by Nick Jacobs

As I approach my retirement from running a hospital Tony asked me to write some thoughts regarding this position.

Remember, no matter how far you push the envelope; it still ends up to be stationery.

The primary reason that I wanted to be the President/CEO was so that I would have the power to make things happen. After nearly thirty years of working to achieve that status in healthcare; after three degrees, two certifications and a fellowship, when the mantle of power was finally bestowed upon me, I made a choice to “never be a president like the majority of the presidents who had been in charge of me.” My primary motivation for this path was that, for the most part, their leadership had not felt very rewarding or productive. The discomfort that they had caused both me and my family was why I wanted to become the boss.

It was my dream to become a benevolent despot, a kind and reasonable leader who cared about his co-workers, but clearly was in charge.

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Probably the most disappointing and eye opening piece of this puzzle for me was that, short of threatening people with their jobs, you very rarely ended up with exactly what you set out to achieve for the organization. Compromise became the key word as you continuously attempted to engage the support of those selected by you to share the leadership power.

In the beginning, when the board allowed me my honeymoon, and when money was relatively free flowing, life was good. We moved along at breath taking speeds, well actually, my first team gave me lip service and very little action. So I changed teams and that time had selected people who could keep up with the pace but who turned out, in some cases, to not be very loyal or entirely truthful. Later, as I picked the third group of talented leaders, I selected loyal, detail people. In my case, because I had learned to delegate efficiently, details had become the bane of my existence. Sure I could do the nitty gritty things, but why bother? Consequently, I surrounded myself with people who would dedicate their lives to these pesky issues. Eventually, however, my perfectionists created a bureaucracy as each detail was vetted to perfection. Some days it felt like I was dancing in a pit of molasses. Don't get me wrong, I love 'em, but we drive each other crazy. My goal is to complete it yesterday and theirs is to complete it perfectly.

So, as I end my tenure as a hospital president, my would have, should have and could have list is a reality that does bother me, yet we have made more progress, experienced more growth, and had more success than most hospitals our size in the country.

So, maybe the real myth was that I could ever have developed patience. Remember, there's plenty of time, but not enough life. Check out the patient, employee, and physician comments on my new website, AskAHospitalPresident.com