutes more, makes that person more resilient, puts them in a position to self-manage their disease, as opposed to being readmitted 48 hours later. And I just want them to make that point for the people that are participating with us today.
Dr. Anthony Orsini (31m 7s):
That’s an excellent point. And no matter what I say to a patient, if they don’t trust me, they’re not going to listen to me. So one of the things we talk about during my seminars is how to build that trust and how to do it in a couple minutes and look great. Stuart, you mentioned turnover. Let’s shift over to that right away, because I want to stand on. This is your wheelhouse leadership. Your books are about leadership, your book. I think it was 1995. The leader in you, we mentioned before people leave, not because of money. People leave because of their bosses. And honestly say, that’s been my experience. And I see hospitals that are failing because of poor leadership. And there’s businesses that fail because of poor leadership. Two questions. One is, are leaders born or are they taught?
Dr. Anthony Orsini (31m 49s):
In other words, I asked them this question to many guests in the past. Can you take the smartest person in the room and teach them to be a leader? Or do you have to take the leader who may not be the smartest in the room? And what’s the most important thing in leadership with communication in respect to communication.
Stuart Levine (32m 4s):
I think that leaders are developed. And I think what is implied in that conversation, which is an excellent question is I always want to understand, does that person have the will to learn. To me, a leader is a person that has the will to learn, or we have I’ll call it mentored over 20 people who become global CEOs and major C-suite positions. And the differentiator in that conversation is if a person has the will to learn, they can do pretty much anything they want. So leaders are people that have the will to learn and the will to listen. People who sit on the sidelines and aren’t current aren’t thinking, but making a call it extraordinary demand.
Stuart Levine (32m 49s):
So number one, leaders are people that have the will to learn. I think the second thing is leaders have the self-confidence because of their values, their belief set to look at data that say, gee whiz, our outcomes are not where they should be. Let’s have an honest discussion. I understand in healthcare, we need to have the attorneys in the room, but with no consequences individually, except let’s not repeat that era in the past, or let’s talk about the efficacy of how we prescribe medicine going forward. And so I think leaders listen to people or they share. They trust them by sharing information and current data and don’t hide.
Stuart Levine (33m 32s):
But for me, a leader is developed to be honest with you, I didn’t go to Harvard I didn’t go to Princeton. I went to Beth Bethpage high school and a local college out here. And you know what? This is a great world. You’ll live in. If you are willing to commit to learning and you can pretty much write your ticket. I believe that I still believe it’s true. And the new social order made me more true than ever because it’s tougher to exert intelligent leadership. And part of that is the courage to sit down. I was on a fortune 500 company that went down. And one of the questions I asked that a board meeting, which was penetrating was why is our employee turnover so high in a particular segment?
Stuart Levine (34m 14s):
The CEO, after what I was a young guy at the time pulled me into his office with his custom made suit and mahogany walls said you know, you’re a young guy there question. We don’t have data like that. I knew then Tony, that company was going down six months later, we became a target or a federal investigation. And so my point is asking questions about employee turnover and really understanding why people are leaving. Is it lack of information? Is it work conditions? Are they concerned about safety for patients requires a lot of trust and a lot of self-confidence in some days. And it starts with us when we started the turnaround that Dale Carnegie, where do you think we got the biggest pushback?
Stuart Levine (34m 59s):
When I said, you know, I want to get a climate survey, a real independent climate survey in the organization. And the pushback came from our own senior management team. People said Stuart they don’t like you. I said, okay, I’ll take that. I wanted to understand wh but then six months from today, we can do it again. I want a baseline. And honestly, reading, it was painful for me. It was painful, but that created a baseline in my mind that said, okay, here are the things we’re going to change. Here are the things we can’t change based on economics and other things, but we’re going to make a commitment to move forward as best we can. And it’s that type of collecting data, independent data that becomes really important and executing behind it.
Stuart Levine (35m 45s):
That’s what leaders do.
Dr. Anthony Orsini (35m 46s):
You know? I see this a lot. I guess the question came from my observation, especially in medicine, I’m sure it happens in business. We take that Harvard-trained physician. Let’s say he’s a cardiologist with all the accolades and he’s got multiple research papers. And we bring them to a very prestigious university with the best cardiologists in the group. We bring him or her into that. And we make them medical director of the cardiology department. And now you had all this talent in cardiology and one by one they’re leaving and nobody asks why, you know, so now you had this great group and then you find out later on that maybe this person was brilliant, but they’re not good at communication.
Dr. Anthony Orsini (36m 30s):
They’re a little rough around the edges in the end. You think you’re hiring someone who’s super perfect for the position, but in the end, you lost four great cardiologists because they couldn’t work with her or they couldn’t work with him. This is a tough question, but you probably can answer it. So now you’re interviewing for this chief of the department or you’re interviewing for a new CEO. How can you tell that this person is willing to learn and can do the job? Is there a secret sauce to figuring that out?
Stuart Levine (36m 59s):
Yes, my son, there are some insights I can share. The number one question that I ask, sometimes we are retained, we are a firm to sit on the other side of the table when there is a vetting process going on for CEO succession candidate. I always ask a question. Can you tell me about the people you have developed? Tell me about the people you’ve developed. And in that conversation, you will hear different responses. And I would say if that potential candidate can not legitimately say, hey, I’ve developed Anthony Orsini over here, and he’s a fabulous physician practicing in Cincinnati today.
Stuart Levine (37m 39s):
And you know, there are STUART LEVINE over there practicing down there in Palm Beach and so forth and so on. So I think asking the right questions in that interview, once you get past I’ll call I, the halo of a Harvard education, that you still need to talk about the core issue, which is healing. And I, for one, feel very strongly that there is a correlation between my body healing and the person who’s touching me, the clinician, the doctor, and believing that he or she has my best interests at heart. And that’s the Joie de vivre. To me, that’s the healing quotient that doesn’t get enough conversation because people sometimes demean it and say, well, that’s a soft skill, oh contraire.
Stuart Levine (38m 22s):
I do not believe that. I think that’s the differentiator. So if you’re interviewing and you’re the person doing that, I think punching the ticket for a great education, we all recognize is very important, but then asking questions that are experiential. Tell me about the people you have developed professionally. And by the way, tell me about what you do in the community because that tells me what they’re involved in. And if they’re only responses, well, I like to play golf or, you know, drink wine, but that will tell you that they’re not involved with people in a community. And if they’re not involved with people in a community, then you can be pretty well assured they’re not going to be involved when I’ll call it.
Stuart Levine (39m 7s):
That department comes together for a Christmas party or doesn’t have the time to walk down the hall and wish somebody a happy birthday or inquire as to how their family is feeling in the COVID crisis or something like that.
Dr. Anthony Orsini (39m 22s):
That’s the drop-the-mic advice right there. I think because that’s about communication and the ability to be able to communicate. So that makes us full circle here. I love what you said about who have you developed the best boss I ever had. I was early in my career, right out of training. It was at NYU that Karen Hendricks-Munoz hired me and eventually gave me the tools to head up a program in the NICU, which eventually became the largest program in all of New York City. And then the only program in New York City. And I started to receive some accolades for that. What I noticed that really impressed me and made her the best boss ever. She never took the credit for the program, but she took the credit for being smart enough to hire Dr.
Dr. Anthony Orsini (40m 3s):
Orsini. And I loved that about her. And there are some bosses and directors who try to take the credit for everybody else. When you can take all the credit for and say, Hey, I’m the one that hired Stuart in the first place. So I’m really smart, that kind of thing. So I love what you said. That’s just, it’s all about communication and the ability to communicate. And that’s why I’m so passionate about this. So, Stuart, this has been great. I finished every, every conversation with the same question and I’ll start it with you right now in your experience as all the years that you have experienced as a leader in healthcare and through life, what do you think is the most difficult type of conversation that you’ve had to navigate? And can you give us some advice on how you were able to get through that and maybe some mistakes or something that you did well that you want to bring everybody to take home as a lesson?
Stuart Levine (40m 52s):
Listen, there are times when, if you’re a CEO or for that matter, a board member where you have to consider making changes of leadership, and those are painful. Those are difficult conversations. I’ve been on both sides of their conversation. And I think that as long as you understand, it’s got to be respectful and it’s got to be on the merits. And so, as an example, if you have followed intelligent protocol and you understand the humanity of leadership and the responsibility and the privilege that says, Hey, you’ve missed your budget. You’ve missed your outcomes by X percent, the last six months or 12 months.
Stuart Levine (41m 34s):
And by the way, you haven’t recruited or attracted requisite people. And by the way, in your department, we have the highest turnover rate of a nursing staff. And I think then it’s not a personal conversation. People won’t, nobody’s going to enjoy that conversation, including you or myself, but at least then you give somebody a frame of reference. And then I always say to people, Hey, look, you can come back to me in 30 days and we can go have a cup of coffee somewhere and I’ll try to help, you know, you’re going forward. But I think as long as it’s on the merits, people understand that, that you have to make some decisions, but have a serious responsibility. I’m a great believer in codified.
Stuart Levine (42m 15s):
We had a client very recently where they were going to terminate an employee. And I heard it at a board meeting where advising the board and a grab the CEO later said, Hey, by the way, do you have all this documented? He said, no, but I said, stop. You’re going to hurt yourself. And by the way, all of your marketing that you are now doing for your Institute, that marketing is going to feel shallow and hollow. For sure people are going to know you have not had a process. So for me, whether it’s looking at a patient outcomes or a compliance issue, documentation in those cases becomes important. And then you have to do the right thing. If you make the right thing based on patient outcomes, that’s the highest level.
Stuart Levine (43m 0s):
That’s what you love. And I love about healthcare because you’re helping people. And that’s what the privilege of leadership is about.
Dr. Anthony Orsini (43m 7s):
How do you start that conversation? So when you’re bringing in that person to let them go, how’s that conversation start
Stuart Levine (43m 13s):
In my experience where I’ve had to be in those situations, when the person comes into the office, say, Hey, look, there’s no real surprise here because you know, for the last six months, every month I’ve met with you on the following metrics, big word metrics. And I’ve asked you, I’ve provided extra firepower on coaching for you. And I’ve done some with you and meetings with your people, your numbers, quality outcomes, your numbers on recruiting new nursing professionals into your department, aren’t working. And here’s why based on the healthcare economics of where we’re going as an institution where you’re lagging, you’re a department, you’re a unit that you’re responsible for is now lagging the institution by 18%.
Stuart Levine (43m 58s):
I have responsibility to the board and the board is asking these questions. So based on that, what I want to do is give you an out package of whatever is appropriate and try to part in a difficult situation in a professional way so that you can go on and take this as a learning experience. And we can go on to do our work. It’s just like that. And it doesn’t take an hour. That’s probably about the time, just a little conversation.
Dr. Anthony Orsini (44m 28s):
Parallels of what you just said and what we teach. I started the breaking bad news program and program has also an acronym and the G and that program teaches doctors how to give bad news to patients or businessmen, how to let people go. The G is gradual is the most important rule of breaking bad news. And it’s exactly what you said. The rule of thumb is that you have to brace people for what they’re about to hear and that the patient or the worker should already know that the bad news is coming before you give it to them. It’s just like a quarterback is blindsided. If they know it’s coming, they can brace for it. And you mentioned about giving the data and what led up to this, that’s the review and program. And so there’s so many parallels into this. And if you understand how to do that, give bad news in the boardroom or give bad news to patients, you can make it least bad for these people.
Dr. Anthony Orsini (45m 16s):
And again, your intention is not to hurt anybody or be mean it’s just it’s to leave on a good basis. I think that’s great advice. So Stuart, this has been fantastic. I can’t thank you enough. I think my audience is really going to get a lot out of this, the business of healthcare and why we need people like you in healthcare, advising us. And as you mentioned, why we need physicians to be on that board and to be all in the same room, if we’re going to do what’s best for our patients. And so I appreciate all the advice you’ve given us today. What’s the best way for people to get in touch with you.
Stuart Levine (45m 48s):
They can just go to our website. It’s a STUART LEVINE dot com and they can see what we do on committee charters, which are very important in health care to make sure that they’re current and reflect the quality metrics and the issues like that. So just be, you know, STUART LEVINE website, and they can find us.
Dr. Anthony Orsini (46m 7s):
And we’re going to add all that into the show notes. We’ll put all the links to this, into the show notes. So you don’t have to worry about writing this down if you’re driving and we’ll put all of Stuart’s information on that. If you enjoyed this podcast, please go ahead and hit subscribe on your favorite podcast platform. If you’d like to get in touch with me and get in touch with me through our website, the Orsini Way. Com. Stuart, thank you so much and appreciate you donating your time to us because I think my audience really learned a lot today.
Stuart Levine (46m 34s):
Thanks a lot, Doc. I appreciate it. And God bless you.
Announcer (46m 39s):
If you enjoy this podcast, please hit the subscribe button and leave a comment and review. To contact Dr. Orsini and his team, or to suggest guests for a future podcast, visit us at Orsini Way.com. The comments and opinions of the interviewer and guests on this podcast are their own and do not necessarily reflect the opinions and beliefs of their present and past employers or institutions.
Dr. Anthony Orsini
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