The new chief medical officer of Memorial Healthcare System seeks to build relationships, foster trust, and embrace teamwork.
Servant leadership embraces a team approach and facilitates everyone's ability to succeed, says Aharon Sareli, MD, the new chief medical officer of Memorial Healthcare System.
Sareli was named CMO of the Hollywood, Florida-based health system last month. He first joined Memorial Healthcare System as an intensivist in 2009. He was appointed as chief of critical care for the health system in 2012. Sareli was promoted to chief physician executive of the Memorial Physician Group in 2019.
HealthLeaders recently talked with Sareli about a range of issues, including the challenges of serving as CMO, physician engagement, and his learnings from playing a key clinical leadership role during the coronavirus pandemic. The following transcript of that conversation has been edited for clarity and brevity.
HealthLeaders: What do you anticipate will be your biggest challenges serving as CMO of Memorial Healthcare System?
Sareli: In general, there has been a no more difficult time in healthcare than in recent years, with supply chain challenges, labor challenges, external pressures from payers, and expectations from patients as they relate to access and service. With all those pressures in play, the goal of medicine remains the same—to treat the patient and give them the care that they deserve. We must keep our healthcare teams focused on providing that care despite the multitude of external pressures.
I believe the impact that COVID has had on people's mindset is truly coming to bear, and my challenge as CMO is to keep the staff focused on what really matters, which is that we are here to provide patient care. The fact that it has become more difficult than ever is a reality, but our challenge is to focus on the task at hand and not to be distracted by external pressures.
Despite the challenges that are impacting every health system in the United States, we have a health system with a situation that is much better than most health systems nationwide. From a financial position, our health system is strong. We see other health systems posting losses over $1 billion. We see hospitals laying off workers. We see units shutting down because they lack staff. We are fortunate not to be in those positions. Despite that, the challenges on the ground are real. It is important for us to keep perspective and important for us to keep focused on what really matters, which is patient care at the center of all things.
The challenge for me is to keep that message going, to facilitate efficiencies, and to make life easier for the people who are delivering care.
HL: How do you plan to keep the staff focused on patient care despite several challenges?
Sareli: I believe in a servant leadership mentality. For me, one of the key things is strengthening relationships and building new relationships. Ultimately, it is about trust, and it is close to impossible to earn trust without action. At the end of the day, you can say whatever you want, but people care about what you do and not what you say.
I have been in this health system for nearly 15 years. I have a lot of relationships throughout the health system—not only with physicians but also with many others. I believe I am facilitating efficiencies and allowing people to maximize their potential and develop trust in me. A lot of people know who I am, know what I am about, and know that I will inspire through action and not inspire through words.
Aharon Sareli, MD, chief medical officer of Memorial Healthcare System. Photo courtesy of Memorial Healthcare System.
HL: You say you have embraced servant leadership. What is your view of servant leadership, and why do you think it will be effective in the CMO role?
Sareli: Servant leadership is about a team mentality and recognizing that your role on the team is to facilitate everyone else's success. If you can embrace the concept of facilitating the team's success and not focusing entirely on your individual goals, that is a recipe for servant leadership. It's more about listening. It's more about common purpose. It's about establishing trust and allowing the leaders around you to realize their maximal potential and make meaningful changes.
A single person, no matter how many balls they have flying in the air, can only achieve so much. My true impact comes from the servant leadership model, where I am enabling others to rise to their true potential. Especially in the CMO role, where the scope of work that needs to be done is huge, the best path to success is the servant leadership model. I believe other approaches are susceptible to failure because I can only succeed in my role by all the people around me reaching their full potential and maximizing the impact they make.
HL: You served as chief physician executive of the Memorial Physician Group. What are the primary elements of physician engagement?
Sareli: This boils down to relationships and a matter of trust. You must build common purpose. You must have people around you—your clinical leaders. You must have those relationships and foundational trust, and you must build on that trust not by what you say but by what you do.
You also must listen more and talk less. You must allow people to be successful and listen to what they need to be successful. Ultimately, people are inspired by leaders who take action and not leaders who talk a good game.
HL: You have a clinical background in critical care. How will this clinical background help you serve in the CMO role?
Sareli: In critical care, there are multidisciplinary teams coming together and rounding on patients at the bedside. Each member of the team can contribute in their own way, but it is really the team that makes the impact on the patient. The intensivist leads a multidisciplinary team to enable care in the ICU, the idea being that by definition patients in the ICU are the most complex patients, and what you really need is someone who is able to keep an open line of vision as to everything that is going on with the patient but recognize that there are experts in each one of the fields.
You must bring the whole team together and understand the value of the team. It is similar to servant leadership, with the link being that the key to success is understanding the value of the team and your role as a leader in facilitating the success of the team.
A background in critical care is helpful in the CMO role. Success comes from team success—not through your singular success. At the same time, when the chips are down, the intensivist must stand up. There are certain situations where you must make tough calls, you must make decisions, and you must make the best decisions you can with input from your team. The CMO role carries that kind of responsibility.
HL: During the pandemic, you played a key role in clinical leadership for critical care. What were the main learnings you gained from this experience?
Sareli: In COVID, a main takeaway is that there was so much that we just could not do. We could not save some patients despite heroic efforts. But there were a lot of things that we could do. It is important to focus on what you can impact as opposed to getting lost in the negativity of what you cannot impact. Rather than to focus on the death and the dying, we had to remember the patients who have lives today because of everything that the care team put into place.
We must remember all the work we did to educate the community about social distancing and the importance of vaccination as well as dispelling a lot of the disinformation. It is easy to focus on the people who believe COVID was a conspiracy and the politics that got involved, but it is important for us to not focus on the negativity and focus on the positive things we achieved. If we saved one life, that was one life that we saved through our interventions.
Perspective is important. You need to focus on what you can do—not focus on what you cannot do. From a practical perspective, COVID was a crucible, and we learned to see what people are really made of during the pandemic under maximal strain. So many people stepped up to the plate and did everything they could. That is a positive to take away from COVID. We saw crisis management at its best, and I am very proud of what the critical care teams achieved during the pandemic.
HL: Now that the crisis phase of the pandemic has passed, what are the primary clinical care challenges facing Memorial Healthcare System?
Sareli: In every industry in the United States, everyone is facing major labor challenges. The labor market has changed. In healthcare, what we saw because of the pandemic was a lot of people retiring early, and we saw people leaving the bedside and switching to other careers.
We are very fortunate at Memorial that we are faring better than other health systems. But I think the most significant challenge for us is, No. 1, recovering from labor shortages. We need to shift systems to make bedside care more attractive and more flexible.
The other thing that is a major struggle is supply chain. We used to take supply chain for granted before the pandemic. Now, there are supply chain challenges in every industry, and healthcare is not immune to that.
Christopher Cheney is the CMO editor at HealthLeaders.
KEY TAKEAWAYS
Health systems are facing supply chain challenges, labor challenges, external pressures from payers, and expectations from patients as they relate to access and service.
To keep staff focused on patient care despite challenges, leaders need to earn trust through action.
In physician engagement, leaders must listen more and talk less.