← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Erik G. Wexler, President and CEO of Providence St. Joseph Health
00:31:42
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- [00:02]
A
At Kindred hospitals, we treat the most medically complex patients with a multidisciplinary team of experienced acute care physicians, nurses, therapists and support staff. We never lose sight of the fact that our patients are people, someone's mother, father, spouse or friend. With our specialized acute care, we empower patients to take the next step in their recovery journeys so they can return to the lives they love. To learn more about care, visit KindredHospitals.com.
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B
Welcome to the Becker's Healthcare Podcast. I am your host, Chris Sosa, and I'm thrilled to be joined today by Eric Wexler. He, of course, is the president and CEO of Providence St. Joseph Health. Eric, thank you for joining us today.
- [00:40]
C
It's good to be with you, Chris. Thanks for inviting me to join you in this really hopefully, interesting discussion.
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B
I have no doubt that will be Eric. This conversation is going to be a little bit different today from the X's and O's of healthcare. We want to get to know you a little bit better and just how you make decisions and your journey as a leader. That sound good?
- [00:58]
C
Sounds good. Let's. Let's do it.
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B
Perfect. So the first question I have for you is, what is something you've learned outside of health care that you've been able to apply to your career?
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C
You know, I think my physical fitness regimen has been an interesting, I think, growth opportunity for me that's helped me in my career. You know, I've learned a lot about fitness and endurance and I'm very committed to working out five days a week. And what it does is it helps me think about mind, body and spirit and how endurance within the fitness space that I'm in also is part of the type of endurance we have to be in. The mission of the work that we have and helps me mentally. It's some of my best thinking time and I just love it.
- [01:49]
B
Yeah, it's a great point. I've learned similar lessons myself over the years, whether it's through martial arts, but just. Or swimming. Just kind of gives you an idea of what your body is actually capable of. And usually, well, pretty much almost always is capable of more, you might think, at first. So that's very interesting how you're able to take that and immediately extract that into the healthcare space.
- [02:11]
C
Well, I think that, yeah, I mean, clearly there's a health aspect to it. They're also from the work that we all do and just speaking in the demands of the kind of role that I'm in and many people are in healthcare, no matter what Your job is, you know, whether you're a nurse or security officer, whatever you might do, having guardrails and also using those guardrails to make sure you get time for yourself so you can renew and recover, so you can take care of people around you, I think is just good. It just represents well, for those of us that are in healthcare leadership in trying to help others try to do the same thing.
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B
I also did want to ask you. It's a great segue, Eric, because one of my questions is how you recover and keep yourself healthy, whether it's physically, emotionally, spiritually, mentally. So in addition to what you put into your body five days a week, which is very commendable, I think, by the way. Yeah. What other resources on that front do you try to employ?
- [03:14]
C
When I got to Providence almost 10 years ago, we had a leadership formation program. It's pretty typical within faith based health care that we do leadership formation. And Ahmed, as you started the conversation today, a lot about the X and the O's, though when I went through the formation program, one of the things that they taught us is how to meditate. And trust me, Chris, that was not me. And if you ask my family and colleagues from prior to those 10 years, they would never think that I would meditate. But by learning meditation, it really helped me during the most stressful times to renew and recover. And as I said earlier, I don't think it is just about being in a CEO role. It can be any role in health care. They're all very, very demanding. And we're talking about maybe one of the most important and highest callings of the type of work people do, and that's to save lives and keep people healthy. So I would say meditation has helped me not only on a daily basis, but if I'm having a very stressful day, I'll find an opportunity to peel away and do that in a way that helps me recover. The other thing, I'll just add one more commitment that I've made and that is when I take vacation time. And I tell my coworkers this all the time, that I have the same expectation for them. I sign out to my chief operating officer. My email says that I'm not available for the next week. And here's a number or name to email to if it's urgent. And I do not look at my email when I'm on vacation. I usually come back on a Saturday so that on Sunday I can catch up and do all the email and make sure I'm ready for a good fresh Monday morning. But I think it's those guardrails we need more of in the workspace these days.
- [05:08]
B
That's very interesting. As far as checking out and not check your email do, even if it's anecdotally, I am curious, do you think you're. That that's fairly unusual for someone in your position to. To be able to do that, or do you think that. That that's just a misconception that a lot of people in your position do find a way to unplug in that regard?
- [05:31]
C
I think it is unusual, but it is increasing. I talk to a lot of CEOs about their experiences, what they do to try to find time, time for themselves and their family. And when I describe what I do, they say, oh, I need to try that. So my own informal asking around, I hear less and less that CEOs or leaders in organizations are willing to do that because we're so giving of ourselves. We feel like we have to be there all the time to make sure that we are supportive and we're good servant leaders. But the challenge with that becomes, are we trusting people around us to do what they should be doing to run the organization when we're not here? Are we renewing and recovering and frankly, for the number of days that we get off a year, are we investing in our most beloved loved ones? I mean, really, what about the investment there and how does that represent to the people around us? So I think it's uncommon. I hope it's going to become more common.
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B
I also want to follow up on the aspect that you mentioned, because it's something that I do. Probably not enough. I come in and out of it just to give you a little insight into my life. But has it caught on with other members of your staff or is it just. Yeah, I mean, is it something that you find that others have found helpful as well?
- [07:00]
C
It has caught on. Every once in a while I'll forget that somebody's on a vacation and I'll pop them an email because I try to know, at least with people that report to me, that I don't bother them while they're away on purpose. And when I don't get a return email or all of a sudden occurs to me, oh, they're away and they're not checking their email. Congratulations. And then there's been a time or two where I have sent an email and somebody's written back to me and I realize it's their vacation and I, I call them out on it. Hey, you're away. Invest in yourself and your loved ones. Don't respond anymore. Otherwise, I'm going to turn your email off for the rest of the week. But I do think it has cascaded, and in our organization, I'm hoping it cascades even more under my leadership.
- [07:47]
B
I also think it's important, the aspect that you mentioned about trusting the people around you. Right. You're anyone in any position of hiring, you're trying to find the best people, certainly. And when you step away, you always want to have that feeling that you can step back. So how do you build that culture of trust where maybe the people who are, whether it's your CEO or someone like that is actually pushing you out, it's like, dude, we got it. That's really what you want, even if it's a little scary at first. So how do you build that into Providence?
- [08:24]
C
I think that this last point you made is really important when you do this for the first time. I remember when I did it for the first time, I don't know, probably 15 years ago, that I asked somebody else if I could have their name on my email, that I'm on vacation, and that if there's something urgent, this person would contact you or I'd let all my co workers know, you're in charge while I'm gone. I wasn't in the role I'm in now, obviously, but I still had a lot of responsibility. It was very unnerving in that first week that. Is everything okay? Am I going to come back to 100 emails? How am I going to be able to deal with those emails when I come back? I'll be punished for that. For the first couple days, I really felt a little nervous and wanted to look at the phone and see what was on. And remember, those were the early days of email being on phones then. And I came back and everything was okay. All right. But I did learn something. I came back late on a Sunday, and then Monday, I couldn't catch up. And so it took me too much time to get back in the swing of things. So the next time I did that, I felt a little better, a little more comfortable, because nothing went wrong. I think the person felt very grateful. They were somebody that reported to me that I entrusted them and they made a couple decisions, and they were really good decisions. But the other thing I learned, I mentioned this earlier, is I don't come back on Sunday. I'll come back on Saturday and then reserve Sunday to go through my emails or I'll do it on the flight back if I'm Coming back on a Sunday. So there are certain tricks to this that I think help. But I would say to you and our audience today that the first time you do it, it's not going to feel good. The second time, it's going to feel better. The third time, you're going to be so happy that you do this and you probably never look back again.
- [10:26]
B
Yeah, I think that the whole. You did learn that about yourself, that you can't just do it all when you're back on Sunday. I imagine some people can do that and prefer it that way. But I also imagine a lot of people in your position are similar ones, are thinking, you know, yeah, I can walk back into work as opposed to running as soon as I hit the ground on Monday or whatever it is. Right?
- [10:50]
C
Yeah. I mean, some people might say, look, I'm going to carve out Monday till noon and I'm not going to have any meetings now. Sometimes you have to. It's a group meeting, an executive team meeting, whatever it might be. But if you can have that kind of control, you could use Monday to catch yourself up until noon and probably you might not feel completely caught up. But a lot of the critical things you could get out of the way. Look, with AI now, I can tell Copilot to prioritize my emails and put the things at the top that are the most urgent. And people say things in their emails that lead Copilot to know whether it's urgent or not. And so using artificial intelligence can help people recover more quickly as they're coming back from vacation.
- [11:34]
B
Along the lines, while we're on the subject of trusting people and those around you, I am curious as to. You mentioned your meditation and other practices that you use to keep yourself balanced and centered and, you know, whatever state of mind you need to be in. But who are the other people that you try and turn to when you're just. You're stuck or just having a really tough day or week or, you know, just having difficulty in general because it happens to all of us.
- [12:01]
C
It does. You know, for the people that report directly to me, you know, our relationships are so intertwined and trusted. I know that I could go to any member of the CEO Council, which are our top leaders in the organization, and sit with them for a minute and share a frustration or a concern. I also can go beyond that group. There are other people that are within our offices here that I interact with often. And sometimes just wandering down to that person's office and sitting down, and they may be having a bad day. Or there might be an issue they're struggling with, and I know it. And I might stop in and say, hey, how's it going? And they start talking with me about it. And I may be talking with them also about a stress point that I have. So I think those trusted relationships are important. Knowing a little bit about each other, getting out of the virtual space is really, really critical to having those relationships. A lot of that has been harmed post Covid where those relationships don't exist. And I find, you know, there's a gentleman by the name of Dr. Charles Sorenson. He's the former CEO of Intermountain Health. And he and I were talking once, he's on our board of directors. And he said to me, when I was the CEO at Intermountain Health, he said, I never felt alone. And a lot of people say, when you're in the CEO role, it's very lonely at the top. I hate that term because I think most a lot of CEOs don't think of themselves as being at the top, you know, and I don't. And he said, I never felt alone because I already had these. I always had these relationships with people that we could have good, thoughtful, heartfelt conversations. And he said, when I became the CEO here, I hope that you will have those relationships and you won't feel alone. And I really embrace that. And I don't feel alone. Yeah, there might be a minute here or two each week where something happens until you get to somebody else, you feel that. But it always goes away when I have a little bit of humility and vulnerability and willingness to just be a human and not try to put myself in some ivory tower, which for me, personally, just. It doesn't resonate with me as a human being. I started out as security guard in healthcare. I understand what it's like to be on the front line of delivering care. I've never forgotten what that's like. And so I think a little bit of I'm just a human like everybody else can help you get through your day or your week.
- [14:37]
B
Okay, a couple things that I really want to follow up on here. The first one being, yeah, the whole lonely at the top cliche saying, what have you, it's. It certainly came from somewhere. You know, regardless of whether we get into the roots of that right now, which we won't. But, you know, it is interesting to me that I don't think you're the only one who has adopted this mindset where it's like, yes, you know, to a certain extent, you Want the buck to stop with you, so to speak, to use another tired cliche. But, you know, but at the same time, no one is leading all by themselves and making decisions. Locked in an ivory tower, to use the expression that you use. So, yeah, it's. It's. It is fascinating to me that, that. That this culture is becoming not one of. I should say, maybe. Maybe it wasn't always. It's less of an I culture than a we culture.
- [15:38]
C
Yes.
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B
Or more of a we culture now than it used to be. So it sounds like maybe you're. You're of that same mindset. Yeah. Grown in that direction.
- [15:49]
C
I. I feel that way. I just think this ivory tower concept is. Needs to be rejected and. And put aside that, you know, I feel very committed to being a servant leader. And so being able to roll up my sleeves and also have humor and enjoy each other is very much a part of who we are as human beings. And it's okay, you know, you don't have to stand out and try to make yourself something special. Be yourself, join up with the team, and you'll find that you then feel like you're more part of the team rather than being alone.
- [16:31]
B
That's an excellent message to be sure. And, Eric, the second thing that I wanted to follow up on was, and forgive me for not knowing this about you, but your background as a security guard, that just certainly you're not the only one who won't be the last one to go from that position to where you are now. People. People can do that, and that's wonderful. I hope it keeps happening. But for you, I am curious. So what led you to connect those dots, from being a security guard in healthcare to being the CEO that you are now?
- [17:02]
C
That's a great question. You know. Yeah. The short version of that is when I was nine years old, I sat by the bedside of my grandfather while he was dying in a hospital. And I was really taken by the love and compassion that nurses and environmental service aides and others were given to him at that very young age. And so from that point on, he passed away. It was very peaceful, and I loved him so much. I really missed him. But what I got out of that was I wanted to be in that very special setting. And when I was in college, I. I had been in high school, an emergency medical technician. And so I kept on trying to get into it. When I was in college, I had the opportunity to earn money as a security guard at St. Francis Hospital in Hartford, Connecticut, and I took the job. I worked a Lot of nights and weekends. And I worked in the emergency department and just was exposed to the goodness in what is a very scary place for people when they're not well. And it drove me to want to stay in healthcare. And so I was in philanthropy for a while and then a chief operating officer of a hospital that I worked at in Connecticut. Her name is Lucille Janetka. She took me under her wing and she gave me more responsibility. And then she became a CEO of a hospital and made me the coo. And so my career kind of progressed from there. But I've never forgotten what it was like to be in the emergency department or walking around that hospital. And I remember that something really stuck with me, and it does today is when I was walking around that hospital in my uniform, which I really tried to look good and had my shoes polished and my tie looked right. That other executives and the security officer, you know who the executives are, that there were times they'd walk by me and I'm not, you know, trying to throw any shade their way, but they wouldn't notice me. They wouldn't say hi. I would say hi, but I'm not sure. I heard a hello back and it made me feel like I wasn't seen. And so for me, as a leader for that point on in my career, I've always tried to see the people around me that are doing this very, very important work. So when I'm out at one of our hospitals and our seven, you know, in one of our seven states or wherever I might be, it could be in an ambulatory clinic or a physician office. If I see, for example, somebody cleaning the floors, that's the person I go up to and say hi and point out how beautiful the place looks because of them. It's just one example of making sure that we see people around us. And I have to tell you, they might get something out of that. I get more out of it. I feel the love and the inspiration internally for me. And it makes me more inspired as a human being and as a leader.
- [19:58]
B
Again, that's the message that I think anyone can take, whether they're in a leadership position or not. I think what you refer to is, has not been seen before. And I think that's a old school type of top down leadership model, which it's certainly effective to some degree. Right. I mean, businesses can thrive in organizations such as Providence, which is a little different. They can thrive under that, but it's not necessarily the only model that can work. And I think you're manifesting that, to.
- [20:34]
C
Be sure, and modeling that behavior. I do a lot of rounding. And so when I'm with, usually there's a couple other people with me when I'm rounding, they see me do that. They usually comment to me, it was nice of you to stop and say hi to that person. And then I tell them why. And I also look for whether my leaders are doing that while I'm walking around with them. Are they saying hello to people? Are we just walking down the hall and they're just passing people and we're not seeing them? So I think how we model that behavior does help it proliferate in a way that's good for our caregivers across our organization.
- [21:13]
B
Certainly. Eric, I've got a couple more things I want to touch on. In general, you've done a great job about getting some of these topics already, whether it's by sheer serendipity or otherwise. But a question I do want to ask you is what is something you've learned about yourself from working in healthcare? I mean, you touched on your process about coming back from vacation and things like that. So that's very helpful, I think. Is there something else you wanted to share along those lines?
- [21:44]
C
Yeah. One thing I have learned very early on, maybe all the way going back to when I was security officer, but throughout the years, is that when we're out in the care delivery setting, we'll sometimes see emotion coming out from family members or patients. And at times what I have witnessed and even experienced is it can seem threatening to those of us that are delivering care. What I've learned is different cultures react differently to what is very scary. Some cultures are very quiet and they're very internal about things and other cultures are very outward. It's how they were brought up and sometimes it's not within our own personal norms. And so we question that and we feel threatened by it. What I've learned is to embrace those moments for those people that are suffering in different ways, sometimes celebrating in different ways as that is part of their culture, and not allowing myself to react to how I think people should react, but to support in a way other people react. And then that creates a more settled space for the people around us.
- [23:07]
B
Is that a. Forgive me if it's not, but is that something you found that you had to teach those who are caregivers or leaders at Providence? Or is this something that. That you've learned from somewhere? Like where. Where did that message proliferate from?
- [23:24]
C
Well, we have a huge commitment as a faith based organization to embrace culture and to ensure that we are operating in a place of pluralism, where no matter what your religion is or where you come from, whatever your background is that we embrace you and we show you love and compassion so that your healing process is as excellent and safe and quality as it possibly can be in a way that we would all want for our own loved ones. And before I came here, I always aspired to that myself. But coming into the health system 10 years ago, what I found is that our core values are very, very aligned to that at Providence. So I've actually learned a lot about that within Providence. St. Joseph Health as an organization, very committed to that pluralism and that embracing of others around us and understanding our, our differences are actually not differences. They're beautiful things that we need to embrace and enjoy and find ways of learning from along the way.
- [24:40]
B
Yeah, you mentioned some of the discomfort, fear, et cetera, that you can have as a patient or as a family over that patient. Because to your point, you don't go to the hospital typically if you're healthy, you're there because you need something. And often that is something that can be scary. So it's certainly insightful and it's heartwarming to know that I'm sure you're not unique in this at all, but that Providence is seeing that on a day to day basis. And they encourage everyone who works there to step back and say, you know what, this is how we're going to handle this. Right. So it is less scary. I mean, I think that's a general lesson of healthcare, but you've put it a bit more eloquently than I. But I just wanted to hammer it home that, yeah, it's, we've all been to the hospital, we've all had family members there, and it's, it's not great that you have to go there, but if people are working it to make. Working to make it less so, then that can only help.
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C
That's right, Chris. Absolutely.
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B
All right, last thing I want to run by you, Eric. Speaking of things that are scary, do you have a risk that you've taken that has paid off? And it can be in the healthcare space, it can be personal, however you see fit to answer that.
- [26:00]
C
Well, I'll talk about a healthcare space risk that I took many years ago. I was the CEO of a hospital in Baltimore, Northwest Hospital, and we had these long, long, long, long lines of people in the emergency department waiting for care. And one of the lines we had were ambulances that were showing up with patients and the EMTs would be sitting there with the patients waiting for them to get a room. And so the rig wasn't back out in the community for emergencies. So this was really not good. And I was visited by the captain of the or the chief of the emergency medical service there and said that this had to change immediately and showed me all the reasons why it needed change. It wasn't a hard sell, right? I got a group of people together from the emergency department and some project managers, and I said, let's put a project together to resolve the wait times in the emergency department, especially for our emergency medical technicians. And I said, come back in 30 days. So they came back in 30 days and they presented this thing on a couple flip charts. And honestly, I was not impressed. I thought, this isn't going to do anything. I listened to them very respectfully. I asked a couple of questions, and at the end of it, I said, let me ask you this question. Is this going to eliminate ambulances from being piled up in our emergency department? It was very quiet. Finally, somebody raised their hand, said, I can answer that. I said, okay, good. And they said, it's not going to. I said, well, what do we got to do? And they said, well, we tried to operate, Eric, within the resources that we have so we could make this work. And I said, oh, I see the problem. So the risk I took was, I said, I want you to imagine in the middle of this table, there's a million dollars in cash sitting in the middle of the table. Now go back, tell me how you're going to spend the million dollars to fix the problem. So 30 days later, they come back, they're all excited. It's a whole new set of flip charts. And they said, well, we have some bad news for you. We didn't spend the million. We spent 600,000 of the million. That's what it's going to cost us per year. But here's how we can eliminate the wait times. We needed a new resource nurse. We need this thing, that thing, and so on. They put it in place, and we, six months later, measured the performance. The wait times had gone down to next to nothing. And it wasn't just six months, didn't start right away. It took time to recruit people and so on. But from the time the program was fully up to speed, we measured it. Within that six months, we were able to see so many more patients that there was several million dollars worth of additional financial support that had flowed through the emergency department. And so, look, I talked a lot about the money Here. But the risk was, how do you give teams sometimes taking off the blinder so that they can do what they need to do to really make a difference and forgetting about the money. Here's what happened. Those ambulances were back out on the streets saving lives. People got into those rooms to be cared for by nurses and medical assistants and pharmacists and doctors and so on. And so ultimately what happened was we were delivering better care and it really wasn't that big of a risk, all said and done. So the lesson to me was sometimes you got to figure out how to take a risk, take the blinders off for the people around you, and maybe the risk will actually pay off. Doesn't mean you can't retrench and go in a different direction. If it doesn't, you always have that flexibility. So it's a good lesson.
- [30:02]
B
Well, I love in particular that this was not as no surprise given the rest of the conversation we've been having thus far. But I love that it wasn't just a decision that you said, okay, I'm going to go do some research and see how I can solve this problem. You said, no, I need to talk to all the people who are in it, which is what any good leader would do, certainly. But you said, yeah, let's not only empower myself, but empower everybody else.
- [30:30]
C
That's right.
- [30:31]
B
Okay. I might have an idea, Eric. You might have an idea. Those might be the ideas you go with, but you don't know that until you're listening to everyone else. Right. And usually some. Some consensus or some better idea emerges from all that conversation.
- [30:49]
C
That's right. Yeah. I found when I try to figure things out alone, they never come out quite as good.
- [30:57]
B
Amen to that, Eric. Let's hope if there's only one takeaway, but I'm sure there will be many. But that's certainly a good one to take away from today with that. Eric, thank you so much for all the detail, all the insight from. From meditation to the program. You just outlined everything that you've been able to. We appreciate your time. We're going to see you at our conference here in Chicago in November. I really doubt that will be the last time. At least I hope it won't. Yeah. It's so great connecting with you, Eric, and as I like to say to our guests, until next time, thank you, Chris.
- [31:29]
C
Appreciate you. And thanks to Beckers. I read you several times a day and appreciate all the updating you do for us. Looking forward to seeing you in November.
- [31:37]
B
Wonderful. Thanks again.