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Collaborative premedication for healthcare leaders

April 16th, 2014

by Kenneth H. Cohn

"Maybe I should premedicate, too," a CEO of a Western community hospital said to me the night before I presented the data on 27 interviews of her medical and nursing staff.

A little context is in order:

  • My wife is a school nurse who rarely gets any of the viruses that students pass around.
  • Ten days prior to my trip out West, she got an upper respiratory infection.
  • Three days prior to my trip out West, I got it too.
  • It lingered for the first three days with the usual nasal congestion, sore throat and sinus pressure.
  • On the day I was scheduled to travel, it morphed into the gift that keeps on giving; I can't think of a single system it did not touch. By the time I met the CEO and medical staff president for dinner, after seven hours in the air and two hours in a car, I looked far from the person they expected to facilitate a two-hour discussion with an ornery medical staff the next day.
  • That is why I reassured them I would premedicate with a decongestant and acetaminophen.


The next day went well. More than 25 members of the medical staff showed up, listened respectfully to the data I presented and engaged in active discussion in small groups and at large over the following questions:

  • What resonated with you?
  • What did you find unsettling?
  • Upon what past events that involved working together might we build?
  • Where do we go from here?
  • What are your top three recommendations to improve the practice environment and improve care for our community in the next three to six months?

We had a shared vision of the hospital's strengths, challenges, opportunities and threats, and a clearer idea of next steps. I reassured them that they had a can-do spirit and vibrant culture.

The reason I am an unabashed cheerleader for independent community hospitals who want to shape their future is I believe nobody faces a tougher challenge than a CEO who aspires to lead confidently into uncertainty. As the CEO with whom I was working confessed her uncertainty, I recalled the words of a community hospital CEO in Connecticut that I worked with 15 years ago:

"If you don't feel the tension in your belly, you're not living and leading change."

Ken is a general surgeon/MBA and CEO of, who works with organizations to engage disgruntled doctors to improve clinical and financial performance.


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