What I Learned As a CEO

After more than twenty years of teaching at Suffolk, I was privileged to have a unique and unexpected experience. From July 1, 2022, through June 30, 2023, I served as the Interim Chief Executive Officer (CEO) of CHP Berkshires (Community Health Programs, Inc.) in Western Massachusetts. This followed six years as a member of the Board of Directors. CHP is a Federally Qualified Health Center (FQHC) that serves more than 30,000 patients in multiple locations with the following services: primary care, behavioral health care, dental care, obstetrics and gynecological care, pediatric care, nutrition counseling, and family services. CHP operates two mobile health units and a mobile dental health unit.

I learned a lot as the Interim CEO, and I want to share some of it.

Introduction

It’s important to preface what I learned by explaining the context for my work. As a Board member for six years before becoming the Interim CEO, I was involved in articulating CHP’s mission, vision, and values. They are:

Our mission is to nurture and inspire healthy lives for people throughout the Berkshires by delivering exceptional and compassionate health care and family services.

As a champion for the well-being of those we serve, our vision is to be a leading choice for health care in the Berkshires and a model for providing the best in rural health care.

Values:

Caring: We treat all people with empathy, dignity, and kindness.

Inclusiveness: We respect all people, value diversity, and are committed to equity in providing care.

Excellence: We strive to maintain the highest levels of quality and, where needed, to pursue continuous improvement in all of our services.

Collaboration: We are dedicated to teamwork and encouraging and appreciating the contributions of our staff, patients, and community partners.

Stewardship: We are a responsible and sustainable resource – as an employer, financially and environmentally – in the communities we serve.

As both a Board member and the Interim CEO, my goal was to support CHP in fulfilling its mission and vision, while living its values to the greatest extent possible. Therefore, much of what I learned was based on how best to accomplish this goal.

This description of what I learned is divided into five areas:

Lesson #1: Knowing the community’s needs is essential.

I have lived in Berkshire County for more than 33 years. I conducted strategic planning projects for two other community organizations, and I assembled the strategic plan for CHP when I was a Board member. And I am married to a community-based psychiatrist, so I thought I had a pretty good understanding of the needs of Berkshire County residents when I became the Interim CEO.

That’s true, but as the Interim CEO, I gained a deeper appreciation of the health, healthcare and social challenges facing many of our residents. This came through conversations with CHP clinicians and staff, members of CHP’s Family Services staff, CHP donors, community leaders, and state legislators. The challenges included constrained access to primary care, a lack of dental care, especially for children covered by MassHealth, and poverty, which manifests in food insufficiency, lower levels of education, joblessness, and homelessness – the social drivers of health.

I also learned more about CHP partnering with and supporting other community organizations, including to provide food to people in need and to address issues related to domestic violence. Given the breadth of the community’s needs and CHP’s role as a leading provider of healthcare and family services, I learned that CHP needed to do even more.

Lesson #2: CHP’s history informs its present and guides how to lead effectively.

Like any organization, CHP has a rich history. What I quickly learned as Interim CEO is that aspects of the history strongly influenced CHP’s culture as well as individual and collective attitudes and behavior. So, my challenge was to identify and acknowledge the most influential aspects of the history and provide leadership in ways that built on the many positives. For example, I knew that I needed to change CHP’s culture to better reflect CHP’s values – especially to be more inclusive, collaborative, and transparent – and enable the staff to be empowered to make more decisions for their own areas of operations. I sought to model the values through my everyday behavior, knowing that “walking the talk” would create positive change.

Lesson #3: CHP is facing a changing financial landscape.

Upon becoming the Interim CEO, I quickly learned that the landscape for CHP’s financial future was changing and becoming more uncertain. The money CHP had received as a result of the COVID pandemic was coming to an end. To better serve its MassHealth patients, CHP rejoined an accountable care organization, with a potential financial upside and downside. And CHP needed address the post-COVID burnout among many staff and recruit more clinical and administrative staff in the midst of a severe labor shortage. In short, CHP needed a new plan to operate in a changed environment.

Lesson #4: Listen to the staff.

I got to know many of the CHP staff quite well. I visited the practices and listened carefully to what the staff shared with me. The conversations enabled me to learn about their perceptions, feelings, concerns and hopes for CHP, beyond what I knew as a Board member. In response, I sought to bring a sense of calm and unity to CHP and provide measured and thoughtful leadership.

In addition, I made myself available to anyone and at any time. I shared my cellphone number with everyone, and some staff called me in the late evening and on weekends. My cellphone was always on and my door was always open.

I opened communication among all levels of management, including talking about difficult topics. I pursued transparency and shared the rationale for many of my actions. One way that I shared my thoughts was through emails entitled “What’s Up, CHP?” to all staff and the Board members. And I opened up the Town Hall meetings so staff members could share their news. The openness was well received.

Lesson #5: Tailor my leadership to the uniqueness of CHP.

From my previous experiences as a healthcare management consultant and a CEO, and as a professor of non-profit management (including leadership) and healthcare administration, I know that different types of organizations and circumstances require different types of leadership.

At CHP, I quickly learned that I needed to redirect the organization around new priorities and strengthen the culture to support excellent performance in pursuit of CHP’s mission and values. I learned how to collaborate effectively with the other senior managers to set the organization’s priorities, which entailed listening carefully to each member’s perspective and suggestions, then assembling a comprehensive list of priorities that reflected the best of each member’s suggestions. In addition, I presented my own priorities that reflect strategic imperatives beyond operations, such as strengthening CHP’s position in Berkshire County.

In addition, I learned about myself as a leader. Clearly, I had an advantage in becoming the Interim CEO because of my experience as a Board member. But being a Board member is not the same as being the CEO, and I’m pleased to report that I learned how to be an effective CEO of CHP. Here’s what I mean.

What I learned about myself was often in comparison to how I performed in previous leadership roles. After about four weeks as the Interim CEO, I realized that I was getting comfortable with my style and had developed my initial CEO perspective and CEO voice. My CEO perspective combined both a broad, strategic view of the organization with deepening knowledge of the individual elements. Early on, I had to determine what my style would be, including how much to be involved in different aspects of the organization, how to communicate with the staff, under what circumstances and in what ways I would make decisions, and when and how I would empower staff members to make their own decisions. I also learned ways to hold others accountable for their performance. I did not shy away from making decisions and holding staff accountable, but I also sought to bring others along with me by involving them in deliberations and making decisions. Accountability is much easier when staff are fully involved.

My CEO voice was based on who I am – because I always want to be authentic – and how I could best communicate with individuals based on what I knew about them and their styles, and the staff as a whole. I was open and caring, I provided encouragement and support, and I shared my sense of humor. Although I had a story for almost any occasion, I listened as much (or more) than I talked. I sought mutual understanding, not only trying to make my own points. And I was willing to say I was sorry when I made a mistake. Indeed, I made some mistakes, such as jumping to conclusions about people and situations before getting the full stories.

Final lesson: It’s all about managing people.

CHP is an FQHC, which means it must meet many federal government requirements. I initially thought that having knowledge of those requirements, beyond what I had as a Board member, would be especially important for me to lead CHP. But that wasn’t the case. Rather, the key to being an effective CEO was understanding and working with the people who are CHP, individually and in groups; being able to listen to them, share with them, inspire them, motivate them, support them, and guide their efforts. This required caring, compassion, consistency, enthusiasm, professionalism, and confidence in their abilities and judgments. It also required an orientation toward service, so that the staff and I were all serving CHP’s mission, vision, and values together, as one, beyond our individual agendas and places in the organizational hierarchy.

I enjoyed being the Interim CEO of CHP because I loved working with the people who are CHP. And I’m still involved, as a member of the Philanthropy Committee of the Board of Directors.