I don't know if Joly made these visits a regular feature of his tenure; I hope so, because working with the front line really makes an impact when it's done repeatedly. Our leadership team joins line workers at Scripps in a number of capacities, and it has become essential to our success. Once a year, for instance, as part of my ongoing training as an emergency medical technician, I trade in my suit for some scrubs and work in one of our emergency rooms as a technical partner. In a hospital, a technical partner works for and assists the nursing team; he's the person making and cleaning the beds, getting supplies, doing EKGs, taking blood pressures, and the like. During my shift, I'll tell the nurses not to treat me as the CEO, but as their trainee and subordinate. “I'm working for you,” I'll say, “because you know more than I do about the work I'm doing today. So please guide me and help me to help you!”
And make no mistake, my gesture is not a put-on. It's real. Once, on my shift, a trauma came in, and the nurses had me throw on a lead protective apron (required during X-rays) and go up to the heliport with a nurse to accept a critical patient from the flight crew. Back in the trauma room, the surgeon had me stand right next to him. “Okay,” he said, “you're going to help me deliver care. The patient has bilateral fractures from a motorcycle accident.” And there I was, assisting the surgeon and nurses until the patient went to surgery. Although any assistance I provided was very limited and took place only under their complete guidance, I still soaked in the complexity of what the other caregivers were doing as well as the compassion with which they were delivering care. These professionals probably didn't have the knowledge or experience to run the whole health care system, but I couldn't do their jobs either. We had a lot to learn from each other. This meant that I needed to consult with them on decisions, not just assume I knew best because I had the “top job.”
Obviously it's not possible to try everybody's job in your organization. But no matter what industry you're in or the size of your business, there are many ways to get a regular array of front-line experiences. One of my favorites is volunteering. I like to get out of the boardroom to teach first-aid classes to our front-line, nonclinical staff. This not only gives me another perspective on health care delivery but also allows me to engage with staff in an entirely different way. When I'm teaching, I'm no longer the CEO; I'm just another first-aid instructor.
For over a decade now, I have volunteered several times a month with the San Diego County Sheriff's Department Search and Rescue team; I hold the rank of Reserve Assistant Sheriff and am responsible for search and rescue and law enforcement reserves. The assignment gets me outdoors – hiking, rappelling, and driving around in the backcountry on 4x4s. The work is sobering, though; we search isolated, rural areas for people lost or stranded and in need of help, and we also perform searches for dead bodies and crime-related evidence. On one occasion, my team was out in the wilderness doing an event to raise awareness about search and rescue. Toward the end of the day, a young woman riding her horse past the event lost control. After hanging on for a quarter of a mile, she fell off, sustaining moderate injuries. I chased her down in one of our rescue vehicles and, along with some colleagues, provided first responder care. Afterward we placed her on a backboard and readied her for transport to the hospital.
I followed the ambulance to Scripps La Jolla and went inside, still wearing my sheriff's department uniform. The nurses on duty looked at me funny – they knew me, because this was the hospital where I did my EMT training, and they were not used to seeing me in this uniform. I asked how the injured woman was doing, and they told me she was fine and in a nearby room with her mother. I went to visit her and introduced myself. Her mother was surprised to learn that the CEO had been directly caring for her daughter. That meant a lot to her. And, as our chief medical officer has told me, my work in the field means a lot to our staff too.
I'm lucky to have a wife who gives me leeway during my off hours to volunteer like this. Rosemary herself volunteers on the front line, which further helps me build a strong relationship with our workforce. Rosemary loves dogs, and she enjoys bringing our Labrador retriever into Scripps facilities for pet therapy visits. Certified therapy dogs like our Amber help alleviate stress and even pain for patients and staff. In her presence, patients feel connected to their homes and their own pets, and they're distracted for a moment from being in a hospital.
Rosemary visits with Amber as often as she can, sometimes a couple of times a week, so she's a familiar sight around Scripps. She doesn't announce that she's my wife, but when someone recognizes her, she'll confirm that she's married to me. Thanks to these little moments, people seem to understand that I'm not just “the CEO” but a regular guy with a wife and a dog. From that, they feel that much better about their own jobs and the organization for which they work.
To be clear, I don't volunteer on search and rescue or as a first-aid instructor specifically seeking to make an impression on front-line personnel and patients. If that were the case, my efforts would probably appear contrived. I volunteer because as a former police officer, I feel fulfilled protecting people and rendering assistance in their time of need. If you're a manager or executive and you're interested in having more of a presence on the front line, find something you're passionate about and volunteer for its own sake. The benefits of staying close to line employees will emerge in due course, without your having to make a special effort. You'll be surprised how enjoyable you'll find it and how much it helps you as a leader.
Do Your Dance
It can be difficult to attribute a clear, quantitative business benefit to time spent on the front line or to any other tactic presented in this book; determining causality is just too complicated. The incredible financial and operational results we've seen at Scripps have resulted from many tactics working together over a period of years. Yet the physical presence of a leader is powerful – I know, because I've seen its effects firsthand.
In 1997, I left a position as CEO of Anaheim Memorial Hospital, a 240-bed facility, and took over as CEO of Long Beach Memorial Medical Center, a much larger, 700-bed facility. The Medical Center had a long central corridor that stretched from the Children's Hospital to the Women's Hospital all the way to the Rehabilitation Hospital and an attached skilled nursing facility. This corridor was so big that at any given time you might see hundreds of employees walking from place to place. What I noticed immediately upon joining Long Beach Memorial was that very few of the employees said hello to one another. They were all rushing, paying little attention. It was a huge difference from Anaheim Memorial, where everyone greeted each other by name.
Witnessing people walk right past one another made me uncomfortable, so I decided, in a small way, to do something about it. I began walking that corridor and saying hello to as many people as I could. This wasn't easy at first: because I was the new CEO, many people didn't recognize me. And because they walked with their heads down, staring at the floor, I literally had to duck down in order to make eye contact and say, “Hey there! How are you?”
I kept doing this, month after month. I also used these walks to rub scuff marks off the floor with my leather-bottomed shoe. After about a year, I began to notice a change. People were looking up more, even saying hello to me. More important, they were saying hello to one another. The whole atmosphere became friendlier. People began to joke about my habit of rubbing off scuff marks, calling my particular style of walking the “CEO walk.” Eventually one of my managers dubbed it the “Van Gorder dance.” Other employees and managers started doing the dance (which incidentally resulted in noticeably cleaner floors). The entire culture of this relatively large organization began to shift, perhaps in part because their leader had left the boardroom and was regularly engaging with the workforce.
Of course, there was more to that story. In a large organization, cultural change occurs only if everyone in a supervisory capacity