Springfield, MO

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Opinion: What happens when health care leaders forget about people

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A small rural hospital hires a cardiologist.

While this sounds like the beginning of a weird joke, if you know a little about health care, this statement is a big deal. Rural hospitals and clinics are critical to providing quality health care to people who don’t live near a large community. Shortages in employees and providers create a huge challenge for rural health systems. Many struggle to find nurses, much less finding specialists. So, when I tell you that a small rural hospital hires a cardiologist, I’m sharing a huge win for the hospital and the community.

As the administration is excitedly patting each other on the back for recruiting a specialist, the new cardiologist starts his first day of work. After one week, he quits.

The cardiologist had been excited to move to the small community. His family was a little nervous about living in a small town, but he encouraged them they’d fit right in. However, the hospital administration did nothing to help him to connect to the community or even to the hospital. They didn’t show him around the town. They didn’t introduce him to people in the town. They didn’t even introduce him to other people within the hospital.

From the first day at work, he was alone trying to build his own practice. Nobody had even asked him what type of equipment he would need. He was surprised to find that he didn’t even have an electrocardiogram available to him. By the end of his first, and only, week, he felt that he had made a big mistake and he resigned.

It’s easy to throw the hospital administration and management under the bus with this story. However, I need to share something else that you may not know about health care.

The health care system is complicated.

Health care is one of the most complex industries in the world. It starts with the fact that taking care of people is hard. People present themselves with ailments and diseases that are difficult to diagnose and treat. As if that wasn’t enough complexity, health care adds more layers with heavy involvement from insurance companies and the government.

Administrators and managers are absolutely consumed with keeping up with policy changes, reimbursement rates and technology. Navigating a rural health system is especially challenging with 1 out of 3 rural hospitals at risk of total failure in the United States, according to a 2023 report by the Center for Healthcare Quality and Payment Reform. Administrators and managers spend a lot of their time learning, strategizing and training around complex issues.

Unfortunately, this means that they often don’t spend enough time thinking about people.

They don’t find enough ways to build relationships or to even say hello to people they pass in the hallways. They don’t ask their employees how they are doing or follow up on concerns. They don’t take time to think about how they react to challenges, often coming across as blunt or negative instead of leading positively.

It’s an understandable issue to be sure, but it’s also one that feeds burnout and turnover for both the managers and their employees. Departments become enemies when personal relationships are ignored. Employees become disengaged or toxic as they don’t feel heard. Patients become dissatisfied as they feel a busy and unfriendly culture.

The rural hospital learned its lesson. Leaders systematized engagement by implementing processes where managers meet with each employee on a regular basis just to check in with how they are doing. They implemented an onboarding program that considers not just technical aspects of starting a new job, but also focuses on creating relationships. They trained their managers to remind them not to fall into the trap of getting lost in the complex process stuff at the expense of losing sight on the people around them.

A few months after the cardiologist left, the hospital managed to find another cardiologist. This time, administration and management met with the cardiologist beforehand to find out what they would need. They showed the new doctor around town. They found out what hobbies the doctor had and connected him with opportunities in the community. This time, the new doctor hit the ground running, creating the seeds for a very successful and impactful practice.

There are a lot of complex issues to be solved in the health care arena, but it’s important to not take our eyes off the people.

Don Harkey is the owner and CEO of People Centric Consulting Group LLC. He can be reached at


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