Excerpt from “Stewardship:The Noblest Form of Leadership – Part II,” Compass Clinical Consulting Profile in Healthcare Leadership with University of Virginia Medical Center Chief Executive Officer, R. Edward Howell.
BUILDING STEWARDSHIP
Dr. Cary Gutbezahl (CCC): You’ve made it clear that you have a very strong obligation to the future, talking about future tense and your sense of stewardship. Could you give us a few aspects of the things you tried to build into the organization from a stewardship standpoint?
R. Edward Howell (REH): First is to develop leaders.
We take all of the management positions and devote a half-day to developing leadership skills for them. This is ongoing throughout the year. Our focus for the next session is accountability. Frankly, accountability is a concept of both management and stewardship, but especially stewardship. We’re developing those leaders within the organization with a skill set around being accountable for their actions and holding their staff accountable to enhance the care we deliver both from an efficiency and effectiveness perspective.
Many of those leaders will be here long after I’m gone, and I believe that is real stewardship.
The second thing that needs to be done is to look at the balance sheet of the organization to be just as important as the income statement. Our balance sheet is part of the university. Although it’s separate when considered by the bonding agencies, it’s a part of the university’s overall financial performance.
We’re the only public university in America with a wholly owned, academic medical center that has a triple-A bond rating by all three of the rating agencies. Many colleagues have challenged me on limiting debt, especially my colleague who was the Dean at the University of Iowa when I was there. He said,
“Why do you limit yourself in terms of your use of debt? Why do you think that such a strong balance sheet is so important?
You could leverage your organization much better to do what you want it to do.”
If I did that, would it be good stewardship?
Putting off the consequences of a decision to leverage our organization to my successor is not good stewardship. Our debt-to-equity relationship is 0.227. Look around our facilities. When you parked your car, you saw our:
- New cancer center
- New transitional-care hospital
- New ICU bed tower
And we’re breaking ground for a new children’s hospital. We’re able to do all of that without over-leveraging our institution or mortgaging our future.
That’s good stewardship.
I don’t know that I will personally benefit from the strength of that future organization, and that’s okay. It’s not only okay, it’s good. It positions UVA for the future—to serve the needs of our communities. In return, I can then say I left it better than I found it.
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