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Michael Carrese (Host):  Taking on new leadership responsibilities presents new and interesting challenges from working with boards to figuring how to stay in touch with what’s happening on the frontlines. Chris Candela, CEO of McLaren Lapeer Region is here to talk about how he’s managed the changes and opportunities that come with advancing in leadership. This is McLaren Leadership PodCast. I’m Michael Carrese. And Chris Candela, you’ve been in healthcare for 20 years starting on the patient care side, now serving as a CEO. As you rose through the ranks, what were the different skill sets you had to develop or expand upon to be successful at each level?

Christopher Candela CEO (Guest):  Starting off as a clinician, then being a therapist, you have to obviously look at the whole picture of the patient. You have to listen to them describe their issues and try to kind of put a plan to help resolve those issues and then see how those results end up. So, as I transitioned into management leadership; a lot of those skill sets transfer over. So, initially, it was very simple from learning the department operations like scheduling staff, how to look at a budget, how to manage your expenses. Those were kind of the frontline things that I had to get familiar with. And then as I went from there, it was kind of more of the advanced type evaluation of things. So, how do you do service line development and how do you market your product or your service? From there, going into multiple department leadership positions; I kind of took that step back and started the same way.

So, evaluate what’s going on, just like with a patient. Take a minute to learn and understand how the operations work and then start to move into either service line development or expense reduction or productivity. Looking at those things and then seeing how your actions create results. And then if you have to go back and tweak it, just like a patient when you are treating them; it’s the same concept all the way through I think to the position that I’m in today. So, eventually, you have got to get the formal training. I went and got my MBA and you learn all the bigger picture items so that you can use those tools as well as you take on more and more responsibility. So, I found all of it to be very helpful and useful in getting to where I am today.

But at the core, to me, I still approach it very much the same way. Take that time to evaluate and understand and learn the best you can what you are looking to take on and then set that plan from there and then manage and follow the results to see if you are on the right path.

Host:  Do you find yourself still thinking about your patients and how you were able to apply that formula?

Christopher:  Yeah, for sure. I mean I will always love patient care at the base of everything. I was actually involved in sports medicine in my area of rehab so, I really enjoyed that. I got to work with a lot of different levels of athletes, professional and Olympic and so I was very fortunate. So, I do miss actually hands on clinical but I think it’s been very useful for me to relate to things operationally so that I can get the perspective of the clinical side of it and the patient side but then put that together with the business side and understanding the bigger picture and how they’ve got to roll together to be able to always focus on quality and the patient first but if you can do it in a way that helps you stay viable then nobody’s going to win. So, I found it very useful to have that core clinical background for sure.

Host:  So, you ticked off a learning you had to do, the budgeting and evaluating, marketing, service lines; all those sorts of things. So, how do you approach learning? I mean those are pretty big mountains to climb for somebody coming into something new like that.

Christopher:  I get bored easily, used to be the joke. So, I always enjoyed again, something new, but I think the core is taking that time to evaluate it all. And then do your homework, learn as much as you can on how things are supposed to operate and kind of what are the basics to it and then apply the principles that you learn as if it’s your own business. So, I try to enforce that and people that are trying to come up through the ranks today, the same idea that you look at this as if everything that you invested is what you need to have an outcome for.

So, you want to be successful, so you want to take that approach and so, having that understanding and then understanding the principles beyond that all the way from finance to hiring and developing the people underneath you all those things are important. And if you approach it that way, and monitor your results, then as if it were your business; I think you are likely to be successful and if you run into those stumbling blocks; I always start my little speech; I do a new hire luncheon every month. So, every new employee I meet with them and I do a very informal lunch and I tell everybody in the room that I am not proclaiming to be the smartest guy in the organization, and I rely on everybody’s input to be able to make the best decisions. So, that’s something that I really believe in, that you have got to have your ears open and your eyes open. And you pursue a lot of that yourself but then you need the help of others to make sure you are at the end of the day, making the right decision.

And when you run into those blocks, you tap into all your resources including others to manage through that. So, that’s kind of the philosophy I’ve used from day one. You never stop learning like the expression goes and I think that’s true and it continues today for me for sure.

Host:  So, when you were chief operating officer, you obviously have a lot of responsibility, but you are still reporting to a CEO and working to implement his or her strategy. So, I’m wondering if you can talk a little bit the differences and the challenges and the rewards of moving from a COO role to CEO and how do you compare those two?

Christopher:  For me, going from the COO role to your point, there is a – you are running out a lot of strategic planning and operational things from the CEO’s perspective. Luckily, I came from a very good environment where my CEO gave me a lot of various responsibilities and gave me a lot of freedom to figure out how to manage that and work through things. So, it was a great learning for me. I think there’s a comfort when you are the COO to some extent to say heh if I run into this problem; I’ve got somebody right down the hall to say this is what’s been going on, this is how I approached it and maybe this is the problem that I ran into and get a little bit of counsel to get through that final piece.

So, that difference when you move into the CEO position; there’s always a resource if you need it but at the end of the day; now the strategies are really driven from myself and there’s a little bit more problem solving that needs to happen along with strategic planning and things like that, that you have to factor in. But again, for me, the COO step was invaluable because my approaches I felt responsible for the operations of the whole hospital and every service and that’s very similar obviously, when you are the CEO, that everything, everything really reports to you and comes from you. So, to me, it was a good stepping stone and again, coming from the leader that I was working under; I think I was very well-prepared to step into this role.

Host:  Yeah, both big jobs to be sure. So, for a lot of leaders, as they move up the ladder; they move away from hands on roles, it is just part of your reality. You don’t have time to do hands on stuff as much anymore. And the question comes, how do you decide what to delegate and what to stay close to as you are moving up and is that determined you think by reporting structure or are there other factors involved?

Christopher:  That’s where I start personally, that it is based on who is responsible for what and so, I always try to give the framework, give the expectation and set the framework and then give the person the freedom to figure out how to get the job done from that point. For me, it’s always easiest the more everybody else can do independently obviously, so I don’t try to micromanage. But obviously, I’m a believer in accountability and timelines and things like that. So, I’ve taken the approach and I tell my leaders that if I don’t have to call you up frequently and micromanage you; that’s a good thing because you’re doing what I need you to do.

If I am more in your business on a routine basis; that’s probably a sign that I’m not getting what I need obviously, so, I’m going to – I can be more hands on if necessary to get to where we need to be but I really try to promote that autonomy and let people develop independently much like how I was given those reigns and I think it’s really a benefit to be able to work through things and problem solve and take a lot of that on of yourself.

So, for me, it’s fun at times, you know to stay into it hands on but obviously, there’s a lot going on from the CEO level, so you just don’t have the opportunity to do that on a routine basis. But things that are vital, things that are important for me personally, when you are coming up on inspections as an example or there’s a problem area of the hospital obviously, I’m more hands on in those scenarios to make sure that we get to where we need to be but for the most part globally; I prefer to let others develop and try to run with the ball.

Host:  So, as a first time CEO, there may be more focus on the role from the board, other stakeholders in the community So, how do you address that and does that impact the strategy and goals that you are setting for McLaren Lapeer?

Christopher:  Yes, I think it has. It creates more awareness I guess I would say. So, coming into at my scenario, a long time CEO who worked with a lot of the folks in the community and the board. They had a trust factor with the person. They were successful here. So, I knew coming in, there would be potentially a little bit more scrutiny and maybe a little bit more of a closer watch on what I was doing. But again, my approach has always been collaborative so, I try to keep lines of communication open. I talk to the board chair and the board on regular basis, let them know kind of the direction that I was looking to take after looking at the data and doing the homework and the due diligence that’s necessary. I didn’t come in and try to upset the apple cart on day one.

So, I still took that same approach of taking time to observe, listen and look around and then gradually move into where you think things can be improved or where the direction you think you want to go and then communicated and kept those line of communication going. So, to me, it was – it ended up being good. I had a very supportive board and a very supportive community and so they embraced me with open arms. So I was fortunate. But I think as well I tried to be transparent and tried to be logical in my approach deliberately so that they had a comfort level to see I wasn’t just doing things in isolation or going off the reservation and doing something that they hadn’t seen before and ask questions as to why.

I tried to preempt that by being communicative and open.

Host:  So, as we are wrapping up, if you could boil it down a couple of sentences of advice for those who are new to a leadership role and what would you say?

Christopher:  I would say if you are new in a leadership role; you have got to take the time to learn that area or that responsibility that you are coming into. Use your resources. Listen to people. Observe and then take those steps very diligently towards change and be open and again, communicate well. But then always see and circle back and close the loop to how are you impacting things and how are the results that you are getting. How do they look? And it’s always dynamic. You have got to be flexible. I think you have just got to take your time and work through it but, the fundamentals are always the same. It’s all about finances, and communication and system development and service development. It’s all kind of always the core issues that you have to look at. But it’s really very similar when you start from the ground floor up to a CEO level. A lot of the things transcend and are the same. So, just do your homework would be my underlying theme, I guess.

Host:  A lot of good advice there and I’m afraid we are going to have to wrap it up. You’ve been listening to Chris Candela, CEO of McLaren Lapeer Region on this edition of McLaren Leader Cast. Thanks for joining us.