Adam Mendler

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Lessons From a Healthcare Leader

I recently went one on one with Brian Paradis, former president of Florida Hospital’s Central Region, a $4 billion enterprise with over 25,000 employees and 2,500 physicians. Under Brian’s leadership, Florida Hospital became the #1 ranked hospital in Florida by U.S. News & World Report for three years. Brian is a senior partner with CSuite Solutions, a national strategic advisory firm led by former healthcare industry CEOs focused on the transition and practical strategies to move the healthcare industry from “volume to value.”

Adam: Thanks again for taking the time to share your advice. First things first, though, I am sure readers would love to learn more about you. How did you get here? What experiences, failures, setbacks, or challenges have been most instrumental to your growth?

Brian: I arrived at my first semester of college intent to complete a double major in social work and theology. At the beginning of my sophomore year, I was an accounting major with little aptitude for it and lacking the required math skills. However, with intense work, I graduated and also passed the certified public accounting and certified management accounting exams (CPA, CMA). I spent the next decades fighting an internal struggle between the hard, numbers-driven, left-brain world and the softer, people-oriented, and creative spaces of my right-brain. One of my early bosses gave me a book by Max De Pree entitled “Leadership is an Art.” The question: what does leadership have to do with art? captivated and led me to deeper discovery. How do we use both parts of our brain in a true partnership?

I experimented with simple ideas like using a cartoon at the beginning of my financial reports to offer a pull quote, of sorts, of the month’s “financial story”. Some ideas worked and some didn’t. While serving as the chief financial officer for Florida Hospital (now AdventHealth Central Florida), I was asked to lead the organization, one of the largest hospitals in the country. I was surprised, given I had no operational experience. This is where my leadership adventure hit warp speed, and then quickly ran into a wall. I realized I was leading from fear; fear of failure. People seemed to want something better for the organization, just as I did, but I wasn’t providing a process for them to be fully on the journey. I began to think and work on how to make my “circles” bigger, to include them. It was slow and painful. It was shortly before this new role that I had experienced a heart condition that was closing my vessels every few months. My future was uncertain, and I had to accept the fact that at a young age I had a chronic heart condition. But the gift came in the realization that to increase my circles, I had to deal with myself, and my ego. I began to understand that ego is like a chronic disease. You have to take your medicine, or it will kill you, so to speak, and it will diminish your leadership. 

I have since been focused on people and performance, building cultures that create, innovate, AND at the same time grow and perform consistently over time. I call it “leading with imagination.”

Adam: What are your best lessons from your experience leading Florida Hospital and from leading it to a #1 U.S. News & World Report ranking three years in a row?

Brian: 

  1. People really matter, so listen to all of them. If you get this wrong, not much else matters. In my experience, without being conscious of this rule, we mostly get it wrong. And when you do get it wrong, say sorry!

  2. Things are complicated, work to simplify them. This is a key part of the art of leadership.

  3. Learn to think systemically. Work to understand the context. For example, it is hard to understand the purpose of a chair, if you don’t know what room it will function in. We are primarily taught analysis in school, but more important as a leader is to learn to synthesize or understand the larger structures a decision operates within.

Adam: In your experience, what are the defining qualities of an effective leader? How can leaders and aspiring leaders take their leadership skills to the next level?

Brian: Create an environment where it is safe to speak up, disagree and challenge. This allows a “best idea wins” high-returns, instead of “my idea wins since I am the boss” which yields lower returns. 

See yourself as the teacher and servant instead of the leader or boss. This allows a focus on unlocking the stranglehold of the few, to releasing the power of the many. It creates an energy to help people achieve more of their potential for the organization's purpose.

Lead with love instead of fear. This is a daily if not hourly decision. It will never be a perfect score, and you will never arrive. It’s more like getting it directionally correct, yet it makes all the difference. 

Adam: What advice do you have for leaders on how to build a winning organizational culture?

Brian: Building anything is a creative endeavor. Recognize that, and then invest in learning more about the creative process. My first introduction to this process was a book by Robert Fritz, simply titled, “Creating.” You have a canvas to paint on when it comes to culture and every action you take and the words you speak are like a brushstroke adding to the picture of culture. 

Be consistent. Don’t react to things like bad news or disappointments. Be disciplined in learning any lessons to be gained. If there is blame, you take it. And of course, if things go well, give the credit away, to those who deserve it. This builds a palpable trust when people see this regularly.

Character does and will always matter, no matter the stories we tell ourselves. 

Adam: You’ve written about the power and importance of imagination. In your view, what are the major themes of leading with imagination? And can leaders harness the power of imagination to engage and inspire their teams?

Brian: In my observed experience, there are seven principles and processes that open the door to the power of imagination in your leadership:

1. Lead with love, instead of fear. Leadership is about people. None of us thrive in fear personally, and it is the same in organizations. Fear is the default if we don’t proactively decide to lead from love. Have you ever heard someone married for 50 years say, “it just happened we have a successful marriage, we didn’t work at it every single day?”

2. Be authentic with a large dose of humility. This is pragmatic and principled. Choosing love over fear, as your core and consistent place to lead from, cannot be done without both authenticity and humility. But they have a pragmatic side, chiefly learning to say things like “I don’t know” and “I am sorry.” Both open safe space for others to come in and contribute.

3. Carefully attend to the environment. This one is about a planning discipline concerning the culture you are intentionally trying to create. It starts with a recognition that you are either influencing the culture or it is being created outside of your care. I think of it like DaVinci approaching one of his masterpiece paintings. He always sketched, before he painted. What are you sketching in the creation of your culture? 

4. Take appropriate risks and be willing to be vulnerable. Brene Brown in her 2012 Ted Talk says, “Vulnerability is the birthplace of creativity, innovation, and change.” I have some friends with rich military careers, and the way they might explain it is there is no attack possible without being exposed and vulnerable, and never has an army won by defending, only an attack accomplishes anything. You must move forward, ever-evolving.

5. Cultivate yours and the organization's curiosity. Curiosity has been around for a while. It’s messy and we repeat phrases like, “curiosity killed the cat.” Yet, if you allow it leverage, curiosity will lead to a changed mind. Try this question: can you be curious and angry at the same time? We are only beginning to understand the different functions and flourishes of curiosity. 

6. Find the fun and have a sense of humor. I think most organizations are unwilling to embrace laughter or understand its power to bring creative culture alive. It is said, “it is only a short distance from haha to aha.” There is something magical, something childlike, and something uniquely human in humor.

7. Connect the dots and do whatever it takes. This is a capstone concept. It is putting it all together, seeing it all work as a leadership model that can scale and improve the predictability of results. It is about understanding your company as a living organism and appreciating the entire ecosystem. It often involved closing any gaps that open and clarifying the "big why" as many times as it is needed. It is all-encompassing and will at moments, be all-consuming.

I might offer a place to start to engage and inspire whatever group you might be working with. I have come to believe that cultivating curiosity, and leading with love, are the two greater-among-equals of the seven keys to leading with imagination. Start learning and experimenting in these two areas of your leadership.

Adam: What are your three best tips applicable to entrepreneurs, executives, and civic leaders?

Brian: 

  1. Get over yourself. 

  2. Listen, listen, and then listen some more and “occasionally” do something about what you hear. 

  3. Don’t be afraid to pivot if your current plan isn’t working.

Adam: What are your best tips for leaders in the world of healthcare?

Brian: Focus on value-creating growth and find aligned ways to get paid for producing value. Learn how to collaborate with others to solve the larger problems of our healthcare system. Be curious, keep looking for the problem, and not just at the symptoms. 

Adam: What advice do you have for healthcare entrepreneurs?

Brian: Find a “calling” instead of a career. Do something you are beyond passionate about and be a difference-maker.

Adam: What is the single best piece of advice you have ever received?

Brian: Nelson Mandela said, “There is no passion to be found in playing small, in settling for a lifeless than the one you are capable of living.” This is the essence of leading with imagination, for yourself, and for those you are privileged to lead.