Hospital Impact—Reflections on gratitude from a 'restructured' healthcare executive

Executive looking out window
It is not easy to stop and reflect when operating a hospital, but one executive got a chance after getting the news that he was being let go. (Getty/Tom Merton)
Mike Heenan

As I walked to where my colleagues were hosting a tea in my honor, I couldn’t help but think it seemed like a funeral.

Everyone knows the merger of three hospitals is happening, but for them there is “afterlife”—for me, my fate has been chosen. Despite four-plus years as an executive and helping build the merger, I was not selected to serve on the executive team. What is one to say at their own eulogy?

I was fortunate. I was not being walked out the door. I was treated with dignity and could plan my departure.


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While staff only heard the news a week earlier, I knew about my departure 10 days ahead of the announcement. My CEO asked me to keep the information private so other announcements could be planned. This was not easy—how do I be “all-in” for 10 days knowing the future will not involve me? How do I keep my emotions in check in front of colleagues, board members, the community and staff?

One could simply walk away, but that would not be right. I was taught to leave an organization with the dignity in which you entered it. But this was not of my choosing. There are many emotions I experienced while being restructured: bewilderment, sadness, anxiety, relief, jealousy and anger.

After discussions with a coach, we landed on the concept of gratitude. For the 10 days I had to show up and be all-in, I would approach each day with a sense of appreciation. Whether it was presenting data, conducting community consultations, facilitating a planning session or walking a patient to a clinic, I would think about what I did to get the organization to where it was.

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It was magical. As day one turned into day 10, I started to appreciate the journey of the past four-plus years and the organization I served. I thought not just of my role, but the people I worked with and their passion for patients. I thought of our outcomes and how we helped patients get home safely after receiving care. And I thought of the patients who trusted us to involve them as community advisory members.

In those 10 days, I also participated in the final merger meeting, during which the speakers highlighted the historical moment that had occurred. Three hospitals coming together was monumental, and I am glad I helped build the future organization.

As I walked to my car, I thought of our frontline physicians and staff, who create history every day. They enter an institution whose customers truly don’t want to be there and are sick and anxious. Patients need us, but they truly don’t want us. Yet our staff welcomes them with open arms. They comfort them. They let them know everything’s OK. Physicians, staff and volunteers play an important role in the milestones of another human being’s life. That’s the history that really matters.

I’ve been lucky enough to see it for more than 15 years. I have witnessed the power of two people, clinician and patient, coming together to trust each other for an improved outcome. And that is what drives me—helping clinicians do what they do best, which is care for patients. As I depart this phase of my career, I am not sure what the next phase will entail, so I share a few thoughts from my 10 days of gratitude:

  • First, as the sector experiences more integration, I hope board members, senior leaders and policymakers remember the work of all those who were with me that day. For it is that single interaction between patient and provider that really matters.
  • Second, I hope leaders never lose focus on the patient. If we put the patient in the center of our compass, we have the power to make monumental change.
  • Third, I hope clinical and corporate leaders realize the power of true collaboration. To that end, I encourage clinical leaders to stop using the words “nonclinical” when describing their administrative colleagues. The word “non” in the Merriam-Webster dictionary means unimportant. Corporate leaders chose to work in the sector to help patients, and their dignity matters. To my corporate colleagues, you must understand how hard clinical operations truly are. Get out of your office and shadow a doctor, a nurse or attend a unit huddle. To be a true healthcare partner, you need to see patient care firsthand.
  • Fourth, I hope leaders adopt evidence-based leadership practices. We do not need to run healthcare like a business, but management tools help us improve.

Finally, I hope people across the sector take care of each other. It is important, hard work that you do. Workplace violence is rising, and we must create safe working environments to create safe care.

I hope the leaders with me that day do not go through being “restructured.” It is not fun. But I am grateful I got 10 days to consider the positives of our work. It is not always easy to stop and reflect when operating a hospital. We undoubtedly have improvements to make in patient safety and experience, but I encourage leaders to pause, appreciate what great work you do and how you can leverage those lessons to enhance future outcomes. I know I will.

Mike Heenan, MBA, is a Canadian healthcare executive, consultant and an assistant professor at McMaster University who previously served as the vice president of strategy communications and organizational effectiveness at St. Joseph’s Health Centre in Toronto.

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