I'm the new CEO of a regional hospital system that desperately needs reform. Quality scores are dropping, staff morale is terrible, and three of our five board members are blocking every change I propose. They're old-guard, connected to donors, and more interested in their own legacy than patient outcomes. I have two paths: I can try to win them over through patience, relationship-building, and demonstrating results. My COO calls this "leading by example" and thinks it's the only sustainable approach. Or I can use the leverage I have—I know about some questionable contracts they've approved, and the major donor who recruited me has offered to help push them out if I give the word. The gentle path could take years we don't have. The hard path could work but might make enemies who torpedo us later. How do you create change when the people in power won't be moved by reason or example? — The Resistant Board in Baltimore
I'm the new CEO of a regional hospital system that desperately needs reform. Quality scores are dropping, staff morale is terrible, and three of our five board members are blocking every change I propose. They're old-guard, connected to donors, and more interested in their own legacy than patient outcomes. I have two paths: I can try to win them over through patience, relationship-building, and demonstrating results. My COO calls this "leading by example" and thinks it's the only sustainable approach. Or I can use the leverage I have—I know about some questionable contracts they've approved, and the major donor who recruited me has offered to help push them out if I give the word. The gentle path could take years we don't have. The hard path could work but might make enemies who torpedo us later. How do you create change when the people in power won't be moved by reason or example? — The Resistant Board in Baltimore
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