Tea Bags, Boomerangs and Yardsticks

Speaker Name: Suzanne H. Freeman
Speaker Title: President
Speaker Company: Carolinas Medical Center
Carolinas Medical Center Website

Suzanne H. FreemanThank you for the generous introduction. Good afternoon Chancellor Peacock, Senator Broyhill, Dean Edwards, faculty, students and guests. It is an honor to be among you today.

Appalachian State University must be among the most fabulous places on earth! And it is being led by one of a truly outstanding executive. Here on this campus you have a front row seat to observe and interact with one of the most capable and visible leaders in higher education. Chancellor Peacock is a role model for any business or academic organization.

As students, you are our future. As faculty and mentors, you are preparing the citizens of tomorrow. I thank you and admire the work you do. I know that it takes intellect, passion, patience and creativity to prepare tomorrow’s leaders for the world they will inherit. It is for all of you that I deliver this message.

This afternoon, I am going to weave the fabric of my journey from novice nurse to president of Carolinas Medical Center. CMC is an academic medical center with an incredible variety of services. We offer the highest level of emergency and trauma care. We do all kinds of lifesaving transplants, including heart transplants. We are about to open an $85 million children’s hospital which will be the best facility of its kind between Washington and Atlanta. CMC is a place where people facing some of the most serious imaginable conditions find caring, healing and comfort.

Before I begin I want to paint a brief picture on what our nation is facing in terms of healthcare delivery. This will provide some context for understanding the challenges that healthcare leaders like me face every day.

Today, healthcare costs comprise 16% of the gross domestic product, and that figure is expected to rise to 20% by the year 2015, unless we as a nation take measures to better control it. America spends nearly $2 trillion on healthcare annually, and that figure could easily double to $4 trillion over the next eight years.

Those without insurance in our country number approximately 47 million. That represents more than 15% of the overall population. Nearly four-out-of-five of those who are uninsured come from working families.

The cost of care to these people is ultimately borne by government, employers, people with insurance, hospitals, physicians and other sources.

When I go to work every day I confront a variety of problems, many of which are exacerbated by lack of reimbursement for the care we deliver. Members of the public do expect, and should expect, that they have a right to receive competent, cost-effective healthcare. However, those responsible for providing such care also must deal with a wide variety of complications. These include:

  • A high degree of government regulation
  • A constant threat of litigation, much of it frivolous
  • Lack of access by those who could benefit from medical services
  • The costs of uncompensated preventive care
  • Consumer expectations, up to and including “futile care”
  • Modernization of systems, to deliver safer care
  • Implementation of new information management systems to facilitate the maintenance and distribution of patient medical records
  • The costs of new technology
  • The costs of pharmacology
  • Securing an adequately educated and trained workforce, especially physicians and nurses.

While I don’t have time to address these issues per se, I hope the list will enable you to imagine the complexities of being a hospital administrator. Those in my profession experience a constant balancing act between compassion and pragmatism. We are mission-driven, but we must have strong business acumen in order to accomplish that mission.

Let me bring things down to a more personal level. Despite the seemingly overwhelming challenges in operating a healthcare organization, one can carve out a small niche and make a difference.

I want to elaborate a bit on how I came from a supportive, spiritual family environment to become a wife, mother and busy professional. I hope you can find something in this story which will help you in finding a happy, purposeful and balanced life.

I also want to talk about the components of successful leadership, especially in these dynamic times. I will give you some insight into the characteristics which, I believe, could serve as bedrock for your life and career. Hopefully you will find something in my message which is readily adaptable to your world.

Listen to this quote from Pablo Picasso.

“My mother said to me, ‘If you become a soldier, you’ll be a general; if you become a monk, you’ll end up as the Pope.’ Instead, I became a painter and wound up as Picasso.”

Well, I am hopeful that my children have gathered the same level of self-confidence from me that Picasso gleaned from his mother. My goal for them was to accomplish whatever they set out to do, including — but not limited to — being an influential leader in their chosen field. The rearing of my children has been the most important and rewarding part of my life. The privilege and responsibility of parenting is something that helps to secure the future of the world.

First let me say a few words about my family. I have a husband, John, and three wonderful, now-adult children. Kathryn is in the audience. She is a junior here at ASU studying criminal justice. She is a beautiful young woman who will leave an indelible mark on our world as she seeks to ensure justice and peace.

Stefanie, our middle child, is a graduate of The Georgia Institute of Technology, a mechanical engineer and talented artist. Stefanie is designing power plants with an engineering firm in Charlotte.

Jason, our oldest, a lover of the great outdoors, graduated from Western Carolina University. He works with his father in the family swimming pool supply business.

My parents are also in the audience today. One could not ask for a more loving and dedicated pair.

I came from a family deeply rooted in North Carolina. We have found evidence of our German Lutheran ancestors living here in North Carolina as early as 1737. It always amazes me that I can identify so strongly with what they must have been like. I know they forged a living out of the land in Davidson and Rowan Counties.

I can only imagine how strong their work ethic must have been, and how firm their religious beliefs must have been, to sustain them. All of these character traits still translate today, down through multiple generations over a 270-year period. How powerful their resolve must have been, to have their values being passed along nearly three centuries later!

I was fortunate to have known five great-grandparents and four grandparents well into my adult life. This unusual experience, together with being the oldest of five siblings, was certainly definitive in making me who I am.

From the time of early childhood, it seemed that I was destined to lead others, to care for others, and to find purposeful work.

I loved to spend time with my elders, listening to their stories of the past, understanding their lessons, and — later on — supporting them during periods of chronic or acute illness as they aged. From very early on, my child’s play was often as a nurse and always one who was "in charge" of whatever situation needed a leader at the time.

By the time I was finishing high school, my ambitions had narrowed to being an educator or nurse. I started my college days right here at Appalachian. I had wonderful professors and teachers here, especially in zoology and mathematics. During my time here at ASU, in my freshman year, it became clear that nursing was to be my future.

After transferring to UNC-Charlotte, my passion was further realized as I entered the nursing curriculum. I now had clarity about what I was to be. My curiosity about sciences, health, leadership and purpose all coalesced. I found that nursing was an excellent foundational program, and one which provided a basic framework for problem-solving and decision-making. Again, another outstanding group of teachers inspired me to work hard and fulfill my passion. Nonetheless, I have since come to understand that my nursing degree was merely the first step in an ongoing quest to find fulfillment.

I began work as a staff nurse immediately following graduation, and within six months I was in a leadership position within my department. From there, I mastered additional leadership functions, each providing expanding opportunities for responsibility and education.

There were some critical elements, however, that continued to fuel my excitement about what I was doing. First, I was making a difference in the health or comfort of patients on an ever-expanding basis. Secondly, I was inspiring my colleagues and support staff to provide compassionate care in creative, innovative ways, and that seemed to strike a positive note with them. We designed changes in our delivery of care that improved our efficiency while enhancing patient perceptions about their experience in the hospital.

By now I had become chief nurse executive and vice president of the hospital, with responsibility for several thousand employees and an operating budget of $100 million. It didn’t take long to realize that I needed a very different type of education to stay in the game with seasoned business executives who had now become my colleagues.

It was then that I switched gears and completed the work for a master’s degree in business administration.

Over the next 10 years I continued to expand my responsibilities until ultimately I became the President of Carolinas Medical Center.

Meanwhile, back at home, I was still a wife and mother. I continued to work full-time, taking time off only to give birth to our three children, with a brief maternity leave for each. John and I were taking turns doing housework, helping with homework, teaching values to our children, ensuring their spiritual development, and taking them to their sports events, practices and school functions. How did we ever pull this off? Well, it was our passion and love for what we were doing that made it happen.

This is where a quote from Nancy Reagan seems to fit: "A woman is like a tea bag. You cannot tell how strong she is until you put her in hot water."

Although I certainly cannot take sole credit for accomplishing such an important feat, I will tell you that I learned a lot about what one can accomplish if appropriately focused. It took exceptional strength to get through those days. I was balancing my natural temperament with the challenges of motherhood in the evenings and by day, business decisions and business relationships commensurate with an ever-changing healthcare industry. I found out just how much strength I had.

Florence Shinn, an author, artist and metaphysics teacher stated: "The game of life is the game of boomerangs. Our thoughts, deeds and words return to us sooner or later, with astounding accuracy."

It is essential to appreciate the fact that each of us creates our own destiny. I always remember the thought that "if you have no destination, any path will take you there."

It is essential to bring children up with "intention". It is also essential to lead organizations with "intention". The similarities in the roles of business leadership and parenting are evident. Again, life is a game of boomerangs. Our thoughts, deeds and words return to us sooner or later, with astounding accuracy. Without question, you reap what you sow.

That is the most basic principle which has guided me as I have parented and as I have attempted to lead. Have I been perfect? Certainly, not. But here are some of the bedrock elements which I believe are absolutely essential for success:

  1. You must have a strong spiritual base.
  2. You must have a purpose.
  3. You must have passion.
  4. You must have integrity.
  5. You must treasure education.
  6. You must be firm, resolute and committed in your beliefs and actions.
  7. You must consider various avenues of approach when making a decision. Select the best option.
  8. You must learn from your mistakes and in the future, make better decisions based upon your lessons from those mistakes.
  9. You must be clear and concise in communication.
  10. You must value people and surround yourself with those who exude qualities you value.
  11. You must treat them with respect and recognize their value.
  12. You must have confidence in yourself and be optimistic.
  13. You must be highly visible.
  14. You must celebrate successes

If you make an incremental investment in leadership each and every day — whether you are raising children or executing your professional duties — you will ultimately produce a measurable outcome. Each investment may be small, but every single investment is essential to the final product.

It is the way we live every day that results in a final outcome. Truly outstanding and successful people put a priority on principles, cause, mission and the work they do. They do this long before pursuing any selfish interest in their own well-being.

Yes, life is a boomerang. The investments you make create the results that you will reap.

Let’s elaborate on leadership for a moment. Leadership only exists when people follow, and you must always understand that people have the freedom not to follow.

I will say that again: Leadership only exists when people follow, even if they have freedom not to follow.

According to Jim Collins, author of the book Good to Great, there are essentially two types of leadership: "executive" and "legislative."

In "executive" leadership, an appointed leader has enough authority and concentrated power to make a decision. I have also heard this referred to as "positional power".

In "legislative" leadership, no leader has enough "structural power" to make a decision alone. The legislative leader must rely on persuasion or political capital. It is only under a circumstance of facilitated consensus that decisions can ultimately be made and carried out.

In today’s world of transparency, ethical questioning and rapid cultural change, the executive style of leadership is rapidly taking a back seat to legislative leadership. I personally favorable the consensus-driven style of management, and follow the legislative model whenever I possibly can.

As a leader, you can function well in the legislative mode if:

  • You have people who are passionate about a common mission or goal.
  • You have people who understand their business and their environment.
  • You have the right people, with the right values, and with the right skill sets and experience.

Leadership only exists when people choose to follow.

And finally let's talk about yardsticks.

Yardsticks are your measures for success. You have the power to choose what those measures are.

I don't know who provided the following quote, but I believe in it: "Success is often the result of spontaneous combustion. You must set yourself on fire."

Success is what you seek when you have passion.

Regardless of the goals and measurements you adopt, remember what Lily Tomlin said: "The road to success is always under construction."

Has my life been successful? Yes, I think so, but I don't say this because of any particular business title or position of power which I have achieved.

My life's success will be measured by what I will leave behind:

  • Children who will make our world better than they found it.
  • A healthcare organization that can sustain the incredible pressures being placed upon it every day.
  • People — and prospective future leaders — whom I have positively influenced along the way.
  • A life well-lived, with a spiritual and moral compass.

Let me conclude with a short piece of verse by Ella Wheeler Wilcox:

One ship sails East,
And another West,
By the self-same winds that blow,
Tis the set of the sails and not the gales,
That tells the way we go.

Thank you for your attention today. I wish you great success and happiness as you go your way.