Becoming a CEO
The enlightenment of a first mandate
It is in 2012 that I got my first nomination as CEO of a health care organization, the (Montreal) West Island Health Center see on LinkedIn. It was a center that had been created through the integration of local primary, acute and long-term care services with a budget just shy of 200M$ and 3000 dedicated employees. The integration didn’t work as expected and the organization was going through a significant crisis. Pretty much everything needed to be done to help the center claim its integrated status and find momentum in delivering health care that way. The hospital, as is usually the case, was the main focus. Within three years, we turned it around. I say “we” as this is the key: teamwork, working with people and designing a step-by-step process to engage with people and monitor progress through well-designed and agreed upon metrics. The human factor became my focus as a leader.
As part of my first CEO mandate and my hands-on discovery of the paramount importance of the human factor in leadership, I enrolled in a year-long mindfulness training. The Laval University Complexity, mindfulness and management program offered by the Faculty of Management was a game changer for the emerging health care leader I was. That training program, experienced in parallel of my first mandate as CEO, helped me deepen my understanding of my own self as a leadership tool. It also helped me fine-tune my style as a humanistic leader, which got reinforced by the success obtained in transforming the organization through mobilization and engagement. This was a cornerstone year in my evolution as a CEO.
The years that followed gave me more exposure to successes and failures, which I used to fuel my mindfulness craft. With time and my own way of saying things the way they are, mindfulness became for me a way of life in order to grow as a human and as a leader. It also connected with my interest in raw facts and reality checks. I believe one of our main challenges in life and especially as leaders is to see reality for what it is, unfiltered, and handle it. It seems simple. It is not. But it is a necessary raw material for leadership to connect, shape a vision, mobilize and execute well. Having the courage to face ourselves and cut through the noise that may come from our own biases, personalities, preferences and the like, whether they are conscious or not, is paramount. My mindfulness was propelled by it and turned into a “raw mindfulness’, which fueled my style as a health care leader. Having to face ourselves in order to understand and factually state what truly is was well coined by Captain Jack Sparrow in the Pirates of the Caribbean’s movie: “The problem is not the problem. The problem is your attitude about the problem. Do you understand?”. Food for thought… isn’t it?
Leading a major health care reform
A new Quebec government was elected in 2014 and immediately started working on a major health care reform that was rolled out in 2015. Major mergers occurred and I was appointed CEO of the newly amalgamated Montreal West Island Center, which integrated eight different organizations and health care missions to create a new, fairly large organization with over 1B$ in operating budget and 10,000 staff.
The reform was carried out swiftly as former structures, staffing metrics and management processes were modified almost overnight (April 1st, 2015). Many integration challenges were created at the same time all while former governance structures were dissolved to give way to new Boards of Directors that were only appointed after the initial phase of the reform. As CEO, my job was to deal with all challenges and assume Board and executive responsibilities to put in place the new organization and proceed with staffing, systems, financial and service delivery integration.
It was quite daunting a challenge but we did it. I say “we” as, yet again, the critical elements of our success were building a team, managing the human factor and mobilizing towards developing and implementing a common vision. Our objectives were to design and implement service programs that would offer to patients and users better, faster and more integrated care. In three years, we achieved most of our reform ambitions and we successfully put on track major infrastructure projects to secure the future of services.
After leading the Montreal West Island Center for many years through difficult and challenging times, I was proud of what we had accomplished. The job was done, well done, and my leadership skills had grown into a style. I felt well equipped as a leader and wanted to explore other opportunities to contribute and keep learning and growing.
Expanding the scope of CEO experience, skills and raw mindfulness
After a short mandate at Héma-Québec (the blood and tissue bank for the health care system in Québec), which was of interest as it was provincial in scope and a different health mandate, I moved to British Columbia in order to join the Provincial Health Services Authority (PHSA) as President & CEO. Exciting perspective to lead from the provincial perspective of a health system.
I joined shortly before the covid-19 pandemic hit… Faced with the many challenges that come with a new mandate, a new environment, a new life to settle, I was now faced with one of the most significant, worldwide crises of the past century. Again, relying on my leadership style and a step-by-step approach, I got involved and helped steer through the first wave, which was the most significant in terms of human tragedy and then the second wave. What a privilege to be part of the meaningful fight against the pandemic! And what a challenge it was… But we succeeded in containing the damages of the first wave and in rallying to be prepared to deal with the second wave. We were ready and delivered.
Unfortunately, success sometimes comes at a price, which may trigger a perception of failure instead. One critical decision regarding a PPE (Personal Protection Equipment) contract that I made in the first wave didn’t turn out as expected and the issue became political, which led to my leaving. As CEO, I had to take responsibility and that’s part of the job. But even though that contract failed to bring the full expected value, the decision to go for it was part of the fight alongside so many other decisions. And it did bring about useful value, which contributed to achieve what has been widely recognized as a successful management of the pandemic. If I were to be faced with the same circumstances knowing the outcomes, I would make the same decision. And I would take responsibility because this is what CEOs do.
My experience as CEO of the British Columbia Provincial Health Services Authority was very rich. It was a privilege to serve during one of the most surreal and critical battles of modern times in health care. I acquired so much experience in such a short period of time. So even though I left in a way that was not of my own design and that obviously I wish things would have turned out differently, the richness of the experience, skills and raw mindfulness I acquired at the helm of a provincial health agency during the pandemic is exceptional. I would do it again. Failure is, to me, an opportunity to learn and grow. Even though it hurts and is challenging, I use it as leverage to becoming a better human, a better professional, a better leader.
Being useful and contributing has always been my main source of motivation. With the skills set I now have as a senior executive in health care, I look forward to exploring new horizons and ways to contribute. Life is full of surprises and I approach it with an open mind.
As I reflected on the past and my development as a leader in health care, I started connecting the dots and realizing that it may be useful to share what I see, what I know, what I think regarding health systems in general, leadership in that context and the many questions that come to mind when reflecting or experiencing health care. That’s how the idea of a blog on health care motivated me. So, there it is… enjoy!