Results in the Hospital

“RESULTS” IN THE HOSPITAL

Robert Armstrong joined the struggling family company when he came out of the

navy. A few years later, his father died suddenly and Armstrong took over what

was then a very small, indeed, practically a marginal business. For more than

twenty years the business took all his time—or almost all of it. For Armstrong had

always had a strong interest in health care. As a youngster he had thought

seriously of going to medical school and might have done so had he not been

drafted while in college. He therefore began to work for one of the major

community hospitals in his metropolitan area almost immediately. He was elected

to the hospital’s board in 1985 and became chairman of the board in 1995.

Armstrong took these duties seriously and gave unstintingly of his time and

energy. By the early 2000s, the Armstrong Company had become a substantial

business. Robert Armstrong, who alone had been “the management” twenty

years earlier, had built what he considered an unusually competent management

team. Though Armstrong was still in his early fifties, business had begun to bore

him. He had also begun to resent the heavy travel schedule that the business

imposed on him. When the administrator of the hospital suddenly suffered a

stroke and had to retire, the Board appointed a selection committee to choose a

replacement and named Robert Armstrong its chairman. Before the first meeting

of the committee, Armstrong met with the hospital’s chief of Medical Services—a

respected physician who had also for many years been Armstrong’s personal

doctor—to decide with him what kind of a man the committee should be looking

for. To Armstrong’s total surprise, the doctor said, “Look, Bob, cut out the

nonsense. You don’t have to look for the man to head up St. Luke’s. You are the

man. No one knows more about the place than you do. No one is better accepted.

And I know—you told me so last October at your annual physical—that your

present job bores you, that they don’t need you in the company anymore, and

that you and Libby are tired of your eternal traveling. All right, so you are making

a great deal more dough as president of Armstrong than we pay a hospital

administrator. But you have enough money and don’t need a big income. Hospital

administrators aren’t that badly paid. They make as much as you pay your vice

presidents—at least that’s what you told us when we last raised the

administrator’s salary in the board meeting six months ago.” The more Armstrong

thought about this, the more sense it made to him. But also, the more he

thought, the more uneasy he became about his ability to do the job. He went

back to the doctor and said, “If I take this job, how do I measure my performance?

2

What results should I be after? What is performance in a hospital, and what are

results?” The doctor grinned broadly and said, “I knew you’d ask those questions

and that’s why I’d love to see you take the job. I know what results are in my work

and in my practice. But neither I nor anyone else knows what they are for the

hospital. Maybe it’s time some disagreeable type like you asks these questions.”

Armstrong took the job and soon became known as one of the most