UMass Memorial Health Care CEO Eric Dickson on how to impress any boss and how to lead a company through changes

UMass Memorial Health Care CEO Eric Dickson has not only been with the organization for almost three decades but has ties to it that run deeper than his career. “I worked as a respiratory therapist here, then went to med school here, residency here, first faculty job here, my kids were born here, I met my wife here, my parents have got care here,” Dickson told Ladders.

As a result, Dickson admits that he loves each and every one of his 14,000 colleagues.  “There’s no other word that I can use,” Dickson said. “I really, really like them? No, I loved those people and I want them to be successful in their jobs.” Ladders spoke with Dickson to find out more about his passion for the organization, his advice for leading a company through times of change, and his most important pieces of career advice.

Are there any major differences between being a CEO of a health care system, compared to somebody in the same role at a more corporate organization?

“I think the biggest difference is you’re truly dealing with life and death situations because that’s what we deal with in health care. And the decisions that you make have a profound impact on truly, and this isn’t overstating it, whether patients live or die. I’m a physician, so I understand making those choices. But you start to apply that to a business where, are you going to buy one piece of equipment, which for increased safety in the OR, or another piece of equipment for the ICU? You actually have to make those trade-offs. So, are you going to add a nurse that’s going to focus intensely on something called sepsis or patients that are deteriorating, or are you going to add a position somewhere else, a chief patient safety officer? We make those decisions here, so the impact of our decisions , from my perspective, is much, much greater.”

Did you always want to get to the executive level?

“I never wanted to get to the executive level. I am a physician first, I often say I’m temporarily serving as CEO. And when you’re done with being a CEO, I’ll go back to the practice of academic medicine, where I belong. Things happen, and you just end up in these roles and that’s been my whole career. I’m a basic scientist that practices emergency medicine, I still practice emergency medicine. I still try to stay involved with research, although that’s a lot harder. And I still think of this as a temporary gig that I’m doing to just help the organization until I can get back to doing what I truly love, which is practicing medicine.”

What’s one aspect of your role at UMass Memorial Health Care that most people don’t know about?

“People think that you become CEO and you have all the power in the world within the organization. And the reality for me is, every step in the organization ladder that I’ve taken, rung that I’ve moved up, I feel like I have less power and not more. When I was an emergency physician, I felt totally in charge when I’m practicing medicine, that’s a front line caregiver. When I was a chairman of an emergency department, I felt like I had a lot of authority, but a little bit further away because the docs were making those decisions.

As I became chief operating officer of a hospital and then president of a medical group, I just felt like I was moving further and further away from having power and being in charge of decision making. And now as CEO, I don’t feel like I run anything anymore, because the president of the medical center runs the medical center and makes the decisions down there. The chairman of emergency medicine makes the decisions down there. The CEO can’t go down there and go over that position and start interfering with decisions that they’re making.

So, I think that’s the biggest surprise for people is when they think, ‘Wow, you’ve got all this authority and power,’ and I say, ‘I feel like I have none.’ Part of that is that I…maybe it’s just that I don’t use it and I’m trying to put people in charge of something and support them, and coach them, and mentor them, and advise them. But you have to let them own their decisions, and either their successes or their failures. So that’s the surprising part of this position.”

So, in your opinion, what do you think is the role of a CEO?

“I always talk about it as three roles, and that is the development and execution of the strategic plan. So we’re 14,000 people in the organization, so there’s one piece of the organization, and sometimes I’m part of that piece when I’m practicing medicine. But if the resource nurse in the emergency department takes a bathroom break, the whole place falls apart, because it’s ambulance coming in, there’s nobody to assign what room to go to, and to activate a trauma to move that patient there. But I don’t show up for a day, and nobody notices. In fact, some people say it’s a good day around here.

I’m worried about the longer-term strategy. Really my most important job is the development and gathering of information and understanding the external environment, and charting a course for the organization and then making sure it gets executed. Everybody does strategy, very few do execution well. A vision statement is a statement to get people excited about executing the strategy. The vision of the organization should always be to achieve the mission at the highest level possible.

When you say vision, it’s really creating the vision, talking about the vision is how you get people excited about the strategic direction. And sometimes people reverse that and say ‘No, create the vision and let the strategy follow.’ I think the two go hand in hand. So really strategy, develop, and execution to achieve the mission at the highest level possible, which should be the vision of the organization. Those are how those things come together.

The second part of the job is people’s development, and that includes putting the right people into the right positions, but once they’re there, developing them into the best problem solvers that you can. So I constantly feel, like I mentioned, the President of the medical center has to run the medical center, but I can be whispering in his ears and say, ‘Michael did you think about this? Why don’t you consider this? This person might have the information that you need. There was an experience once I had that this will be helpful.’

I want everybody to achieve their wildest ambitions in their roles, that’s my personal vision statement. To create an environment where everybody can… My friends, family, and coworkers can achieve their wildest aspirations. So that goes for Michael and the rest of the teams. So strategy, development, execution, people development. And the third is communication, right? Because there are 14,000 people, over 120 different sites. And I think it’s getting them excited about the vision, achieving the mission at the highest level possible, and talking to them about the plan, and recognizing and helping them see their role in achieving this.

So in the past six years now, we’ve got…well, coming up on 80,000 frontline staff ideas we’ve implemented across the healthcare system. And the way we structured that is 400 business units, each with an idea system where we’re asking employees for their ideas about how we can achieve the things that are most important to the organization, but in their area. So if getting people appointments as quickly as possible is a goal, we want to say, ‘What ideas do you have about improving access in your area?’ And then they post an idea on an idea board, and the team gets together, they talk about the ideas. They work to execute it, implement it, and then we celebrate their successes.

So those 80,000 ideas, or even probably the thing that I’m probably most proud of in the organization, I set the goal of giving out 20,000 candy bars a year in the organization, just a little thank you. They all say, ‘Thanks for taking great care of our patients and one another.’ And a lot of it has to do with at their huddles, at their idea systems, thanking them for their help and coming up with ideas and solving problems that make things better for our patients and our people. It’s all really tied into the culture that we’re trying to create here.”

You led UMass Memorial Health Care through a period of major transformation and growth. What is your advice for leading an organization through changes?

“Everybody here loves this organization. I’ve been here for the better part of three decades, worked as a respiratory therapist here, then went to med school here, residency here, first faculty job here, my kids were born here, I met my wife here, my parents have got care here. And that’s not a real unique story around here. Nobody goes to work at Hanover insurance and said, ‘Oh, I had my kids here, and I brought my parents here for care when they were sick.’ The people are so tied in and they love the organization, they want it to succeed, so it’s recognizing that we all want the same thing, we might disagree about how to get there.

What I did was set true north for the organization. And that can be, again, a part of the vision. But I define that as, moving forward, we’re going to seek to engage every one of our people every day in making this the best place possible for our patients and for our caregivers. And engage every one of our people every day in making this the best place to give care, the best place to get care. And all of the decisions that we make in senior leadership and middle management and at the supervisory level, and all of the resource allocation is going to be about making things better for our patients and our people and engage everyone throughout that process, because that’s tough to argue with.

And because it did say engage everyone, so I talked about the 80,000 ideas. Every one of our people can show up at a huddle in their area. Talk about performance in the area that matters most. I meet with every one of our 400 managers every year. Our managers are taught, get together with your people on a regular basis, talk about performance in your areas that matters most, ask your people for their ideas about how they can improve, help them implement their ideas, and celebrate their successes. If you work as a supervisor, manager, executive department chair, division chief, vice chair, whatever it is here If you’re in a leadership role here, that is the minimum requirement. Because that’s engaging every one of your people every day and coming up with ideas about how you can improve on the things that are most important.

So everybody wants to know if once they bought into the vision, to true north, “Alright, what do you want me to do?” So for the frontline worked force I said, “I want your ideas about how we can improve performance on these things. Quality, access service was the first tier. So everybody knew what their job was, and with that, we had a pretty amazing transformation early on. Financial performance got all the attention because we went from junk bond status to A minus. But we’re able to do things in the population health space, we’re able to build new companies, we’re able to implement an IT system. We’re able to improve quality and patient satisfaction. And once it starts to work, people get behind it.”

With an organization as large as UMass Memorial Health Care, are there any defining characteristics in your opinion?

“Yeah, and it’s intentional, it’s not by accident. So two pillars of the culture. Everyone in the organization is involved with problem-solving, taking the waste out of processes, such that we improve the patient experience and the caregiver experience. So everyone is a process improvement engineer, everyone is a problem solver. The way I talk about it from culture is, we need to create an army of problem solvers. So every person on the way in the door as a new employee here is taught process improvement, industrial engineering techniques and problem-solving. So that idea system is pillar one of the culture.

Pillar two of the culture is that everyone is treated with respect every minute of every day. So we actually have standards of respect here, and there are six standards: acknowledge people, celebrate their success, be responsive, be a team player, listen to people. I feel bad…I always forget one of them. Oh yeah, be kind, be kind. It’s the hardest one to follow, too. So we asked our caregivers, ‘What does it mean to be respected?’ And these are the six tops answers. So yeah, thousands of people and this is the six top answers.

And we said, ‘Okay.’ We trained everybody in the standards of respect and every new employee gets trained in the standards of respect on the way in the door. And every manager in the organization is measured against that, through a 360 evaluation every year. So it’s those two things. If you come to work here, you’re going to have two jobs. If you’re a nurse here, you’re going to be a nurse and do what a nurse does, and you’re going to help find new, better ways to do your job. Same thing for the docs, same thing with the pharmacists. Same things for the people that work in the cafeteria.

And that if you work here, you’re going to treat every member of the care team and our patients and their families with respect every minute of every day. So those are definitely the defining pillars of our culture. Do we get it right 100% of the time with 14,000 people and 120 practice sites? No, but we get a little bit better every day in terms of being able to implement that. And for me especially, the respect one, it all starts with me treating everyone with respect every minute of every day, and works from there.

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This week we 'crashed' the 5East and PICU team Idea huddles at our University Campus. Teams signed our giant traveling 40k sign, posed for photos and joined in the system-wide #cheersfor40kideas celebration. Not only did we learn about exciting projects, progress and implemented ideas and successes, we celebrated…a lot! Some teams celebrate ideas with a round of applause or three cheers, but not the PICU team. They arrive at their huddle with pom poms in hand, ready to celebrate progress, achievements and each other's ideas. ****(TIP: be sure to flip through photos to view pom poms in action)*** So, #cheersto40kideas and cheers to the 5East and PICU teams! Special thanks to 5East Nurse Manager, Georgina Gardner, for letting us "crash" your idea huddles. #cheersfor40kideasTo celebrate our Idea System and the 40k ideas implemented across our system, we are featuring idea boards, idea huddles and the caregivers and teams that brought these 40k ideas to life. 💡💡💡💡💡💡💡💡 "At @umassmemorial Health Care, the goal of the idea system is to get everyone engaged every day in making things better for our patients. " -Dr. Eric Dickson, President and CEO @umassmemorial ▶️To learn more about our Idea System, visit www.everydayinnovators.org #ideasystem #everydayinnovators #umassmemorial #aroundoursystem #CTIC #ideaboard #ideahuddles #healthcare #lean #healthcareinnovation #cheersfor40kideas #operationgameideaboard #ideasystems #PICU #umassmemorialPICU #5east #umassmemorialinnovators

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What advice would you give to someone interviewing at UMass Memorial Health Care?

“I’ll answer two questions even though you asked one. So people always ask me, and they come and they’re young physicians that want to become CEOs someday or administrators. And they say, “What advice would you give me about how I can move to your position?” And I say, “It comes down to really two things. One, you’ve got to always treat people with respect. If you’re remembered as a jerk that didn’t treat people well, somewhere along your track, somebody will impede you from moving forward because they will say that person was a total jerk, that person was a womanizer, that person was this, that person was that. So you have to find a way to treat everybody with kindness and even in difficult situations.

And the second is you have to deliver results, because you’re not going to move forward, up in any organization if you don’t really deliver results and you better know what those results are from your boss’s perspective. So when you take a new job, what would success look like? What measures would I improve if I was successful in my job?

And the third thing is I say, volunteer to take a problem that your boss is having and solve it for them. And say, ‘Boss, I have extra time and I’ve got a little extra capacity, is there anything you I can work on for you?’

Somebody did that at a level in the organization that must be four or five direct reports away from me in a meeting the other day. ‘Dr. Dickson, I really would love to take on some additional projects. I have something.’ And she’s now leading and crushing it, one of the most important projects on the strategic plan that I just didn’t have anybody to assign to. I said, ‘Okay, I’m going to give her this.’ And then three days later she had come up with a way to do this through technology that would have taken me months to do myself. And now that’s a person that’s slated for moving closer to the corner office I guess. So volunteering to take things on and not asking for it, that’s intuition.

One of the highest positions you can hold as an academic physician is department chair. It’s something you do late in your career that I got to do very early in my career. I was in my thirties when I became the chair of an academic department, with people in their sixties working for me that had much more experience in academic medicine than I did. And how I got that job and how I tell people is I said, “When you go in and you’re interviewing for a job, everybody’s going in and saying, ‘Well I want this resource, I want this resource, I want this resource.’

And that’s what people do to me all day. And they go into a long queue of people that want something. I was nowhere near qualified to be a chairman of a department. The Dean said, ‘Well, what would it take to get you here?’ I said, ‘Dean, what I’d like to do is come in and pick the existing resources that you have, reorganize some of those so that we could generate more revenue for the department. And when we’d create new resources. What I would like is for you to commit to give some of those to the department to support our academic mission.’

We wanted to get a residency started, which we did. We wanted to build a research lab, which we did. And I said, ‘But I don’t need anything from you to start, what I need to do is improve your processes such that they’ll create more resources. And when I do, what I’d really like is just a commitment from you that you’ll share.’ And after a few minutes, after he picked his jaw up off the floor, he said, ‘Well, when do you want to start?’

I don’t need somebody that can take new resources and improve performance for an area, there’s lots of people who can do that. I need managers to come in and improve performance of an existing area with existing resources. That’s a special person. And that’s what I told this board of trustees I would do, and what I told the previous CEO when he gave me President of the medical group, and he said, ‘What do you need?’ And I said, ‘John, please put me in charge of the medical group and I’ll take it and I’ll run it better than it’s being run today. And I’ll create new resources, and when I do, I need some help on these things…but not until I deliver value for you.’

I got that job on a 45 minute interview. And those jobs usually go national searches. And I often say, ‘I have no idea how I got to this position.’ I’m a basic scientist, NIH funded scientists who’d like to work in the emergency department, but then they say, ‘Oh, can you do this chair job? Could you be COO of the hospital? Oh, could you be president in the medical group?’ Because I was chief medical officer here. And then the board came to me, “Oh, could you be CEO?” And at some point I had to say, “Geez, maybe it’s not just,” I’ll use one bad word, ‘s**t luck.’ There probably is something that I should think about and try to do more of….you’ve just got to go up and volunteer to help solve the people’s problems. Volunteer to do some extra work for one of your bosses on a project that wouldn’t otherwise be your responsibility, and you will get their attention if you can solve the problem. Now, if you can’t, thanks for the effort. And if makes things worse, that’s a bad career trajectory. So you still got to deliver results.”