Chapter 22: Communicating the Need to Change

Chapter 22: Communicating the Need to Change

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Description

Dr. Leach talks about how he communicates with faculty and staff at MD Anderson about the need to change. He explains that he has been influenced by Harvard leadership specialist, John P. Cotter, who wrote a book called A Sense of Urgency. Dr. Leach explains some basic concepts from the book, then describes how he goes about talking to heads of departments and divisions to create buy in from leading faculty members who will disseminate the message.

Identifier

LeachL_04_20130429_ C22

Publication Date

4-29-2013

City

Houston, Texas

Topics Covered

The Interview Subject's Story - The Administrator; The Administrator; Career and Accomplishments; Influences from People and Life Experiences; Contributions; Leadership; The Value of the Oral History Project; Professional Practice; The Professional at Work; Professional Values, Ethics, Purpose

Transcript

Tacey Ann Rosolowski, PhD:

Well I wanted to give you the opportunity to say anything additional that you may want to say. If there are any more bragging right things you want to add at the end or other comments you’d like to make about— Leon Leach, MBA, PhD Well, I just wanted to thank you for taking the time to do this. I think what we have experienced—the history of MD Anderson— There’s a lot of things we did right. There are some things that maybe not so much. But all we did, we learned from, and we should learn from. And I think that will help us to avoid mistakes of the past. But I think it’s a marvelous institution. I have enjoyed my sixteen years here and look forward to many more. But I think it’s going to be a lot more challenging, because the world is changing, and it’s hard when you’re the best at what you do to see the need to change. And that’s kind of my concern is that when you say being nimble, and you’re 20,000 people nearing $4 billion in budget, it’s hard for something that big to be nimble. And yet it’s our game to lose. We’ve got the resources to do this, and we just need the will.

Tacey Ann Rosolowski, PhD:

Are there specific strategies that you’re using right now to communicate the need for that nimbleness and the need for change? Leon Leach, MBA, PhD Yes, if you give me a second, I’ll go up there and get it for you.

Tacey Ann Rosolowski, PhD:

Sure. (laughter) (End of Audio 1 Session 4) (Start of Audio 2 Session 4)

Leon Leach, MBA, PhD :

This book probably expresses it best. It’s called A Sense of Urgency by John [P.] Kotter. John Kotter is probably the guru on leadership at Harvard University, well written, well read. The book is an easy read. It’s an airplane flight. You can get most of it done on an airplane flight, and it’s entitled A Sense of Urgency, but it’s as much about frenzied urgency and the things that bracket a sense of urgency. On one hand, you have complacency. On the other, you have frenzied activity. The frenzied activity is, the rubber is not meeting the road. You’re running around trying to get things done, and you don’t have a plan, but this sounds like a good idea. Let’s go do that. Complacency is, I've already got a full clinic, and I don’t entertain anything new. I don’t want to change anything. I want to keep doing what I'm doing. A true sense of urgency is somewhere between those two, recognizing the realities and moving in a prompt, nimble fashion to address them, and the book probably explains that better than any I've read. What I'm doing is, do I have a plan? My plan is to try to educate others to the need to change, because we’re living in a world where—and he talks about this in here. When you're the biggest and the best, why would you change? I have a series of dinners where I'll take three faculty out to dinner. I won’t bring the book with me, because it gives them something they have to carry, but I'll get the book to them afterwards, and I'll talk to them about what’s going on, a lot of the stuff that we talked about. Not so much the history—and some of the history of 2008 and 2009, because we have been through this before, or a version of this.

Tacey Ann Rosolowski, PhD:

I was going to say, it’s kind of interesting. As rotten as 2008 and 2009 was, it was sort of a testing ground.

Leon Leach, MBA, PhD :

It was a testing ground, and when we came out of it we were so efficient that we topped off the Pickens fund, half a billion dollars in about three years. We can do it. We did it. It’s scarier this time around because these are permanent changes that are happening in our healthcare, where back then it was a perfect storm.

Tacey Ann Rosolowski, PhD:

Responsive to the situation.

Leon Leach, MBA, PhD Yeah, three unique situations came together that caused that. It’s a quick read. They get a free dinner out of it, and these are the leaders. These are the faculty leaders, because it has to be at that level that we drive change. I could stand up on the pulpit and preach all day long, and unless folks out there decide to embrace it and drive change, it’s not going to happen.

Tacey Ann Rosolowski, PhD:

Who were some of the individuals that you're speaking with that are going to take this down farther into the ranks? Leon Leach, MBA, PhD I can tell you who I'm having dinner with tomorrow night. It’s basically division heads and department heads. Well, I can’t tell you because I don’t—my iPad or my iPhone is in the—but it’s Paul [F.] Mansfield [MD]. It’s generally department heads. It’s the most influential thinkers among the faculty level, among the faculty leadership, and it’s kind of randomly picked. I do specifically the four subdivision heads, some department heads and some people that are what I call rising stars. They’re getting engaged and want to help change MD Anderson. Some people I don’t pick only because when Jack [D.] Stobo [MD], who tried to make changes at the Medical Branch—I interviewed him kind of like this for my PhD, and I asked him what he would have done differently, and he said he spent far too much time with people that didn’t want to do this and were naysayers, and he was never going to convince them. He should have spent a lot more time with the people he was going to convince. It’s not that I won’t spend time, but if someone has got their mind made up, I'd rather spend time with somebody who doesn’t that might see the logic, and this is not a soothsayer type thing. It’s reality, and it’s happening more and more. Not so much in Texas but—and you're seeing it happening here. St. Luke’s decided to sell their hospital because of the changes that were coming. Catholic Health Initiatives out in Denver, they’re a national player. They know how to do ACOs, and they know how to make things more efficient. You've got Memorial Hermann that’s getting more and more into that business. Methodist is strong. They’re a bastion. It’s not clear to me—unfortunately they’re moving in to that arena, but the change is going to happen. Even though it’s not happening first in Texas, it doesn’t mean we won’t be immune to it.

Tacey Ann Rosolowski, PhD:

What do you think the—what are the—how do I say it—resistance points among the faculty that you anticipate, and what are the things that they are more easily going to embrace? Leon Leach, MBA, PhD Some of them we already talked about. “It’s fine but not my administrative part.” I think some of them they will embrace, and this will be a variable. Some people, as we change to a new system—an off-the-shelf system—you're going to have some people that will embrace that. You're going to have some people who say, “You know, I really liked ClinicStation. I don’t know why we ever moved away from it.” You're going to have a variety of reactions to that. Some people just won’t like the new because it’s new, and they have to change. Probably the most common complaint out there, it’s, “We’re back to different compliance, and isn’t there a better way? Isn’t there a more streamlined way?” Well, the problem with compliance is you have to comply.

Tacey Ann Rosolowski, PhD:

And compliance in what area? Because there must be a whole range of them.

Leon Leach, MBA, PhD It’s primarily regulations are in place upon us by governmental entities.

Tacey Ann Rosolowski, PhD:

And this isn’t just institutional review boards and regulation of research but other things as well.

Leon Leach, MBA, PhD It’s part of that. It’s part of that. There are some challenges with HIPAA as far as making sure you're in compliance, but you have to dot the i’s and cross the t’s. Can we more systematize that? Perhaps. But it’s not going to go away, and it’s not going to get to be a piece of cake. Compliance is compliance. You have to comply. But that’s fairly common, and I wish we could wave a magic wand and make it go away, or we could at least wave a magic wand and make it very systematized. The concerns will be pretty much all over the place depending on what is that particular faculty’s view. If they came from a place that used one of the systems where we were down to two systems—and I don’t want to mention their names—but if they came from a place that happened to use one of those, whoever the winner is, they’ll probably be fine. If they were just now getting used to ClinicStation after years and years of dictating medical records and doing it all manually and here is another change, they may not be fine.

Tacey Ann Rosolowski, PhD:

They’ll have to shift. Well, thanks for answering that. Leon Leach, MBA, PhD Thank you. That one is yours.

Tacey Ann Rosolowski, PhD:

Thank you so much. Thank you, and thank you again for your time today. I know it was an extra session, so I appreciate it. I know how busy you are, especially with the budget due.

Leon Leach, MBA, PhD I look forward to reading it over, or if you have any further questions, you know where I am, so don’t hesitate.

Tacey Ann Rosolowski, PhD:

Thanks Dr. Leach.

Leon Leach, MBA, PhD Thank you. Have a good day.

Tacey Ann Rosolowski, PhD:

And I'm turning off the recorder at 19 minutes after 4:00.

(End of Audio 2 Session 4)

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Chapter 22: Communicating the Need to Change

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