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Health Leadership P8

Does anybody know what they are? What are trans fats? Does anybody know? They are manufactured. They are genetically manufactured. They are changed – I don’t know about genetically, but chemically changed, altered, to increase the shelf life of food. So as a manufacturer, if you make bread, it will last longer if you use trans fats. And that seems like a good thing for whom? The manufacturer. I remember as a kid, “Don’t eat butter, eat margarine!” And you could put the margarine in the middle of your table and not refrigerate it, and it would lay there for a week, you know, and it’s like, you could still eat the margarine.

I had a college professor once that went to a fast food restaurant, bought a milk shake at the beginning of the semester, put it on top of his book case behind his desk. At the end of the semester, brought it down and drank it to prove that it had not spoiled. There are hot dogs in landfills that are sixty years old, still completely intact. So we can make food cheaper, but what is it doing to us? Because now, instead of 9% on our healthcare, we’re at 18%. Instead of 18% of our food, we’re at 9%. So here we are in this geography, and one of the main engines of the geography was ripped out. And what happens? And how do we sustain this?

If we want to stay here, if we want to have a future here, if we want our children to grow up here, what are we going to have to do individually and collectively to make this work? We’re going to have to pick up the slack. And how do you pick up the slack of someone who is essentially a cardinal, you know, at the American Vatican called Washington DC? How do you pick that slack up? You don’t do what you’ve been doing. You don’t just keep doing business as usual. You can’t. You can’t afford to. You can’t afford to. Windber Medical Center was gone.

Gone. Gone. I had a couple kids in college, you know? I had some big bills to pay. It didn’t meet my needs to have it go away. It didn’t meet my needs to have to relocate. And so I said, “Let’s do it differently. Let’s make the best of a hospital, the best of a spa, the best of a hotel. Let’s found a research institute. Let’s not be the flea that’s banging your head against the top of that lid.” And you know what, I could spend four hours telling you all the things that went wrong and how hard it was, but that’s not the point. The point is everything makes sense in a large enough context. And you need to sense what is happening and let it happen and be alert to your changing environmental conditions, reframe your limitations to become opportunities.

I mean, where could I have had a better opportunity than a hospital that was going out of business? Nowhere. Nowhere. No one would have given me that power. They wouldn’t have done it, and [inaudible] I look back at what I really was impacted by there, I walked into there [inaudible] care unit, their hospice. It was the first rural hospice in the United States. It was started by a visionary CEO who I believe either worked at the Mayo or the Cleveland Clinic and was killed in a car wreck about a year into his tenure. But he had this idea, and he worked with a doctor, and they opened the first rural hospice in the United States in Windber in 1977 before anybody would pay anything for it.

And I walked into this hospice for the very first time, and you know what I saw there? I saw people being treated with dignity. I saw people being treated in a manner that grabbed my heart. There was a guy with his loved ones, and it was after eight o’clock at night. I thought wow, that’s pretty wild. Visiting hours are over at eight because that’s the calf path we follow. I went to the next room, and there were a bunch of people, and they were singing. And I thought wow, they’re singing, this is after hours. It’s supposed to be quiet here. It was nine o’clock. I went to the next room, and the guy’s dog was in the room with him because he was dying and he wanted to see his dog. And I went to the next room and I heard someone say, “Yes sir, yes, we’re going to have the van out here tomorrow.”

His last wish was to go fishing one more time, and the nurses loaded him up and took him fishing. And I thought, “Why do we have to die to be able to be treated like this? Why do we have to be dying before people give you permission to treat other human beings as human beings? To nurture them? To care for them? To hold them? To feel for them?” And so that’s the premise upon which I made my statement. You love the hospice? Let’s do what you do in a hospice. That’s where it came from. So then I went to the employees, and Rod may or may not remember this, but I met every single employee in that hospital in my office the first two or three weeks I worked there.

Everybody came in. They had seven minutes. Five to seven minutes. Me and them. A chair, a chair. That’s where my house is. If you need to kill me, you know where to find me, you know? My door is always going to be open to you. Tell me about your family. Tell me about your dreams. Tell me about this place now. Trade seats with me, and tell me if you were the president of this organization, what would you do to make it better? And I took copious notes, and when I retired, I found that folder with all those notes in it, and we implemented hundreds of those ideas. And we learned more in that two week period than we would have learned in ten years. We know who was sleeping with whom, who took what parking place. We knew who was stealing, we know who was drunk, we knew who – it was just an unbelievable education. If you ever get a chance to be the head of something, take the time, take five minutes, and spend it with each employee, and you’ll hear stuff that’ll blow your mind.

But it’ll also educate you. I got more education in that amount of time than I could have ever gotten in ten years. And then we talked about the fact that we’re going to have to change, and we’re going to have to change in nontraditional ways, and so we had town hall meetings around the clock, and we had something called pizza with the president. For their birthdays, they got invited to come in, they could ask me anything they wanted and I had to answer it. It was their birthday present. So we were transparent. We showed them our financials. And sometimes it wasn’t a good thing for them, because sometimes it was very painful, and they were very scared, just like me. But you know what? At least they knew what was going on. They didn’t have to go home at night and make up all the bad stuff like we all have to do usually, because we don’t know what’s going on. So we get all paranoid. We go home at night, we say, “Oh, the sky’s falling, the sky’s falling and little black ghosts are coming and pulling us into the sewer.”

And so we were open, and we were transparent. And we started with the twenty-four hour visiting, and loved ones were invited to stay over. I mean, I have to tell you, when I said we were going to invite loved ones to stay over, you would have thought that I said to nursing, “Okay, ladies, gentlemen, here’s the deal. Bring your firstborn child in, stand him in front of the hospital, and I’m going to kill him.” I mean, that’s the way that was received. Resistant to change is an understatement. When we decided to change the walls from pink, doctors were coming into my office saying, “If you do that I’ll take my patients to Memorial and to [inaudible] and I won’t come here anymore,” because we’re painting the walls.

Resistance to change. The good news is I was on my honeymoon, and so they weren’t going to fire me in the first six months because they’d have to pay my contract. We asked for double beds in the OB suite. I went to [inaudible], the bed manufacturer, and I said, “I want double beds in the OB suites.” They said, “No. We don’t do double beds. Nobody does double beds.” I said, “You know, they made a baby together. Would you mind if they slept together after the baby’s born?” “Well, we’d  have to make special beds. Blah, blah, blah.” We got double beds. Guess what? Everybody used them. They liked them. Duh. You know? We could sleep a family of four in a palliative care unit with balconies and special bathrooms and a private kitchen where you could go, and if your loved one wanted brownies one last time before he left or she left, you could go make brownies. You could lace them if you wanted to. I didn’t care.

So the first [inaudible] came from the palliative care unit, and initially, the board and the management team and the medical staff verbally supported the concept. “Yes, we love our hospice. Yes, this is a great idea. Yes, let’s do it, let’s do it, let’s do it.” Within about eighteen months, this is what they realized I had done. The power went from them to the patients and their families. Now, understand I had one group of physicians who were primarily Windber [inaudible] guys and no ladies, and then I had a group that were from the Philippines. There were two power bases, and periodically, the heads of each group would come into my office and say, “If you don’t do what I tell you to do, we’re going to close this place down.”

I mean, if I could play that recording back for you, the number of times I heard it, you’d all just fall asleep because it’d be so boring. Over and over and over and over and over. And how are these people trained? They were trained like House. They were trained to be what? Do you know what the great description would be for that? It’s a real popular word right now. Anybody know what it would be? Bullies. They were trained to be bullies. In fact, a lot of them had probably been bullied in junior high school, and now it’s like revenge of the nerds, you know? It’s like they were trained to be bullies in medical school, and so it’s like if you don’t do it my way, I will take my ball and go home, and you will be out of work and I’ll close this place down.

That’s what I was up against. That’s the kind of push back, irrational push back, resistant to change. The paint was the first major one, then one time – we had something called spiritual touch. Any of you ever hear of spiritual touch? I had never heard of it. I didn’t know what it was. Spiritual touch does not involve touch. It should be called spiritual not touch. You know, the patient’s laying here, and someone who’s been trained to do this basically stands over the patient, closes their eyes, and kind of does this. Now, for some people, this has a huge, unbelievable impact on them. I don’t know what it is, and I don’t care what it is, because their whole thing is they’re moving energy fields and they’re moving, you know, the chakras and all that stuff.

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