Excerpt  from   “Stewardship:The Noblest Form of Leadership – Part II,”  Compass Clinical Consulting Profile in Healthcare Leadership Interview with University of Virginia Medical Center Chief Executive Officer, R. Edward Howell, by Cary Gutbezahl, MD.

Dr. Cary Gutbezahl (CCC): One of the things I was impressed with as you went through the reorganization of University of Virginia(UVA) is the element that you had of bringing in people who will eventually be groomed for succession. So it wasn’t a new car that just drove in and started driving the organization, but a person who had the opportunity to be groomed under your tutelage.

R.Edward Howell(REH): Actually, I looked for a person who had skill sets that I didn’t have but that the organization needed. I’m committed to quality, but I appreciate that quality has evolved into a science and there are whole skill sets required to support that science—the statistical analysis and the systematic approach.

We needed someone with skills that complemented mine—fiscal responsibility, strategic vision—but also some I didn’t possess and we didn’t have anywhere else in the organization. That requires a pretty frank assessment of the individuals in the organization to ask, what are our strength and weaknesses?

What do we need to take us to that next level?

CCC: And part of that was that the person understood stewardship as a leadership principle??

REH: Yes. Stewardship is a noble style of leadership. It is not easy. In fact, it’s very hard and against normal human inclinations. But it is the best. To be a good steward, you have to have a mindset of a faithful servant.

In healthcare, we may have lost sight of the concept of servant. We are here to serve those who come to us for care.

As I look back on my career, cost-based reimbursement was such a very bad way of paying for healthcare. I know it was politically expedient, but it resulted in no incentive for efficiency. It insulated healthcare from everything else that went on in America, which was market-driven.

With time, costs got out of control and we concluded that healthcare should be a business. I’m not sure that conclusion was correct. The conclusion that healthcare should be run on sound business principles is correct.

But if you look at the driving forces behind health reform today, it’s recognition that in many respects, a pure business model isn’t working.

Forty eight million Americans are uninsured. Maybe healthcare should be a social good that is run according to sound business principles. A social good that all Americans need but that it should also be run according to sound business principles is a different mindset.

As an individual responsible for a social good—caring for our loved ones—what comes with that is a service to the public. Part of that service is stewardship—leaving the place better than you found it.

No one has ever said it better than Ralph Waldo Emerson:

“To laugh often and much;

to win the respect of intelligent people and the affection of children.

To leave the world a better place.

To know even one life has breathed easier because you have lived.

This is to have succeeded.”

A noble goal for any healthcare leader.

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DOWNLOAD “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.