Leading with an Abundance Mentality

Doubt Your Doubts

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
My guest today is William Mahoney – President and CEO of Cox Medical Center in Branson Missouri one of the most popular and long-standing vacation destinations in the Midwest. William shares a mass casualty story that made national news and the testimony of one survivor’s unconscionable loss, which he suggests likely prepared him and his organization for the pandemic.

While a former Marine – William made it clear what he learned most about leadership came from Al Mahoney – his very own drill Sargent – better known as dad.

William is also the senior Vice President of the health system’s Community Hospital Group overseeing Cox Health’s rural hospitals.

TAMMY:
Mr. William Mahoney, Leadership and Storyteller Extraordinaire, welcome to the Leadership Lens Podcast.

WILLIAM:
Hey, Tammy, Queen of Motivation, how are you?

TAMMY:
Well to say I'm overjoyed to have you as a guest today is an understatement and our listeners are about to discover why. So, it's been a while since we’ve worked together, which is another great story of the immeasurable power of relationships. So for our listeners, William and I met through an OB friend of mine who had relocated to your neck of the woods joining your medical staff. Remember, William?

WILLIAM:
I do.

TAMMY:
And he had just delivered your… wait for it everyone... wait for it…He had just delivered your tenth child, William. Ten kids, running multiple hospitals. My question is wow and how?

WILLIAM:
I married well! Tammy and I always wanted a large family and we got it. You know I think back now, eight of those ten are girls. The first seven were girls. We had a son pass away. But it's interesting those girls now, talk about humility of your children, six of them out the home and four are married, and I got brave one day and I said, hey girls, I text them and said, tell me about characteristics of me and how would you rate me?

And it was like, you know, hey empathy honesty, hard-working, charitable, kind, forgiving, self-aware. And every one of them had my weakest trait that they listed separately, and it was self-awareness. It's pretty humbling but I've been reading more on generational differences since then.

TAMMY:
Has it helped? Are you going to resurvey them?

WILLIAM:
Oh, I'm not going to resurvey them, that was too humiliating.

TAMMY:
Well, I love it and it just speaks to who you are, that you did something about it. You're like, okay, I'm going to get better. I'm going to figure this out. And I know the one significant characteristic that I'm quite familiar with is your servant’s heart.

So, for our audience a few years ago, it was after our contract ended with you at Cox, we hadn't been working together business-wise, we remained friends, but I remember the father of my best friend had a heart attack while he was vacationing in your “vacation destination” market. And he was taken to your hospital. I emailed you hoping that you would maybe find some time to do a fly-by, stop by and see him. But instead, you immediately went into the hospital over a weekend to see him and his family, giving me props like I was some VIP, but more importantly, you made them feel like dignitaries. You made them laugh, you comforted them, you prayed with them. They still talk about it today.

So, I'm just so looking forward to our listeners, being able to hear your heartfelt leadership stories and lessons shared along the way, because you are so open and transparent. So, if you don't mind, can I ask you a few questions about your leadership journey?

WILLIAM:
Please do.

TAMMY:
Did you always know you wanted a leadership role?

WILLIAM:
Oh yeah. I always wanted a seat at the table ever since I’ve probably been about eight years old.

TAMMY:
And was there a pivotal point in your career or defining moment that felt like an epiphany or affirmation of your chosen path?

WILLIAM:
I went back to school, we had three children at the time. I was twenty-five and when I was going to school, I interviewed a school supervisor, a superintendent, a psychologist, and a hospital administrator. And openly, Keith Steiner, in Idaho was a rural hospital administrator, I went in and I interviewed him, and he said, this is a great career if you want to help your community, help people, work with smart people, and it not be a job, but it's a calling. And all of a sudden, something just hit me when he said it was a calling.

I didn't want to do my career to just be doing a job. I watched my dad work in Caterpillar, in the factory, and I told myself I never wanted to work in a factory and do that my whole career, waiting for 30 years for a gold watch. So, when he told me that was a calling it clicked and I said, there's the road I'm going on.

TAMMY:
Wow. Have you used that since as you're talking to young leaders or aspiring leaders?

WILLIAM:
Yes, I have actually. To me, healthcare is a calling and I talked to people about that. When it's a calling, it allows you to do things differently than you would if it was just a job.

TAMMY:
That's good. So, what do you think are the top leadership challenges today professionally and organizationally? And then how do you face those challenges?

WILLIAM:
Definitely workforce issues, trying to find labor right now. The pace of change is crazy! We are transforming. Generational differences, I told you about my own kids, I learned a lot there. And sometimes the newer docs kind of shock me with some of their requests. The safety net responsibilities that we have of public health. When we went through the pandemic, we're in a rural town, we became Public Health because our Public Health Department had three people working in it. And I would say, just the economics you know, we're an economic engine for our communities. And that's been a challenge. And I would even say leadership. There’s a lot of people when it gets tough, go into self-preservation mode. And it's tough and that's why I think you're seeing a lot of people get out of the business.

TAMMY:
How do you deal with those challenges?

WILLIAM:
I definitely try to listen. I want to be real. I’m vulnerable. I try to connect. I try to communicate to my people honestly, make a plan and execute. I had an experience in my life about why it's so important to listen and connect to people. You know this story, but when I was twenty-three years old, over thirty years ago, I had a son that was born with hypoplastic left heart. He was in the hospital then home, in the hospital then home. And finally, we were in a hospital in Chicago, and out on the couch sleeping, and then our beeper went off to go back into the NICU. And when we came to the door, the surgeon said, Well, your son bought the farm. And I said, He what? He said, you know, he kicked the bucket. And my wife was in shock at that point. And I said, you mean he died? And he said, well yeah.

We walked in and they were taking tubes out of his body. We held him, he was cold, but we were both in shock. And I can't say that is my main motivation for going into healthcare, but I want to make sure that at people's worst moment that they ever have, I want to make sure that I listen to them, I care and I connect.

And so that's what I think we're going to have to do with the challenges we're facing today. And I always think of, I picture my son, Kyle, I'm always reminded that when I have people who come in - people who are addicted, people who have issues that may not be resolved in this life, it's important that I be there for them, that's part of the calling part.

TAMMY:
Wow, that's powerful.

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

WILLIAM:
Well Tammy you know, I've been in rural twenty-six years of my career. I have done rural turnarounds. I've done four rural turnarounds. So, I walk in now and I almost feel like I can feel it, but a lot of its culture. When you walk into a place and you find out that there's meetings outside of work with staff other than what's going on in the company. When you see a self-preservation mode instead of what's best for the whole. You can look at the scores of the bottom line, the quality scores tell you a lot. And patient feedback if it's not good or it's not even being recognized, you know that the places are close to going off the rails.

TAMMY:
Well it's funny that you can feel it and hear it now because you have so much experience. How are you going to pass that on to the next generation?

WILLIAM:
I've been keeping journals since nineteen eighty-six and when you know, it's my time to leave this planet, I'm going to hand this to my kids. I speak to groups. I email my team. I'm vulnerable, I tell them, hey, this is what we've done here, some things we could have done better, things I could have done better. And I speak to a lot of colleges and businesses about leadership, about lessons learned and some are good, and some are so good but as long as you don't make the same mistake twice as one of my bosses told me.

TAMMY:
Well you know Tiller-Hewitt, because we've worked together, you know, our organization works with leaders that want to consistently deliver strategic growth and measurable results. So, what are your secrets and success strategies around strategic growth (and you know, we know, not all business is good business) and measurable results?

WILLIAM:
You know Tammy, I'll say something about your company when I worked with you before I answer that question. You're one of the top three people that I've ever met that is high on accountability and just getting to it. You're not a middle person with excuses. It’s like okay, let's find out what's there, and let's work on it hard, and let's get it done. And let's make sure it's measurable. I’ve always appreciated that, and you helped me grow.

But the things I try to do, again, I listen to the patients and the doctors, the people closest to the care. Make a plan. I assign it to people. I have a big bi-win mentality. Now I'm not you're going to assign you a goal and there's no bi-win, and I see that as accountability.

And then cascading goals and KPIs (key performance indicators) to drive results. And openly, when I go into hospitals that are losing two, four, five, six million dollars, those things are missing all the time. I think what happens is it’s that leadership component. There's not a ton of leaders out there anymore. There are a lot of managers, but leading is uncomfortable and you have to do things that are uncomfortable. And when you tell people, this isn't working, we've got to execute a little bit faster or do things differently, you're not always popular and we live in a world where people want to be popular.

TAMMY:
Well thanks for the shout-out to Tiller-Hewitt, by the way, first, I appreciate that.

You were a marine. I guess, once a marine, always a marine. So, has that helped you with your discipline around your planning, KPIs and accountability that you just described?

WILLIAM:
I wish I could tell you, yes.

My father, Al Mahoney, is a drill sergeant. I grew up at five years old and we worked in construction him. I went in the Marine Corps at seventeen. I was fortunate, I got meritoriously promoted. And openly, it was easier than working for my father. But the Marine Corps does teach you discipline, I have a lot of pride about that. I consider them the greatest fighting force there ever was, but openly, they refined what my father put into me. They had to give you breaks for lunch and dinner, he just had you grab something on the roof and eat while you were nailing.

TAMMY:
So the Marines needs to thank Al, huh?

WILLIAM:
Well, you know, the Marine Corp, they improvise, adapt, overcome. I'm not sure he had any slogans; except we need to get it done so our revenues are higher than our expenses.

I’ve got to say that helped me when I got into leadership. My father just said, you've got to have more revenue than expenses regardless. And what I've had to sit down and turn around and tell people, this is what we have to do regardless of who's happy, unhappy, at the end of the day, this needs to happen for us to be here in the future.

TAMMY:
I love that you simplified it. It's not rocket science but you're right, everyone tries to make it so much more complicated than it needs to be.

Well, how can leaders constantly re-energize themself as leaders given all that you just said?

WILLIAM:
When covid-19 was starting, I started to feel a little bit negative. I never had a real negative day in my life. I’m fortunate that I haven’t had depression or anything. I hired a life coach. I started to ask her these questions. And she started working on these things and talking and taught me to make sure I get enough sleep, make sure you get exercise. Take periodic time-outs. I’m the master of the four-day weekend. Labor Day, I take the Friday off. Memorial Day, I take the Friday off. Okay? Focus on what’s going right, what you can control.

Then she gave me an exercise - this is the life coach part. She said, William, you have to get the stillness and that helps you get the ego and all the crap out of your mind and gets you to your authentic self. Once we are in an authentic state and we are true to ourselves, that’s when we can really make the decisions, we need to do that affect us, the best to help us re-energize us. Because when we are ourselves that will help us.

For example, you might not like your job. Well, I need the check and need this, need this. But once you go through the stillness and you get rid of the, you know I need the job or maybe I can't get another job or what happens if this happens, and you get your authentic self. You say, I'm not happy. I need to do something different. That's when you're going to get to the point where you feel re-energized and strengthened.

When I drive to work, I have 20 minutes, it's quiet. And that's my stillness to get into my authentic self. And so the decisions I make each day, are authentic decisions for me.

TAMMY:
Wow, that's powerful. Thank you. So, as it relates to managing in a crisis, which I'm not sure that we're really out of a crisis, we're just in a different phase of it, but from an insider's perspective, how would you describe the current state of the United States Healthcare System?

WILLIAM:
I would say this, nothing is certain. It's fragmented. It's disarrayed. It's transforming. We have workforce and bottom-line challenges. We have payer issues. Someone did very often during pandemics and it wasn't us providers. But I would say this, FEMA and ARPA monies, in my mind, have only delayed the inevitable. We're going to have to change. We're going to have more to a wellness system. But I have got to tell you this, and this part keeps me motivated, this is the best opportunity I've seen in my career to show leadership.

You must have an abundance mentality and you got to come up with some ideas. When you're the leader, they're paying you to set that vision, to get people moving in a certain direction. I don't think there's any perfect answer now. So, anything you come up with, uniformly with your docs, your board, your community, your team is probably going to be good.

But just be open to modern healthcare and listen to everybody's views, that game has changed. I mean, when you see the Kaiser's of the world, the Cleveland Clinic's all losing at billion a quarter. They don't have the answers either. And if you watch mergers - most of these mergers don't result in any better margins at the bottom line. So, your ideas for your community just as long as you work with your patients and your docs, is going to help you in these times of crisis. And so I just say, be true to yourself and what you feel and see.

TAMMY:
With the demands on all leaders today, the million-dollar question is: what are some tips to be more efficient and get more done?

WILLIAM:
I'm not excellent this, but I'll give you a little bit of an answer. I work on tough things in the morning. I definitely do the stuff like I said, the stillness, the authentic self. Strategic time off. I definitely utilize my executive assistant. I delegate, and I say no to more to opportunities than I say yes.

Early in my career I'll speak here and I'll do this. Now, I'm pretty selective about who I say yes to, and that has helped me. I also think your morning habits are huge. When I wake up, I wake up, I say my prayers, read my Scriptures, I take a fifty-minute walk and a brisk, walk. I guess I call it brisk. A little sweat on my forehead when I’m done, I guess. Then, take my shower and I have that 20-minute ride to work where I have my stillness, and I'm just pondering the day and I am trying to listen to what my authentic self is telling me or in my mind with the Holy Ghost is telling me whispering to me.

TAMMY:
I love it. So, what are maybe three takeaways you learned from managing through a pandemic?

WILLIAM:
Well, I'll tell you what, I'll tell you a little story is that okay?

TAMMY:
Yes, please.

WILLIAM:
I had a pandemic happen before the pandemic happens if you will, in my community. Three years ago, we have lakes by us here and we have something called the duck boats. They ride on the streets, and they go in the water. About 7:00 o’clock one night, the duck boats went in the water and a freak storm hit and turned it over.

I get a call at the movie theater. Hey, we have a mass casualty, come to the hospital. So, I did, and we didn't know what was going to happen. Well, we found out that 17 people died in that and a bunch of people came to the hospital. One lady came in and she lost nine family members. Her and her thirteen-year-old nephew, at the time. They were wet, no cell phone. They didn't know numbers because everything was in their cell phone.

For the next four days the national news was here. There were GoFundMe groups trying to make money. Our community response was incredible. Our team did incredible. But there was not a lot of sleep to be very open with you. During that, the lady lost her three children, her husband, her in-laws, her name was Tia Coleman. You can Google that. That's where it's fascinating. It was like a pandemic. I mean it was a crisis.

That was three years ago, she came back four months ago and she said to me, in the worst day of my life, William, you and your team were there, and you don't know why I'm alive today is because you all gave me hope that life would be better - by the way you treated me.

I have to give our governor credit that day too. He came through. He would not take a picture with the survivors, because he didn't want to do something that looked disingenuous. I always commend him for that. So when I think about managing through a pandemic, we kind of had that as a warm-up, if you will. You got to show empathy to people. We're not always going to agree, especially during the pandemic. My community is probably one of the lowest communities for vaccinations. People get very frustrated, but we have to disagree without being disagreeable.

The second one is we have to give ourselves grace. When I think about the pandemic or that duck boat accident, we were tired, we didn't do everything perfectly, but we led with our hearts. And then we must lead and connect and support our caregivers. I don't think we realize how much our caregivers are giving, especially with these workforce shortages And then you got people, out in public mad because you're masking, or you're asking them to be vaccinated and all they're doing is trying to take care of you. We saw violence rise tremendously during the pandemic and that was hard for me to watch. We obviously hired more security. We got some things on the badges, alarms that they hit to show us exactly where they're at if they're ever cornered. We actually put guns on our safety officers for the first time. We do definitely need to connect and support our caregivers. And you’ve got to take action. You may not be perfect, but you got to do something.

TAMMY:
That’s great. Who wants to have a mass-casualty pandemic before the pandemic? But it was nice that you learned something from it and armed you to be better during the next pandemic.

WILLIAM:
I would say, our team, they always went back to that. Hey, we got through the duck boat tragedy, we can get through. This is the only difference is the pandemic lasted longer. It definitely still mentally wore people out and stressed them.

TAMMY:
Well, how do you pass on these important lessons? Is there anything we haven't covered that you want to tell your colleagues or aspiring leaders on any lessons you learned to save them some grief and maybe save lives too?

WILLIAM:
I think the big thing is, always keep trying to learn. Keep thinking about scenarios and situations. I look at this way, if you're true and trustworthy and you're an authentic person, people will give you grace if something doesn't go as well, because there's sometimes it's not going to go well. When you don't have enough staff, and people are trying to take care of various situations, you can only do what you can do.

I think of mental health. We have a huge shortage in our state of Missouri for mental health. And there's not a lot we can do when people come in. We treat them and we have some inpatient, but there is such a lack of outpatient treatment available for people, especially those without insurance. And so just do the best you can, but I think just try to get yourself prepared each day so when you walk in, you are at least prepared to handle these situations with all of yourself, not a part of yourself.

TAMMY:
I can't believe our time is almost up. This has been fascinating but I do like to end all of the interviews with what we call the rapid five wrap-up. So, can I fire a couple of questions that you?

WILLIAM:
Better tie my shoes.

TAMMY:
Get ready - here we go! Okay, what are you currently reading or have read that you would highly recommend to your colleagues?

WILLIAM:
The book, Abundance by Steven Kotler and Peter Diamandis. This is a cool book about innovation. The future is better than we think it's going to be. There are nine billion people out there right now who don't have access to healthcare innovations. You think about Africa, all these countries are going from a third-world life up to more of a middle-class, if you will. And this is going to have more and more people enter our systems without as many people to take care of them probably. But the technologies that are going to come out of this are incredible. So, the future is not going to be bleak for healthcare.

TAMMY:
I love it. All right. What's one word or mantra you live by?

WILLIAM:
Probably my life purpose and that's to make a difference in people's lives by showing them someone still cares. There's a great little 12-minute YouTube by Adam Leipzig called Finding Your Life's Purpose in 5 minutes. I'm kind of slow. It took me ten minutes and that's kind of how I came up with this for my life purpose.

TAMMY:
I'm writing that down. And you told us how you start your day, but you want to add anything to that?

WILLIAM:
No, it's what I do. I start with prayer, Scripture study, that brisk walk and I drive to work so I can ponder and get myself into an authentic state.

TAMMY:
Sounds like a great routine. What do you think is the most important characteristic of a leader?

WILLIAM:
You need to be trustworthy and accountable. People ask me when I interview docs or different people for vice-president positions in my three hospitals I'm responsible for. And openly, if I can't trust you, it doesn't matter what your skills are.

TAMMY:
Good. What is one word or piece of advice you would give to your younger self?

WILLIAM:
Oh, I would slap him around a couple of times. I would say this: Doubt your doubts before you doubt your faith in yourself, in your God, in whatever you believe. And I'll tell you that because, openly, I would drive by that hospital that was maybe a hundred beds when I was over a fifty bed. But I’d say the person running that, well, they must be real smart. I wonder if I could ever run something like that. Then each time I got promoted it was, all right. I wonder if I could do that, you know? And I had a lot of doubts, because I grew up in a blue-collar world and this is more of a white-collar world in administration, and so I openly, I just had to eliminate that. I doubt my doubts now, I don't let them drive me.

TAMMY:
That's good, doubt your doubts before you doubt yourself. I love it.

Well, William, thank you again for being such an amazing guest on the Leadership Lens.

WILLIAM:
Thank you so much. And hey, keep changing the world. That’s your calling.

TAMMY:
Thank you.

CLOSING:
Tiller-Hewitt works with leaders who want to consistently deliver strategic growth and measurable results.

The organization is recognized as the leading experts in strategic growth, network integrity, and physician engagement. Thanks for listening to this episode of the Leadership Lens. For more leadership resources and strategic growth solutions, visit tillerhewitt.com.