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The Leadership Demands of Healthcare Reform Catalyst Learning
When Dr. Thomas C. Dolan, outgoing President and CEO of ACHE addressed the AHA annual meeting earlier this month, he offered candid words to leaders struggling with the demands of the current landscape. “I have probably used the word “challenge” in the title of over half the speeches I have given in the last forty years,” he explained.  “Challenge is not a strong enough word for what we face today. What leaders are facing today are demands – actions that I think are required if healthcare reform is to be successful.” Dolan shared four categories of demands: those on ourselves, our organizations, our healthcare system, and our society. On a personal level, leaders cannot rest on their laurels and wisdom; to keep their organizations moving forward, they must be knowledgeable about things like rapid process improvement, lean, six sigma, accountable care organizations, medical homes, risk sharing and many other topics. On an organizational level, Dolan feels that hospitals must institute hiring and HR practices that attract and retain employees who willingly make healthy lifestyle choices and can serve as models to the population at large.  He also calls for increased diversity and inclusion. “A multicultural society requires multicultural leaders.  Unfortunately… while minorities represent a reported 29 percent of patients nationally, they comprise only 14 percent of hospital board members, 14 percent of executive leadership, and 15 percent of first- and mid- level management positions.  This situation must change,” Dolan says. He encourages organizations to recruit for diversity and create inclusion by establishing philosophies, policies, practices, and procedures to ensure equal access to opportunities and resources. From a system level, the demands are great.  A lack of interoperable IT systems plagues progress in information technology; healthcare costs, along with pricing disparity in pharmaceutical and medical device industries, are out of control.  Leadership must demand cohesion, consistency, and efficiency. “There is no question in my mind that we will reduce healthcare costs in the future.  The only question is whether it will be done irrationally by government or rationally by the healthcare leaders in this room,” says Dolan. Last, Dolan turned to society at large.  While everyone has the right to basic healthcare, society in turn must demand that individuals take more responsibility for their health.  He calls for pressures and incentives for achieving acceptable BMI, blood pressure, cholesterol and for not smoking.  He also stresses prudence when making decisions regarding curative rather than palliative care and calls upon leadership to help society address this issue. While healthcare for all has taken decades to achieve, Dolan believes the goal is attainable. “My generation wanted to provide healthcare for all; I believe in the next ten years you will.  We do need more leadership for our patients, communities and society, and I believe you are the leaders who will provide it.”  

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