Thursday, September 04, 2008

Health Care Leaders at 30,000 Feet

The Times of Trenton (New Jersey, USA) reported this insight about the leadership of large health care organizations:

Bristol-Myers Squibb [BMS] is preparing to shut down its aviation operation at Trenton-Mercer Airport, sell four aircraft and dismiss about 32 employees as the drugmaker and leading Mercer County employer seeks to cut costs, according to sources familiar with the company's plans.

The company will sell its two Gulfstream V jets and two Sikorsky S-76C helicopters, terminate pilots, mechanics and other personnel, and move out of its hangar at the airport in Ewing.

Other corporations with aviation operations at the airport include Unisys and drugmakers Pfizer, Johnson & Johnson and Merck, Hughes said.

Bristol-Myers' two jets could sell for approximately $40 million each depending on their age....

The helicopters could fetch $6 million each, according to and other sources.

It is understandable that BMS, having some rough financial times, and operating under a corporate integrity agreement (see post here), wanted to cut costs. This post is not about criticizing the company's plans to shut down its aviation operation.

What is striking is how this short news article opens a window into the lives of the top leaders of at least some of the largest health care organizations. (Note the reference to the aviation operations of Pfizer, Johnson & Johnson, and Merck in the article.) Although the article did not explain why BMS operated two Gulfstream V jets, and two Sikorsky helicopters, it is hard to see how they might be used other than to transport top corporate leaders in the style and with the convenience to which they have become accustomed.

Thus, this aviation operation symbolizes how top health care organizations have come to serve their leadership more than any other constituency. It may reflect the belief, heavily promulgated in the last two decades, mainly by these top leaders and their advocates, that CEOs and other top leaders are not like you and me. Their work is so important, their insights so brilliant, and their time so valuable that they do ought have to deal with the more mundane tasks of life, like waiting in an airport departure lounge for a delayed connection.

The notion that corporate CEOs and other leaders are inherently so brilliant and their time is so valuable can be argued.

More important, in my humble opinion, may be the effects on these particular organizational employees' values and beliefs of how they are buffered from real life. Remember that what used to be called "ethical pharmaceuticals" are meant to relieve symptoms, mitigate disability, and even sometimes cure the diseases of individual patients. Understanding how well they do so requires some understanding of the lives of the ordinary people who take them. Yet the leaders of pharmaceutical companies have now been increasingly protected from experiencing the vicissitudes of life that their patients or clients, or employees for that matter, experience.

In fact, the leaders of smaller, and even not-for-profit health care organizations may also be protected from such vicissitudes, although perhaps not quite so much as the CEOs of large corporations. For example, many presidents of the universities that house medical schools, while they do not have access to corporate jets, do live in fully staffed houses and are transported by university supplied cars driven by university supplied drivers.

I would argue that thus the leaders of these organizations come to identify more with their fellow members of the power elite than they do with patients, clients, students, employees, and health care professionals. Hence, their ability to understand at a gut level what health care is all about is diluted, especially as they sit in the back of their chauffeured automobiles, or especially in the luxurious cabin of a Gulfstream V at 30,000 feet watching the world go by below.

(For some idea of this experience, see the Gulfstream web-site here.)

Hence, I suggest that to improve the leadership of health care organizations, we must make sure that they have a better understanding of the real life in which their products and services are used.

Hat tip to Ed Silverman on the PharmaLot blog.

(For discussion of Pfizer's fleet of aircraft, see posts here and here by Dr Peter Rost, and this post on PharmaLot.)


MedInformaticsMD said...

Merck's former VP for Research IT commuted into Nj and Philadelphia from the Minneapolis area, and I do not believe commercial aviation was involved.

I also observe corporate helichoppers daily as I live a mile from West Point, PA.

The commute between three Merck sites (West Point, Rahway, Whitehouse Station) by car is about 1.5-2 hours. I know; I used to drive it.

Having a video workstation-equipped limo must be too expensive.

Anonymous said...

they should sell it to carilion's corner office inhabitant. nz