A Hospital CEO Who Wants Other CEOs to “Give a Damn” About Their People


Here's an interesting column from Becker's Hospital Review, written by Michael Dowling, President and CEO, Northwell Health.

I'm guessing he created the headline, since the phrase “give a damn” doesn't appear in the article:

Michael Dowling: CEOs — Give a damn about your people

Who are the CEOs he is speaking to who do NOT give a damn? What inspired him to write this?

“…investing in our 68,000 associates is my most defining and crucial responsibility as president and CEO. If you are fortunate enough to call yourself a healthcare leader, the same is true for you.”

Wow. That sounds great. I hope he walks the talk, as that sounds like Toyota and their “development company” approach (focusing first on developing people).

Blunt talk, delivered forcefully, from Dowling:

“For the executive who doesn't think they have enough time to invest in their people, I have two questions:

1). What are you really doing with your time? And

2). What could possibly be more important than your people?

If we can't find time to be with employees who do all the work and deliver the care, then what the hell are we doing as leaders?”

Dowling writes about new employee orientations. Given the high turnover rates in healthcare, the high churn of employees creates a lot of new employee orientation opportunities, even if total employment isn't growing.

Dowling answers his own question a bit, pointing to leaders who are paying attention to “macro issues of healthcare” but he points out leaders ALSO need to focus on their employees and that includes making more than a superficial appearance at orientations to give what I'd call “the royal wave.”

He offers to answer questions from employees during these sessions, but I think more importantly tries to help individuals see how they are part of a system.

“I illustrate the connectivity of our health system, and how every department, site and person is interdependent. In most health systems, employees are immediately placed in a department or unit upon their hiring, and it is very difficult for them to see how that one division works with the rest of the organization. I want them to understand the totality and mission of the health system. We are stronger when our employees see how all the pieces of our organization are connected, and every person knows his or her work is important.”

He's visible and impactful enough that he says he “would never be able to slip into the rank-and-file as an ‘Undercover Boss.'” It's not just CEOs who are sometimes unrecognizable… I've seen hospital VPs and even directors who go very unrecognized by their frontline employees.

It's not just a one-off orientation encounter:

“Beyond that, I regularly meet with groups of employees for breakfast and then individually as opportunities unfold. This past week, I met with three employees one-on-one. One gentleman who is earning his master's degree asked to interview me for a paper on leadership. I said “yes,” which is my universal response when employees ask to meet.”

That's great.

In contrast, I know a nurse at a hospital who sent a very well-reasoned four-page letter to her CEO about problems that weren't being addressed. The nurse respectfully asked for a meeting with the CEO to talk. This CEO wasn't a “yes” leader. About a month later, the nurse got a two-page letter in response from the CEO, with no opportunity to meet and talk. Nothing was delegated down, either, for a VP or director to talk with her.

I'm dumbfounded by a situation like that. I know CEOs are busy, but if you can't take 15 minutes for an employee, then “what the hell are [they] doing as leaders?” — Dowling's words.

If you have the time to write a two-page letter, you have time to have a respectful, adult conversation in a face-to-face manner. And this is an organization that has published an article about how “Lean” their culture is. Hmmm….

Dowling makes another great point about trying to see through the eyes of patients and visitors:

“During our time together, I always find a way to encourage employees to look at Northwell from the outside in, not only from the inside out. When you walk into your workplace, imagine you are not an employee but a patient. As employees, we can often become oblivious to our surroundings, looking at things but not really seeing them.”

A CEO could also encourage other leaders to view things from their employees' perspective, as leaders can also become oblivious to their surroundings.

Looking at things, but not really seeing them… I love that phrase and that's one reason why I always suggest that “going to the gemba” or “doing a gemba walk” has to mean more than going and standing in a hallway staring at some whiteboard.

Hospital CEOs like Vance Jackson spend time going and observing the real work being done, as we talked about in a recent podcast:

Dowling wraps up his piece:

“Invest in your people. Give them your time, answers, ears, attention, perspective and, perhaps every now and then, selfies. Healthcare has its challenges, but nothing gets done without teams of people. Working in this profession is not a job — it's a privilege and responsibility.”

Well said.

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. We all have visions of what CEOs should be, in the context of Lean or otherwise, which is typically some form of servant leader. Invariably, we are disappointed because CEOs like Mr. Dowling are outliers. This has been the case since the dawn of modern management practice more than 100 years ago — with seemingly no improvement, despite all the academic research, practical training, education, and role models to help people become better leaders. So, one has to look elsewhere for cause-and-effect, which will lead to uncomfortable realizations. The leadership you and I don’t like exists because the corporation remains more fedual in nature (due to preservation of traditions and thus lack of evolution) than the quasi-democratic institution that is required for TPS and Lean. In addition, capitalism, which we all admire and believe in, is simply poor at producing large numbers of leaders like Dowling, Jackson, Kaplan, or Byrne. Continued showcasing of these progressive leaders does nothing to influence the “bad” leaders and frustrates people who are stuck with such leaders. It’s the Betamax vs. VHS situation applied to corporate leadership: the technically better product fails in the marketplace; in this case, superior leadership fails and inferior leadership wins. It is unfortunate that people (non-executive employees) have to suffer. It is likely that we must wait for the drivers of the bad leadership problem, fedual-like corporation and capitalism (market economy), to evolve and create a more hospitable climate for Dowling-like leaders to proliferate. This will, of course, take time, and it may not happen in our time. In the meantime, we do all that we can to affect change, just as we should be doing — but with a better understanding of the current state and with greater patience and equanimity given the slow pace of change.


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