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I’m in Healthcare…Everything Is a ‘Challenge’

By Michael C. Backus
President and Chief Executive Officer of Oswego Health, the parent company of Oswego Hospital

If there is one thing in the past three years I’ve come to learn is that hospitals are not equipped to adequately speak up for themselves and admit that things aren’t always rosy.

We have issues and sometimes saying, “it’s a challenge,” simply does not do the issue du jour justice.

When I think of a “challenge” I think of something I can actually fix or at least sufficiently address to show progress toward improving the “challenging” situation. President Franklin D. Roosevelt famously said, “Above all else, try something.”

To me, that’s a basic obligation of leadership – being part of the solution.

How does one healthcare CEO in a rural/suburban lakeside community in the great state of New York, address what are national workforce shortage headwinds facing a 143-year-old community institution that relies heavily on government payers such as Medicare and Medicaid that pay roughly sixty cents on the dollar?

That’s my “challenge” and any ideas may be directed at and are greatly appreciated. Admitting that some “challenges” may be beyond repair is important.

Doing the same old, same old is the definition of insanity as far as I define the word. Looking at processes with an eye toward technological innovation, workforce (development) recruitment AND retention initiatives, beyond compensation, and taking calculated risks is what is required to address the “challenges” of today.

That means we have to tackle once-sacred constructs that no longer address the healthcare needs of today’s patients.

  • We need on-demand caregivers who are highly skilled in emotional intelligence beyond their clinical training because today patients require more of their attention and bring more “challenging” “information and healthcare needs” to their visit than ever before.
  • We need payers, public and private, to understand for every denial hospitals successfully appeal we should get an improper denial adjustment or some credit for services rendered and payment delayed.
  • We need government bureaucracies to understand the daily pressures healthcare systems are under and move quickly to address process improvements that help close funding gaps.

Those are just three needs that address the “challenges” that all health systems face presently.

Others are not as simple.

We need patients to understand the “challenge” facing healthcare globally today and that shame/blame doesn’t work well when health systems have little that they can do to defend the actions of caregivers. Consider the following:

We can’t share with you why your wait in the emergency department is four hours (or more.)

We can’t share with you that behind the curtain we are managing a patient (or two or three…) who has been verbally and physically abusive to our staff.

We can’t share with you that that same patient(s) has been discharged, and returned by law enforcement, only to be abusive again (and again and again…)

We can’t share with you that we had three call-ins because our staff gets sick, have kids that get sick, have family members who need care, and every once in a while like to take a day off to collect their breath.

We can’t share with you that behind that door, that curtain, that wall someone is in much worse shape than you are, and right now, in our clinical judgment, they require our attention at a higher level than you.

What we can share with you is that we are trying.

We know you’re there in the ED.

We see your name on our board with the exact amount of time you’ve been waiting.

We know your ailment, and if you don’t think we do, please ask politely for an update if your symptoms have changed while you’ve waited.

We want to help you and get you out of the waiting room or emergency department as quickly as possible, and we believe in giving high-quality care.

We have key performance indicators that help us improve our services and we try to meet them every single day.

I realize in today’s world patience is a fleeting virtue and when you (or a loved one) don’t feel well it is scary – that’s your “challenge” at that moment. Once you’re in our doors though, you’re our “challenge” and we will meet it to the very best of our ability. That’s the promise my team and I make to you at Oswego Health.

In writing this editorial I hope to start a conversation that helps us come together as a community to solve collective problems because these aren’t largely just “challenges” facing Oswego Health. You can replace my name and insert any other hospital CEO. Likewise, with any other healthcare institution providing care in an emergent situation. We’re all “challenged.”

We have to address “challenges” as constructively as possible ourselves and communicate broadly what we need from partners including patients and their families. That’s community care. That’s creating a healthcare culture that is constructive within todays “challenging” environment.

I hope you’ll join me in that construction in whatever manner you can. As a patient. As a caregiver. As a teammate.

Help healthcare address the “challenges” we face by being part of the solution.

Check for open positions and apply or refer a friend.

Volunteer. Give Blood. Donate to the Oswego Health Foundation…or simply drop us an email at with an idea you have to help us get better.