The Boardroom That Becomes a Physician Dining Room

At 23, Scott Kashman was an administrative resident at Charity Hospital in New Orleans. He hadn't wanted to go there. A mentor told him he could always work at the private hospitals, but he would never again get to work at a place like Charity.

One day his boss took him to a legislative hearing. His boss had tried for nine months to get on the agenda to request funding the hospital needed to care for an underserved community. When he finally did, he was ridiculed publicly. Walking back to the car, he turned to Scott and said, "Well, that didn't go exactly as planned, so we'll go back and we will do it again next time." A couple of months later, he got the funding.

Scott, then president of Ascension St. Vincent's Riverside Hospital, told me during our Belonging and Retention season that this moment still shapes how he leads. He keeps a piece of Charity's flooring in his office.

Scott came to healthcare administration almost by accident. He planned to be a psychologist. His mother, an occupational therapist who went back to school when he was a teenager, saw his love of patient care and his interest in business and suggested health administration as a backup. That combination still shows in how he leads. He pauses, often, to explain to his team why he is making a decision, so they can apply the reasoning the next time.

Ask for it, and take it well

Around the same time, while working as a psychiatric counselor, Scott got a lesson from a housekeeper. She told him the CEO gave wonderful talks about culture, but when she cleaned the front lobby, he rarely said hello or even looked up. Her advice was simple: just be kind and say hello.

Scott has built his leadership on that kind of feedback. "I would encourage people to go back and ask for that feedback and graciously accept it. That means don't get defensive when people give it to you." In his experience, most leaders do get defensive. Every defensive response teaches people that honesty carries a cost, and eventually the feedback stops.

He also learned what happens when leaders stop listening. At a previous organization, he heard from frontline staff that more than 20 critical care nurses were about to resign. Senior leaders told him he didn't have his ear to the ground. Within three days, 23 resigned. His lesson: "Be open to the fact of you may not have your ear to the ground as well as you think you do. So it's important to stay humble."

Leaving the executive suite

Scott spends two or three hours at a time working inside other departments, and he gives people one instruction: "you have to put me to work." He learned the value of it as a graduate student, when he observed a surgery in his first weeks at Charity. The surgeon later told him the team trusted him more because he had been willing to come into their world.

He brought his own family along too. His son and twin daughters have rounded with him in the hospital on holidays since they were about eight.

Giving the boardroom away

Once a month, his boardroom becomes a physician dining room. Physicians' badges open the doors to the administrative offices.

I love the symbolism of that. The boardroom is where decisions about the hospital get made. Scott described it as an almost literal way of inviting physicians into the administration's home. It tells them they are part of the team, not people waiting outside a locked door.

Physician burnout is one of healthcare's biggest challenges, and Scott believes much of it comes from feeling shut out of decisions. Sometimes, he admitted, it is his own fault for not communicating the direction clearly enough. Open doors, honest conversations about what a decision means for each practice, and even a little laughter go a long way. He is a big fan of laughter as medicine, and he and several physicians have shown up in costume on holidays.

What belonging looks like in practice

Belonging is often discussed as a feeling. Scott's habits show it is also a set of decisions leaders make about where they spend their time and who gets access to them.

• When did you last ask for feedback, and how did you respond when you got it?
• Which department could you spend a few hours inside this month, doing real work?
• What space in your organization signals who matters, and who could you open it to?
• When frontline staff warn you about something, do you assume you already know better?

The boss Scott watched at 23 probably never knew how much that moment would shape a future hospital president. Every leader is modeling something for someone, whether they realize it or not.

You can watch my full conversation with Scott in Leading with Empathy, part of the Belonging and Retention season.

Leaders who receive feedback well and open their doors to the people doing the work earn something no title can provide: the truth.

Want to explore these ideas further? Learn more about my work on leadership, identity and conviction at www.theglennllopis.com.