Though managing industry reform and resulting regulations with budget shortfalls and limited resources isn’t exclusive to community healthcare, the reality of how this all plays out is amplified in the rural sector. Unlike CEOs at large metropolitan systems, those at smaller hospitals in less populous areas have to contend with disproportionately fewer resources to deliver the same level of care as their urban counterparts.
Everything from physician and personnel shortage to the challenges of geography are felt more acutely in the rural setting, which means leadership here must be especially agile as it embraces the goal of every CEO at any hospital, no matter the size: to ensure their demographic gets the most consistent and highest quality healthcare possible.
With examples from three CEOs from community hospitals who are successfully navigating this sometimes-rocky landscape, below are three suggestions for those leading their own facilities outside the illumination of big city lights.
Successful executives in all industries understand the need for flexibility and a pioneering spirit, but CEOs at smaller hospitals live their lives in this space. If challenges are only viewed as problems instead of opportunities to create new and better solutions, the job will consume you. For example, a smaller environment—including workforce and patient population—can be especially beneficial when trying out new processes. Compared to the larger, more diverse populations at bigger systems, rural hospitals can develop programs faster and more quickly identify what’s working and what needs revision.
Related, Rob Monical of McPherson Hospital in McPherson, Kan., says as CEO of a smaller facility he gets to be involved with all departments in his hospital, which is what he loves about rural health care.
“The draw for me as a young CEO was to get my hands dirty, and learn as much about helping patients without being a clinician,” Monical says, adding that in his experience, buy-in and family-like sensibility contributes to a high level of job satisfaction across the workforce.
While a rural hospital workforce may be small, the staff is likely made up of members from the community who are well connected to it. With a population just under 22,000, Sedalia, Mo. is one such location where the local hospital, Bothwell Regional Health Center, employs a significant proportion of the residents.
“We’re the second largest employer in the community, so a lot of people rely on us,” Bothwell CEO John Dawes says of the 145-bed facility.
But Dawes has parlayed the responsibility into a trump card. Facing the same hurdles other smaller communities deal with in recruiting physicians, Dawes has turned to the community to help connect with talent during the interview process.
“We handpicked a few ambassadors from the community,” he says, explaining that the “ambassadors” are used to customize the visit and the interview process. If the candidates have kids, for example, someone will be there who can talk about issues important to parents.
Dawes is implementing another hallmark of successful rural hospital CEOs—they engage with their communities. Seeing the hospital as a microcosm of the geographic location, then finding ways to connect, can boost brand awareness as well as patient confidence.
In his role as CEO, Dawes has chosen to participate in the local chamber, the local United Way and his church. Because he sees himself as the face of the hospital, he wants people in the community to get to know the hospital in more positive environments than just the emergency room.
Still, challenges exist so CEOs of community hospitals must find ways to raise awareness where it can be most effective. Professional organizations and advocacy groups can offer more than just networking and mentoring opportunities. They can add decibel level to the national discussions that are affecting rural healthcare.
In her role as CEO of Holton Community Hospital in Jackson County, Kan., Carrie Saia has testified at the U.S. Congressional level. In July 2015, Saia reminded the House Ways and Means Subcommittee that, “Rural hospitals face a unique set of challenges because of our remote geographic location, small size, scarce workforce, physician shortages, higher percentage of Medicare and Medicaid patients, and constrained financial resources with limited access to capital.”
When time is critical, Saia has confidence that her facility can quickly triage and stabilize Holton residents who’ve suffered a stroke or heart attack so that they can be safely transferred to nearby facilities with more specialized treatments. These services can make the difference between being discharged or suffering severe disabilities, which is why she says she’s working to urge lawmakers to minimize the regulatory burdens placed on rural healthcare providers.
In the end, patience and tenacity may be the best friends of the community hospital CEO. This is an environment that stretches its leadership to do more with less on a daily basis. The reward is worth it, however, agree Dawes, Saia and Monical.
Working with people who are always looking out for the hospital continues to make Monical appreciate the particular challenges of leading McPherson Hospital, adding that being surrounded by great people makes the job enjoyable.
Although he admits there are days he may drive in a little slower, he maintains, “I never regret coming to work.”