Q: Why did you decide to move from serving as an ASC administrator to hospital CEO?
William Stangl: I’ve been in healthcare my entire career. I do have some military experience, and once I got out of the military, I filled a series of leadership positions that went from public health to cancer center to hospital and physician practices. From there, I made the jump to the surgery center, and then the jump to this position as hospital CEO. There was actually another step between those two, where I worked in a hospital outpatient department. I’d been involved in hospital senior leadership before, and that broad background gave me the experience and knowledge to fill a position like this.
[Hospital leadership] is something that I always wanted to do. Many classes and other educational opportunities provided varied training — [on topics] from leadership to patient satisfaction — that were extremely beneficial. I put in many more hours because there is a lot to learn, more areas of responsibility and it therefore takes more time to build the environment the way you want it to be.
Q: What has surprised you the most about becoming a hospital CEO? How does the job differ from leading an ASC?
WS: The job is broader in scope, and relationship-building is even more important. There are more people that you must influence, and you have to be able to delegate. You actually have staff to rely on, so you don’t have to do everything yourself. Leadership is certainly more evident in the hospital, and the ability to influence people and develop relationships with people comes to the top.
I think you really need to make an effort to be visible in the hospital — out there with your staff, not just secluded in your office. Although we know there are meetings to go to and other commitments, you have to be out there among the staff and the patients. And one of the most important things is the relationship with physicians.
Q: What issues get in the way of successful hospital/physician relationships, in your experience?
WS: I think because I’ve actually managed physician practices and been there, it really helps to understand the stresses that are put on the physicians on a daily basis. Whether they’re employed or independent, they’re still trying to provide good medicine and manage their own businesses in the best way possible. It’s important to recognize their needs and also try to develop goals that are acceptable for everyone.
I think common goals and communication are important because [physicians and hospitals don’t always see eye-to-eye]. Hospitals may be looking for physicians to cover the call schedule for emergency room services, and physicians are trying to achieve a certain quality of life and balance that they have going on in their practices. Somewhere in the middle is the area where you can both agree and go from there.
Q: How do you feel your work as an ASC administrator prepared you to run a hospital?
WS: I think some of the basic skills are necessary, such as organizational skills and the ability to multi-task. The ability to work with others is important, too. ASCs have their own rules and regulations that need to be followed, and this is even more important in the hospital setting.
Q: What would you tell hospital CEOs about ASCs that they might not know?
WS: You can run things more efficiently and improve satisfaction [relatively easily in a surgery center]. It is extremely difficult to enact change, create efficiencies and achieve significant gains in patient satisfaction in the hospital. In the surgery center, you almost take these things for granted, and trying to move things along in a large institution takes a lot more effort. It also takes a lot more support from the people that are involved and the staff in the hospital.
Q: Conversely, what would you tell ASC administrators about hospital leadership?
WS: There’s certainly a lot more to know [as a hospital leader]. Relationships are key. And probably even as important — if not more important — is to be out there among your employees on a regular basis and to listen to them and to be open to their ideas. It’s important from a leadership perspective to do what you say you’re going to do. If you say you’re going to make something better or buy new equipment or hire new staff, you have to do it on time.
Q: What do you find the most rewarding aspect of both positions? The most challenging?
WS: I think the most rewarding for both has always been the patient and the patient care — to see someone come in when they’re injured or sick and have such a good staff and physician interaction. I think a really good patience experience and outcome is really satisfying and rewarding. And having a patient and their family have that exceptional experience is really a reward.
The most challenging aspect of both roles is the changes in payor reimbursement. Everyone is fighting that, whether you’re an ASC or a hospital. The regulations and rules that the government enacts are often unfunded mandates that cause problems for both organizations. I think that across the board, it’s important to have good people and good fits in your organization that can support leadership and their vision for the future.
Q: How do you see the relationship between hospitals and ASCs evolving over the next few years?
WS: Depending on regulatory issues, hospitals and ASCs might be forced to work together. When you talk about accountable care organizations, they may be in the same boat in those organizations, working together to deliver care at a lower cost to those covered lives.
Related Articles on ASC Operations:
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5 Things to Remember When Adding Spine to Your Surgery Center
