Leading Under Fire

The Surprising Leadership Secret

INTRODUCTION:

You’re listening to Tiller-Hewitt’s Leadership Lens Podcast. If you’re a leader - or an aspiring leader - who wants to stay relevant and impactful… YOU’RE IN THE RIGHT PLACE.

At Tiller-Hewitt we believe it’s faster, smarter -- and less painful -- to learn from leaders who have walked before us. That’s why we invite top leaders to be our guests on the Leadership Lens.

Your host is Tammy Tiller-Hewitt – Founder of Tiller-Hewitt HealthCare Strategies. Let’s jump into the podcast.

TAMMY:
Today on the Leadership Lens Podcast we have Dr. Steen Trawick, the Chief Executive Officer and Chief Medical Officer of CHRISTUS Shreveport-Bossier Health System. Dr. Trawick started his first dual CEO/CMO position less than a year before the global pandemic hit. Then his hospital was the first in the health system and region to admit a COVID patient. So, thankfully his “can’t over-communicate” approach with his board of directors, medical staff, associates, and community was one of the many success secrets he shares.

He describes the top 3 leadership challenges and the warning signs of when the organization is getting close to running off the track. To add suspense, his hospital has the highest staff turnover rate - in the entire health system - but also has the highest patient satisfaction and one of the highest associate – or employee – engagement scores. You’ll hear how that is possible.

One of the many tweetable moments during the interview was when he shared his philosophy for himself and his entire organization saying, “If you can’t tell me how your job relates to patient care, we need to talk!”

TAMMY:
Dr. Steen Trawick, welcome to the Leadership Len's Podcast. I am so thrilled and honored that you're my guest today.

DR. TRAWICK:
You know I love talking to you, Tammy so this is going to be fun, and I look forward to our visit, and hopefully I'll be able to share a little bit of wisdom with your audience and I look forward to our conversation.

TAMMY:
Awesome. Well, you know, this isn't the first time we've been behind the mic together. We shared the platform a couple of times for ACHE, The American College of Healthcare Executives.

DR. TRAWICK:
That's right. In fact when we first met, I think it's important to tell folks that it was really on a consulting opportunity when I was working for a different company and working with CHRISTUS, and you came in and that's really how we met. And because of those results, you know, a couple of years ago, we actually had the opportunity to present this physician retention and turn-around for hospitalists at the ACHE. And it was great because Dr. Finley, who was actually the CMO for the hospital that we were working with and I got to look back on the big physician retention project that we all did together and created this case study that later led to an IBM Watson Top 100 Hospital for Speed of Improvement award. It was really cool because at the meeting we had the CEO of the hospital there in the audience. During the presentation, he was informed and was able to share with the entire audience that that award had been given. And, you know, this whole case study is actually on your website if anyone's interested in reading it. That was really a fun time to be able to do that and look back and share that with folks at ACHE.

TAMMY:
I forgot about that cherry on the top that he was in the audience. Oh you have a better memory than I do. Yeah, and I remember earlier this year you and I presented battle-tested lessons for leading strategic growth. And in all honesty, just prepping for that talk was mind-blowing, in terms of your experiences and your jaw-dropping stories about leading during the pandemic.

DR. TRAWICK:
Yeah. It's so weird because if you're in the thick of it, you sometimes forget what all happens and what you're going through and being able to ask those questions really allowed me to reflect back on, you know, the time that we started and we're going through that process and some of the big moments that happened. And I'm sure we're going to talk a little bit more about that later today.

TAMMY:
I hope so. I mean the bottom line is here just such a great storyteller, so I can't wait for our listeners to hear some of your heartfelt leadership stories that I've repeated I bet you fifty times over, they were so heart-felt. And then the lessons that you learned along the way. And just so you know, I prefer the word lessons over mistakes, but I do like how Warren Buffett used the word mistakes, when he said “It is good to learn from your mistakes, but it is better to learn from other people's mistakes.” So before we jump in, do you mind if I tell our listeners a little bit about you? Because I know that you are way to humble to share some of the good stuff.

DR. TRAWICK:
Surely that will be fine. Thank you!

TAMMY:
Well to our listeners Dr. Steen Trawick is on the line today and he is currently the Chief Executive Officer and the Chief Medical Officer of CHRISTUS Shreveport-Bossier Health System, which is in North Louisiana, is the only faith-based health care provider in the region. It’s also among the largest employers in Shreveport-Bossier with 1,300 Associates and over a 500-member medical staff. And an important note here, Dr. Trawick started his first and dual CEO/CMO hospital leadership role right before a global pandemic. Truly, baptism by fire. In fact, Dr. Trawick how soon before the pandemic did you start in this role?

DR. TRAWICK:
I started in August of 2019 and of course this began in March, so it was just seven-eight months at the most.

TAMMY:
Wow.

DR. TRAWICK:
Yep.

TAMMY:
You were barely getting your feet wet. Well, let me go on. So, Dr. Trawick did a Med/Peds residency. He's a board-certified internal medicine. He's had years of experience practicing medicine, including hospital medicine and served as a medical director for a national hospital medicine organization, which is where we met. That's inside the hospital. Outside the hospital walls, you serve or have served in many leadership roles, including president and speaker of the house of delegates with state and local medical societies. You're on LSU boards, you’re the honorary commander of the 2nd Medical Group at Barksdale Air Force Base, you're active with Boy Scouts of America where you're currently an executive board member and a former scoutmaster. You're active in your church, even a Sunday school teacher, which I would love to attend one of your classes. And last a true family man. And you and your beautiful wife, Rhonda have two children, a daughter Allison who I guess will be following in your footsteps studying pre-med at Baylor. And then a son Graham, a high school senior at Loyola College Prep. So speaking of Graham, will you please share the story about the book you had made for his eighteenth birthday, very recently.

DR. TRAWICK:
Yes, ma'am. I'll be glad to do that. I know how much you love leadership and parting leadership wisdom on others, and I sort of felt a little funny sending you this, but I did want you to know this is really a cool thing. I thought, okay, he's my only boy and my last to turn eighteen and I thought, you know, what can I give him that would be meaningful now, as well as throughout his life. And I had the idea to reach out to several of my friends and even some of his that are older, and I told him what I wanted to do and I sent them an email and I said, please this is for Graham on his eighteenth birthday and I would love for you to talk about your successes. What has gotten you to where you are today in business and in your career and your personal life and your Christian life, but also talk about failures and mistakes that you've made and lessons that you've learned throughout your life. Then I wanted everyone to please offer some advice for your eighteen-year-old self. What would you tell Graham that you wish you could go back and tell yourself at that age? And you know, as I thought about this, I never dreamed the response would be so great. But the response that I got was just amazing and I took all of these stories and bound them into a book and gave them to him for his birthday. And I don't think he can truly even appreciate the meat that is in that book. But it's something that I think he'll treasure and will be helpful hopefully throughout his life.

With leadership and especially with our children, you know, folks they think that you know, this is just the way it always is, I've always been a CEO or always wanted to be a CEO and I've had a ton of people ask me, is this something you wanted to do all your life? And the answer is no. And my kids think that's so funny. They don't remember seeing me during residency when I was making $25,000 - $28,000 a year and my wife who was a schoolteacher was making more than me. They don't see all of that. So, it was very interesting to be able to share a little bit about that in that in that book for him.

TAMMY:
Wow, no, so that was a question I was going to ask though. I am surprised. So, can you tell me more about how this wasn't the path, you thought you were going to be on, and did medicine prepare you or not prepare you in any way to lead?

DR. TRAWICK:
You know, it's a question I've asked myself especially going through covid and in what we're up against now, and I think, you know, why did you do this? I'm a firm believer that God orchestrates your path and things that happened, they happen for a reason and His ways are much higher than ours. And I've had some incredible opportunities throughout my life where I wanted to be a physician. I wanted to take care of people and help folks and I loved what I did in clinical medicine and there was probably this pivotal time that my boss, the CEO of the region for CHRISTUS came to me and said, you know, I want you we're going to go with this hospitalist company and I think it would be a good opportunity for you to take over as the regional medical director and later became the associate chief medical officer for that company. Luckily, I had all the CHRISTUS accounts. I got to go to all these different hospitals and meet folks at the system office and get to know people and they got to know me. So, it was an opportunity that I did not see when I first took the position. But you know medicine, obviously helped me be prepared, but that leadership piece is different and I always try to think, how would I want to be treated through this situation and try to respect that, but there's been leaders and mentors along the way that have really helped me grow in that role of leadership. One thing that I've noticed that I wish that I had more of was the business education. And obviously, I've learned a lot along the way but that would have been nice to have had a little bit more training in that.

TAMMY:
Tell me, was there perhaps a defining moment, you know, you felt an epiphany or an affirmation of your chosen path?

DR. TRAWICK:
I think that what I shared a second ago when Steven Wright, who was my boss at the time. He was sort of over the entire region. This region state of Louisiana and Southeast, Texas for CHRISTUS. And you know, when this opportunity came for the hospitalist group, they offered me a regional role within this company. First of all, I didn't want to leave CHRISTUS. But secondly, I didn't want to leave clinical medicine and he said I think this will be a good opportunity for you and I think back to that moment, that if I had not prayed about it and listen to God's plan and actually taken the step, and that's part of the learning process was taking that step, I would have never positioned myself to be in this role now. I think that that was probably the defining moment, but those years that I spent with Sound Physicians, I was with some incredible mentors that taught me so much that I could just never say thank you enough for what I learned.

TAMMY:
I love that you use the word mentor too. I think a lot of times people, confuse the word mentorship with some kind of, you know, a new teacher or like I'm a grown adult now, I finished school I don't need a mentor. But I love how much value you put on that and put a different light on in terms of the value that mentorship brings in all phases of your career.

DR. TRAWICK:
I heard this quote many, many years ago that says the day that you stop learning is the day that you die. If you think you know it all, oh goodness you're going to be in trouble. Being able to accept the fact that they're still a lot more to learn. And there's people out there that are way more versed in certain subjects and topics and how to do things that's when you can truly glean. People want to, they want to share what they know. They want to share, what they've learned, you just have to be open to receive it.

TAMMY:
That’s good. One question, back when you switch from medicine to leadership, some doctors call that going to the dark side. Did you get any pushback or any criticism from your physician colleagues about switching teams or going to the dark side into hospital administration?

DR. TRAWICK:
I did. And it actually was sort of comical some of the comments that I got but, you know, the good news was that Tammy, that I had worked with most of these positions on the medical staff. I've been Chief of Staff for the hospital for so long, you know, back in a few years ago and gotten to know folks. So they knew me, the type of physician I was but the type of person I was probably more importantly and so it wasn't like some somebody going to a different hospital or going into a leadership role that they didn't know. And you know, the feedback I've gotten recently has been mostly positive from the standpoint of it’s nice to have a physician in this role somebody that gets it and understands it and especially during covid.

TAMMY:
I think it’s ideal in covid and anytime. But, I remember you talking about some of your covid experiences and how you got pushback from one of your doctors and it was like a light bulb went on for you. I don’t know if you want to share that story at all. How you kind of got the feel of what non-physician leaders go through when physicians feel like you’re not qualified as a non-physician to make these decisions on behalf of the clinical team.

DR. TRAWICK:
Sometimes you have to make decisions that are not always popular. And I feel that as CEO you're representing, not only the physicians that work here but also a very large staff of associates and so they're depending on you to make decisions that are right for the patient. Sometimes I believe that we as leaders get lost in the minutia and we forget our purpose and what we're supposed to be doing. If we keep the patient, you know, at least in health care, if we keep the patient at the center, most of our decisions are going to be the right thing. They may not always be popular by every group. But usually, if you can explain it from the standpoint of, this is why I made this decision, this is why we're moving in this direction, people will more or less respect that and follow you.

TAMMY:
Right. Well, what do you think of the top leadership challenges today both professionally and organizationally?

DR. TRAWICK:
I think probably the number one issue that I have found would probably be the generational gap. I mean, I'm now in the old man category, I guess in my fifties and so I'm starting to see a new generation not only of associates, nurses, respiratory techs and other folks. But you know, I’m also seeing a new generation of physicians coming out and I think that that being able to identify and recognize that the way we've always done it is not always the right way, and that there are other ways to skin a cat, if you will, to, to do things and that generational gap, you can really learn a lot and, and grow as an organization by some of the ideas of doing things differently. And I believe that that is probably the biggest thing.

I will say, probably two other things that I have noticed is having to learn in healthcare to do more with less. We're told to cut costs, but they want us to innovate. They told us, you know, they tell us we need to cut costs but we need to grow services and so we've got to look for different ways of doing more with less.

And the third thing that I found is challenging is you know; it would probably be the rapid change that we're experiencing now in life. I mean things are changing so quickly, look how fast this vaccine got rolled out. Look at how fast we pivoted when covid happened. With technology, with social media, with the internet, you know, everything's different, and so I think that's a big, a big issue too.

TAMMY:
Yeah, you know, it's funny that you say that - two things in the letter that your part that you wrote to Graham was what is popular isn't always, right and what is right isn't always popular.

What do you think are the warning signs when an organization is getting close to running off track?

DR. TRAWICK:
When you know, you start having high turnover. When things start going different ways and then it's just that you have to start looking for culture. What is your culture like? You know, why is this problem here? You know, sometimes we as leaders want to ignore it because we don't want to, you know, we're like, oh, well it'll fix itself or well, I don't want to admit that because it's a problem. But if you don't attack that head-on, you can get in big trouble. And very interestingly, staffing has been a huge issue for all healthcare throughout the country. We’re right there with everyone else and very interestingly, we have had probably one of the highest turnovers within CHRISTUS from our nursing and other associates. But Tammy, it's really cool because we have the highest patient satisfaction within CHRISTUS, and we also have extremely high associate engagement. It’s really a dichotomy of how do you have this high turnover, but you also have good patient satisfaction and good associate engagement. And I have to believe it's the leaders that are part of each of the different areas that we have, they're so inspiring and they build this culture of who we are, who we want to be. And that just permeates everywhere throughout the entire hospital, and I think that's really important.

TAMMY:
Wow, that is amazing, honestly. I sat on the committee that scored a bunch of articles that were submitted to ACHE for the ACHE article of the year. There was not an article that I judged that was anywhere near the story you just described. I mean to have the highest turnover. Yeah you've got to write an article about that. I mean, that is amazing. You don't hear about that. You're right, that's a crazy dichotomy. You've got nursing highest nursing turnover, but the highest patient sat, highest associate engagement that's awesome. So, everybody's going to want to know what your secret is for sure. That's thank you for sharing that.

DR. TRAWICK:
It’s not me. It's definitely our leaders that are throughout the hospital. They love what they do and they love who they get to work with, and they love taking care of patients. I tell everybody in the hospital if you can't tell me how your job relates to patient care, then maybe we need to look at your job, and why is it important here. Every single person in this hospital that has a job here, including me, has to be able to tell your leader, each other, me, whatever how it relates to patient care.

TAMMY:
That's a tweet right there. If you can't tell me, how your job relates to patient care, we need to talk. That's good. That's good. So if you had to start all over again, what was your first step be? Start all over and you can pick as the CEO/CMO as a physician, as a combined role.

DR. TRAWICK:
Probably if I had to do it all over again, I would listen to my mother, and I'd major in business. I had a really, really, really good time my first quarter at Louisiana Tech when I was an undergraduate and she told me she said, well you know, maybe just need to change your major to business. Maybe you're not cut out to be a physician. And I was like, oh yeah lady I'll show you.

But, you know, she's a very a wise person. And you know, I think that she saw something in me that maybe I didn't see it in myself at the time and if I had to do it all over, I think I would probably major in business and take the pre-med, you know core work to get in medical school.

TAMMY:
Wow, I’d listen to my mother. You know that's music to a mother’s ear. So, what's your secret weapon? What would you say your secret weapon is or your secret talent is?

DR. TRAWICK:
I would have to say, probably consistency. I try to be consistent. You know, nobody likes to work with, nobody likes to be friends with someone who's up and down all the time. You don't know what you're going to get when you walk in. I try to be very consistent. I try to treat people with respect, and I try to build relationships. I believe relationships are key to your work, to your family, to your friends, everything you do. And, you know, investing in people is well spent time. I love listening to people's stories. You learn about them. You learn why they tick the way they do. And I guess probably my other one is, I love to encourage people. I try to be an encourager.

TAMMY:
Well, those are all great traits of a great leader Steen, that's awesome. I love as I said earlier your stories of managing through a pandemic were just mind-boggling. But I would like to hear as we talk about managing in a crisis. What were three takeaways that you learned from managing through a pandemic?

DR. TRAWICK:
To communicate, number one.

Number two would be to communicate and

Number three, to communicate.

TAMMY:
Oh, okay. Good, let me take note on those.

DR. TRAWICK:
Those are complicated. So, if I say it, everybody’s like- yeah, yeah, whatever. But how did you do that? And so the saying to communicate better is sort of cliché. But I think the how is more important and probably I'd like to share with you some of the things that I did.

I found out that people wanted to hear from me as the leader. The physicians wanted to hear from me. The associates wanted to hear from me. The media, the people that live in our community, they wanted to hear from our hospital leaders on what's going on. And so that communication piece, I realized I didn't need the shy away from it, I needed to get out in front of it, and that was key. Personal phone calls to board members. Personal phone calls to physician leaders. I remember bringing our whole leadership team in on the very first covid patient that we had and telling them, here's where we are, this is what we're going to do, and we're going to have to learn as we go.

I found out that the best way of communication was scripted, it was purposeful, we did it frequently and it was strategic. As we went forward, we couldn't do it enough. They wanted to know what happened daily. So, we started sharing daily communication that went out to give folks an update of how things were changing, what's different today than it was yesterday or last week. But the cool part was, you know, sometimes it maybe two or three pages. Nobody wants to read two or three pages. We would bullet at the top, here's what's included. We were very clear, so the detail was below, but at least you could get the quick summary at the top and I would say that was probably our strongest ability to proceed forward, because really none of us knew what we were doing. It was really scary.

TAMMY:
So now what? I mean, so you learned all those great things and had awesome outcomes because of it, so now that the crisis is somewhat over or, you know, much less, how are you keeping up that kind of communication?

DR. TRAWICK:
You know, as we still do it, we don't do it as often. We had a strategic command center that we kept open for quite some time and I think that was very helpful to folks. Any question, any problem they could get online, they could you know, Zoom, whatever. If they went in the hospital, they could come by the command center. They could reach out. But we also wanted to make sure that we stayed in front of things. We got folk’s input and so we made changes. It really taught us a lot about how to be nimble and a sort of versatile at the way we were doing things. Which, you know sometimes it would take like a Baptist Church you know, you get all these committees together before you make a decision. And we recognize sometimes we just got to turn on a dime. And folks understood that because we kept them informed.

TAMMY:
Right. So you've kept that practice up of better communicating on a more frequent basis or at least on some consistent cadence?

DR. TRAWICK:
We have and you know, we still send memos out frequently. We did end up closing the command center. Fortunately, we've had a nice reduction, in our covid patients, so we were able to close that, but we still try to maintain, you know, now with the vaccine mandates and those kinds of things coming down, we try to make sure that folks are aware of what's going on, and so we still kept a lot of those communication plans in place.

TAMMY:
Awesome. I love that. So, as it relates to innovation and empowerment, I know it's two different words, but I'm going to bring them together, you talked about how one of the challenges doing more with less which forces you to be innovative and look to your team to empower them. So how are you as it relates to innovation and empowerment of your people, how are you blending those two together to encourage creativity and innovation internally?

DR. TRAWICK:
The big thing that we do, we try to be very inclusive of our front-line folks. I mean they're the ones that are doing this and they're the ones that know when something's not working correctly. They know when we can do something differently and more efficiently, and so we try to be very inclusive of them. We want them to supply us with that kind of feedback. We've developed things, bright ideas. We reward folks for coming up with good thoughts and action items. We like for folks to be, you know, this is your idea, let's develop this. Let's let you be the lead in this. And it gives people ownership and it encourages them and gives them, really empowers them to be thoughtful. You know, everybody talks about high-reliability organizations, and we really try to incorporate that in all that we do. We want folks to feel comfortable raising their hand and saying, hey, I think we need to do this differently. Or, hey, this is not working and there's a mistake we need to fix this.

TAMMY:
I love that! So how do you make sure that your team is aligned and focused on your overall goals of the organization as we go into this next phase of change?

DR. TRAWICK:
I believe in our mission. Our mission here at CHRISTUS is to extend The Healing Ministry of Jesus Christ, and I try to make sure that our associates hear that from me often. And I want them to hear from our leaders often, because that's ultimately what we're doing. You know, it doesn't matter what your mission is, but you need to have one and need to know it and you need to practice it. Because it's not going to be perfect every time, but you need to make sure that they understand that core values are important, and we need to make sure that those are known and followed. I think culture is important, but I will also say, you know, you can’t improve on what you don't measure or can't measure. And so having clear goals laid out and being able to measure those goals with different ways and reporting those back to folks saying, I don't believe everybody gets a trophy. I believe that the winners and losers, and we celebrate winners, and we try to help build up losers and folks that have fallen short and we encourage that. We don't put you out to pasture. We want you to get better and we think competition is healthy and good. So, we want folks to feel empowered to do better, come up with new ideas. How can you achieve these results? But you've got to identify the goals first.

TAMMY:
Yeah, spoken by a true athlete. Not everyone gets trophies. That's very funny. So, last question, before we go into our rapid five wrap up. What mistakes do you see leaders make frequently? And if you could tap them on the shoulder without embarrassing them, you would.

DR. TRAWICK:
I think not exhibiting humility and practicing Integrity, or character, good character traits to other folks. I also see leaders not building relationships with people. You know, people don't really care how much you know until they know how much you care. If you know the people that you're working with, they'll follow you to the ends of the earth, because they believe in you and they want to do well for you. So, I think you know, building those relationships with people, and especially the people you work with are so key.

TAMMY:
Well, this has been amazing. I could keep asking questions and listening to you for hours. I can't believe our time is already up. But if I could, before we wrap it up, can I fire a few questions that you that we refer to, as our rapid five?

DR. TRAWICK:
I hope I don't stumble, but of course, you can.

TAMMY:
All right. Number one. What are you currently reading?

DR. TRAWICK:
I'm reading actually, two books. Flying to the Wind by Lieutenant Colonel Dan Rooney. It's a book about how he learned as a fighter pilot and as a PGA professional, he was actually both, how can you be better? How can you do better? How can you draw on experiences in your life and become a better person?

The second book that I'm in the process of reading is GRIT by Angela Duckworth. I love that book. It's a true testament. I remember not getting in gifted and talented when I was in elementary school and thinking, you know this is the end of the world. And remembering and learning through my life that it's not necessarily how smart you are, it's how much passion and perseverance you have. And that's what really matters - the grit. She says the grit is way more than the talent.

TAMMY:
I love it. I agree. How do you start your day?

DR. TRAWICK:
I get up every morning at 4:30 - every morning - during the week. I run. I have a group of guys that I run with.

TAMMY:
Okay. Number three. What is the most important characteristic of a leader?

DR. TRAWICK:
Humility. I think integrity and accountability is, you know, I haven’t really mentioned that, but I think accountability is important. You got to be accountable to yourself, to your family, to your people you work with, people you work for. And that's very, very important. So, if I had to pick one of the three, probably Integrity would be the most important, but I think the other two are very important also.

TAMMY:
Okay. What is your secret talent?

DR. TRAWICK:
I fly airplanes.

TAMMY:
Oh, really?

DR. TRAWICK:
Yeah. I've been a pilot for almost twenty-five years, and I actually got my pilot's license because I was terrified of commercial flying, and someone talked me into taking lessons and I thought I would never ever fly. But I fell in love with it and have been doing that for twenty-five years.

TAMMY:
That's awesome. And then last what the word of advice that you would give to your younger self?

DR. TRAWICK:
Spend more time with your father. I wish I had spent more time with my dad before he died. He was young. I was only twenty-two when he died, and I wish I had spent more time with him. And I would also say probably spend more time with your family because, at the end of the day, jobs come and go, people come and go, but your family is your rock. They can be a true support system for you. I know mine is and I wouldn't be where I am today without them and I surely wouldn't be able to go through my day, not knowing that I’ve got a wife that loves me and prays for me every day. And I have children who love and respect me …on most days. Probably not every day, but I think they love and respect me and I'm proud of that. And what's the old saying? You'll never meet someone on their deathbed saying I wish I'd spent more time at the office.

TAMMY:
Well, thank you so much for your time and your insight and wisdom and experience. I know I have enjoyed it. And I know for sure that our listeners will as well. So, thank you again. Dr. Trawick.

DR. TRAWICK:
This has been a treat, Tammy. Thank you. And I really appreciate you asking me to do this. This was fun.

CLOSING:

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