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Whatever it takes: the virtue of resourcefulness



Lesson from Everyday Life By Theodore Lewis

Portland, Maine—I had just received my first hospital assignment at Leland Memorial Hospital in Riverdale, Maryland (just north of D.C. in Prince George's County). However, this was not an assignment I wanted. The corporate owner of Leland (Adventist HealthCare Mid-Atlantic) had announced a plan to close the hospital because the state had categorized it as a high-cost hospital and thus refused to give Leland state-controlled rate increases.


As a result of the owner's announcement, the Leland staff and board, backed by the community, rose up with indignant protest. The mayor of Riverdale, along with a community activist group and the county’s commissioner, went to court and obtained an injunction prohibiting the owner from closing the hospital.


The owner responded by firing the administrator and the board. Ron Marx, my boss and CEO at Washington Adventist Hospital in Montgomery County, Maryland, was assigned the responsibility for Leland. He called me in to tell me I was being sent over to Leland as the onsite administrator to pick up the pieces. Talk about being thrown to the lions! I tried protesting the assignment, but Ron wouldn't hear of it. He said, “Ted, you are the right one for this job."


Ron Marx was an extremely beloved and talented hospital CEO, who understood that the key to a hospital's success rests with positive working relationships with service area medical staff.


Each week I would meet with Mr. Marx, who was a great mentor, for his advice and support of this green executive. I was charged with, among other things, changing the attitudes of the physicians and community in the Leland service area.


The largest physician practice in Riverdale belonged to J. Richard Lilly, medical director and founder of J. Richard Lilly and Associates. Dr. Lilly’s office was within walking distance to Leland, yet his patients were not being referred to us.


My job was to find out why, and then change things. I sent our talented physician relations specialist, Mary, to get an appointment with Dr. Lilly. No dice.


I tried getting an appointment myself and was rebuffed. As I reported on my lack of success, I was hoping Mr. Marx would accept the futility of the situation and agree that I should move on. However, I was wrong.


He said, "Ted, I want you to utilize the principle of ‘whatever it takes.’”


After mulling over Mr. Marx's mandate, I realized I had to look at alternatives I hadn't previously considered.


Because I hadn't had a recent physical checkup, I decided to call and schedule an appointment as a new patient at Dr. Lilly's office.


When I showed up at the scheduled appointment time in the lower-level main entrance/waiting area, I could tell that the staff had no idea who I was.


I filled out the required forms and was sent up to the mezzanine level area, where the clinical exam rooms and Dr. Lilly's office were located.


A nurse ushered me into an exam room, took my vitals that she detailed in my new patient record, which she placed in the chart holder on the exam room door. She then gave me a patient gown to put on, told me Dr. Lilly would be in shortly, and shut the door.


After changing into the universally awkward and embarrassing attire, I sat on the exam table with apprehension. Finally, the door opened. Dr. Lilly, in white lab coat with a stethoscope, introduced himself as he grabbed the clipboard with my chart. He shut the door and lowered his head to scan the biographic and medical information on the clipboard.


On the first page he read that my occupation was the administrator of Leland Hospital. His jaw dropped. Without raising his head, he looked above his glasses and examined me with x-ray vision.


There was a long pause. Then he began to share how he felt about Leland Hospital when he was just beginning to establish his practice. He described the unkind and discriminatory treatment he received when he tried to practice at Leland. Being unknown, and not a member of the Seventh-day Adventist physician community, he was shunned.


He found out he was not even welcome in Leland's cafeteria. As he was sharing this experience with me, somebody knocked on the door, reminding him there were other patients waiting. “I don't want to be disturbed,” he responded.

Smarting from such rejection, he went to a competing hospital that welcomed him with open arms and where he had since been referring his patients.

He said I was the first Leland administrator to ever pay him a visit (I didn’t mention the difficulty trying to meet with him).


While sharing his pent-up sentiments, Dr. Lilly performed my thorough physical, and I began to understand why he was considered one of the best primary care physicians in the state.


Months later, Dr. Lilly changed his attitude toward Leland and began sending his patients to use our services. He also introduced me to the county commissioner, who later became the next governor of Maryland.


Embracing the "whatever it takes" principle resulted in many other amazing things happening at Leland, including healing of the deep divisions in the community.


A dedicated hospital and medical staff worked together to improve operations and increase admissions.


Together with Leland's stakeholders, a plan was developed to request the state to grant Leland a rate increase. If the state approved the plan, the owners would make a long-term commitment and investment in the hospital. If the state denied the request, the community would not oppose the closure.


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Wanting to reduce the number of hospital beds in the state, they did not approve the plan.


Consequently, the hospital team decided to manage Leland’s closure in the most excellent manner, with a goal to get each staff member placed in new jobs within 90 days—whatever it took. Mission accomplished.


The following year, the Maryland American College of Healthcare Executives honored me as “Young Executive of the Year”— all because of the principle "whatever it takes."


Theodore Lewis is the former CEO of Guam Memorial Hospital and has a health care consulting business based out of Portland, Maine. He is collecting stories about lessons learned in life and can be reached at theodorelewis@yahoo.com.




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