What’s your biggest challenge right now?

The biggest challenge right now, I would say is workforce, no different than the rest of the state of Maine — inside and outside of health care. finding the number of people we need to do the work that we need to do is becoming increasingly challenging. We have probably half a dozen in the hospital and then maybe another half a dozen across our outpatient clinics. Roughly speaking, I don’t know the precise number, but it’s kind of a rolling thing. What my two cents on it is with the economy the way it is and unemployment so very low, a lot of our front-line and entry level positions, we just don’t retain as long as we used to. That is a symptom. I speak to many, many business owners and leaders outside of health care and they’re experiencing the same thing in this area. I don’t think health care or Bridgton and Rumford are unique.

I think we’ve abandoned the whole idea of traditional advertising in the want ads. We do a lot of very targeted digital and direct marketing about our organization. What we really focused on is the culture here, and the idea that so much of the values in western Maine are about small town, small community. Who the leadership team is played a lot more into the scenario, like who your manager and your co-workers are going to be. We talked intently about the expectations of our staff and the culture and the family atmosphere. It’s pretty interesting. While we’re not different in terms of our recruitment, we are different in that health care is one of the few industries where we have four different generations in the workforce. And there are some people who just manage the way they manage, and there are others of us who look at that as a unique opportunity to speak and to work with employees differently based on their individual traits.

In the course of your career, what’s the most important lesson you have learned?

This is something I talk a bout with  our new orientees. We are taught so many things in our life, how to walk, how to talk, how to eat, how to dress. But one thing that we’re never actually formally taught is how to listen. The best lesson I’ve learned is the power of listening.

Many solutions come from listening and anybody who thinks they know it all is a fool. To me, the best leaders are the ones who assemble their teams and listen to the diverse ideas and solutions that are out there to the very complex problems that we need to solve every day, and brings them together in a way that … creates the best possible solution. When you look at why people stay, it’s not about titles, it’s not about money. It’s always about … feeling respected, feeling engaged. And that means you have to connect with people in a way to show that  you understand what they’re contributing, that you value them.

How to do you manage change?

My mantra is summed up in three words: improvise, adapt and overcome. You have a plan, right? We’re going to change X, Y or Z. Here’s our plan. It’s well thought out, we’ve used data and we’ve made decisions in the past, and we’ve learned what’s worked with that and what hasn’t. And we’re adapting that. And then when it comes time to execute a plan, I think you need to be fluid. Being flexible is too rigid. You need to be fluid. You need to have the rollout. You adapt to the environment, you improvise. When things that you thought would happen don’t, and then you overcome any barriers that get in the way.

That resonates with people. Really good staff on the front lines understand that you can a have a plan but, particularly in health care, things can change and they can change really fast.

That quote, by the way — improvise, adapt, overcome — is a line I took from Clint Eastwood in a movie called, “Heartbreak Ridge.” And is it easy? I’m going to steal a line from Tom Hanks in the movie “A League of Their Own.” “No, it’s not easy. It’s hard, but the hard is what makes it great.”

How do you prioritize goals?

I think it’s very important to look at our goals individually, but then how do they gel together? For example, every organization has a financial goal, right? What’s the financial target? And every organization more than likely has a goal of retention. Sometimes, the obvious answer is boy, you know, the more we retain our staff, the less we’ll have to spend on recruitment and that will help our bottom line. Sometimes you have to spend more money or shore up your team with temporary labor and that can be more expensive. So you have to look at your goals in terms of what’s the short term?

Sometimes, we are very focused on the long term, I’m staring at a laminated chart of our goals for the year that have to do with safety or quality, that have to do with our patient experience, have to do with our team member experience, and have to do with growth and then obviously our bottom line. So we know that in the long term, the safer and higher quality an organization is, the less it costs. That’s just a proven fact. And the same with with patient experience. But we also have to invest in training and education, to make sure that our staff are up to speed on the latest safety and quality measures and techniques, as well as teaching experience and team member experience.

We’re going through right now an exercise where we’re training all our staff on the power of one, which is how one person can make a difference. That requires an investment and we are going to make that investment because it will pay dividends in the long long, and it’s just the right thing to do. If we were solely focused on earnings, we would probably cut all that out and make a better quarterly margin this quarter.

Where will the organizations you oversee be in five years?

I remember when we used to do strategic planning for five years, and now most people are afraid to do it beyond 18 months.

I would say in Bridgton and Rumford, we’ll continue to lead Maine and the nation in high quality care. They will continue to serve the community as they have for more than 100 years, but our access to care will improve. We will have more access to primary care, we’ll have more primary care providers. We’re always recruiting.

And I think you’ll be able to engage with our health-care environment in a multitude of ways — call, click or come in. I think our relationship with our customers, our patients which I frequently call customers, will change. I see the rise of artificial intelligence on a national level and I think it will be more warmly embraced in our local markets. And our access to specialty care will become far more robust.

We’re changing the model of health care. We’re the only system in the state of Maine that’s actively trying to get people out of the emergency room and into walk-in care, and out of the hospital for surgery and into an outpatient center. My hope is that we’re advancing the health of the community, that the community is healthier tomorrow than it is today if we’re doing our jobs properly. The way we engage the community is different.

I sit on the board of the American Hospital Association, and what I continue to see is as we continue to squeeze our pressure on the GDP, there’s more and more acceptance that we need to move more to evidence-based medicine. The opioid crisis is a huge issue right now. There’s a lot of research and a lot of change in the way care is provided in the emergency department and in primary care, but also in surgery. There are surgical procedures now where zero opioid  based pain control is prescribed post-surgery because the research shows it actually doesn’t help. And when opiates are prescribed, instead of 120 pills the research shows that somewhere between 50 and 30 is the appropriate amount.

I think we’ll start to look at the evidence and the research that continues to go on. It’s about adding value as we transition from getting paid to do something — pay per click — to a value, which is getting paid to keep people healthy. We screen women for mammograms at 40. And someone said, I bet if we did it at 30, we would discover more cancer. And so they tried it and lo and behold, they did. They found more cancer. What they later discovered was that it was the wrong the question. We shouldn’t be asking if we will find more cancer. We should be asking if we would lower mortality if we screened earlier. Can we improve people’s lives? The answer was no. We found more cancer. We subjected people to more treatment as an industry, but we didn’t actually change mortality. So they moved the screening back to 40.

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