My Greatest Shortcoming as a Senior Hospital Leader

One of Three That Sometimes Held Me Back

As I think back to my early experiences as a hospital executive, I recall a fairly steep learning curve. The AAPL management courses I attended helped. But it wasn’t until I saw the principles taught in those courses applied in the real world that they started to sink in. And that’s also when I began to see my greatest shortcoming as a leader.

Most financial, human resource and management concepts eventually became second-hand. With mentoring and experience, I became comfortable with most aspects of my job.

my greatest shortcoming dalai lama

But there were several duties that I struggled with through much of my career. They remained my greatest shortcomings. But I developed strategies to overcome them. 

Root Cause of My Weaknesses

When I think about it, most of my management shortcomings relate to employee relations. I have concluded that my personality traits naturally contribute to these deficiencies.

Through various personality inventories and introspection, I know that I am an introvert and more a logical thinker than an emotional one. I am good with details, but not the best at seeing the big picture.

my greatest shortcoming introvert

Your personality traits may be different, so you may have different deficiencies. But I found specific challenges in the following areas as a result of these tendencies.

My Greatest Shortcomings

Number 3. Conceptualizing a New Organizational Structure

As a novice execute 17 years ago, I was very happy to simply accept the area assigned and try to achieve the best performance. This was generally simple to do, since I had excellent directors working with me.

I was comfortable delegating tasks to them and letting them do their jobs. It was just a matter of encouraging them and serving as an advocate and supporter when they needed resources to complete an important project or task.

But the CEO and COO were very good at looking at the “org structure,” and seeing opportunities for synergies. They might shift a director to a different VP to align certain skill sets; or combine Quality Improvement with Case Management to achieve synergies; or move Infection Control under QI to take advantage of expertise in the department.

In all of the management and leadership courses I have attended, I have never seen this topic addressed.

It took me a long time to begin to see those kinds of opportunities within my division. That kind of vision seems an important yet elusive skill to acquire.

Number 2. Succession Planning

This was a very foreign concept to me. The continued success of any organization is dependent on the smooth transition of leadership and management. Anyone can, and eventually will, be replaced.

Every director and VP should have a working document, subject to regular revision, that describes how the work will be completed in their absence.

This is something that’s very easy to put off. I commonly used the excuse that it would be difficult to describe a succession plan for myself that did not just consist of hiring a new CMO. After all, my team of directors led pharmacy, quality, laboratory, and medical staff relations. And none of them were physicians with my background.

But an effective leader must be able to design a plan that shifts current managers and directors into positions to take on important functions of the CMO, until another physician executive can be hired or the various duties can be transferred to other senior executives.

And Now, Shortcoming Number 1. Hesitating to Intervene With a Failing Employee

I once had a director for a small department who demonstrated a number of his own weaknesses as a manager. He performed some of his duties at a mediocre level, and occasionally demonstrated some potential to improve.

But there were issues that he really struggled with. His interpersonal skills were often lacking. He was not always accountable and would make excuses when he failed to follow through on certain assignments.

He could be very passionate about his pet projects, but somewhat passive aggressive when working on projects he didn’t see as important. This was fairly obvious to everyone on the senior executive team, especially those whose directors and managers who had to pick up the slack when this employee faltered.

I knew it as well. He was definitely a C player at best. And as we encouraged and coached employees to move from C to B, or B to A players, he never seemed to budge.

Yet, I found it difficult to find concrete and specific measures of his performance to hold him to. I always wanted to give him another chance to improve. My coaching clearly failed in getting him to “up his game.”

This director was managing an important area and had a sizeable budget. He was expected to perform at the level of the other 50-plus directors in the organization. The success of the organization depended on it.

But I avoided confrontation. So I tended to let things slide longer than I should have.

The Hammer is Dropped

Through a series of staff departures and changing roles, he was made responsible for an area that typically reported to the CFO, a very seasoned executive who ran a very tight ship. So, he was moved from my division and began reporting directly to the CFO shortly after assuming those duties.

The CFO identified his performance gaps and began to coach him. He penned written warnings for the director several times, attempting to clarify his concerns regarding the director’s missteps. He involved the VP for human resources, the three of them meeting to discuss this ongoing problem.

The director then committed a serious violation of one of our policies and was eventually terminated. This all happened within six months of moving to the Finance Division.

I often wondered whether the CEO and CFO had orchestrated the transfer of this director in order to bring him under a more experienced and capable senior executive. Had the director still been my direct report I doubt that he would have been moved out of the organization so quickly.

Coming Clean

So, that’s probably my biggest shortcoming. Over the years I have gotten better at addressing these situations. I try to be more proactive, and provide ongoing feedback to direct reports about their performance, both good and bad. And I’m better now at setting boundaries.

stop right there my greatest shortcoming

Stop Right There!

I’ve made a commitment not to allow that to happen again; to be clear with my expectations; to provide regular feedback and to take action for the benefit of the team when action is needed.

I’ve also learned that “writing somebody up” should not be looked at as punishment of a poorly performing employee. Instead it serves as an unambiguous warning that the current performance will not be tolerated. And it forces all involved parties to define clearly what good performance looks like. Some managers need that wake up call to motivate them to make meaningful changes.

Minimizing the Effects of My Shortcomings

Those are some of the biggest weaknesses I’ve identified so far. I thought that by sharing some of the more glaring aspects of my failings, it might serve as a trigger to examine your own shortcomings and address them.

We all have them. And we shouldn’t dwell on them for too long. In fact, in the long-term, we grow more by enhancing our strengths than by trying to eliminate our weaknesses.

But once you’ve identified your weaknesses, you can try to minimize their effects by:

  1. Hiring direct reports with strengths that can offset your weaknesses;

  2. Enlisting your colleagues as mentors to help identify your weaknesses and remind you when they are interfering with your effectiveness;

  3. Tap into the skills of the Human Resources Department when you’re facing particularly challenging employees; and,

  4. Consider formal business coaching to address your blind spots.

Have you identified any professional shortcomings that have hindered your success?

Do any of my shortcomings resonate with you?

Next Steps

Please add you’re thoughts and questions in the Comments. I will respond to them all.

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Until next time.

Please note: I reserve the right to delete comments that are offensive or off-topic.

  • It’s tough to fire someone, especially when the employee may have built friendships and roots in the organization. However, nothing will hurt a company more than a bad employee who does not change after constructive feedback. I think the most important thing is to learn something from the experience, which it sounds like you definitely did.

    When I was still involved in my families business, we would occasionally have to fire an employee. It’s never fun and always the last resort.

    • John Jurica

      Absolutely right. I’ve found that some of us in the caregiving fields (nursing, social services, medicine) seem to have a higher likelihood of dragging our feet, even when it is clear what we need to do.

  • Lars Nycum

    Great summary of some of the more challenging aspects of a Physician Executive. It is interesting that we will often find numerous reasons not to intervene with an employee/team member… i.e. rationalize that maybe they are not underperforming as much as our data shows. I once had a CEO tell me (when I was a Medical Director earlier in my career and struggling with a termination decision ) that by not intervening and moving the employee out of the organization, that we where failing them…we where not allowing them clarity around their lack of current success and thus, not enabling them to identify another area that they might find success…..this logical approach helped me put things in a better perspective.

    • John Jurica

      I like that Lars. I did not get into HOW to move someone out of your department or organization. But your comments point to that approach. Sit down for a serious conversation about their future. Explain why the current situation is not playing to their strengths. Discuss the long term benefits of moving on. Make a commitment to help them find the right job for them. I think the process can be made much more productive than I used to think.