Scripps Health CEO Chris Van Gorder's life reached a pivot point in November 1978. He just didn't know it at the time.
As a 26-year-old police officer, Van Gorder suffered severe injuries when responding to a family dispute call in Monterey Park, Calif. After multiple hospital visits over the course of a year, he learned that the police department had retired him because of his injuries, ending his nearly five-year law enforcement career.
To land a new job, Van Gorder didn't look far.
Respond To Adversity Like The Scripps Health CEO
Van Gorder applied for a position running safety and security at the orthopedic hospital where he had just completed a lengthy stay as a patient. It wasn't too much of a stretch for him: Before joining the police force, he had spent nearly a year working in a hospital emergency department followed by two years as a security officer.
Initially, the hiring manager was skeptical. But Van Gorder talked his way into the job — promising to work for minimum wage for 90 days to prove his value — and quickly thrived in his new role.
The career switch served him well. Over the years, he took on more responsibility in different areas of the health care industry. By 2000, Scripps Health, a nonprofit integrated health care system based in San Diego, named him president and chief executive.
Van Gorder: Build Your Career
Over his 23 years at Scripps, he led the sprawling organization through myriad challenges. Today, the 70-year-old Van Gorder oversees a system of hospitals and other medical facilities with approximately 17,000 employees, 3,000 affiliated physicians, 2,000 volunteers and roughly $4.3 billion in annual revenue.
Van Gorder joined Scripps in December 1999 as chief of health care operations. In May 2000, he became interim CEO at a low point for the organization. With an operating loss of more than $20 million, an employee turnover rate as high as 20% and a dire need for capital investment to stay competitive, Scripps was struggling.
From the outset, Van Gorder knew he had to bring people together.
"I had a previous job where doctors would campaign against management's decisions," he said. "But when those doctors got seats on the board and were privy to information, they understood. I learned that when smart people are given all the information they need, they will probably reach the same conclusion."
Form A Cabinet Of Advisors
As one of his first moves at Scripps, Van Gorder formed what he called a Physician Leadership Cabinet. Comprising both doctors and administrators, the group started meeting regularly to devise strategy and recommend steps to produce better results.
"Intentionally, we had physicians drive the agenda," he said. "Physicians need to be heard. And they need to understand why decisions are made" by administrators.
The partnership paid off. Working as a seamless unit, the team produced a financial turnaround, lowering turnover and boosting morale. Van Gorder was promoted from interim CEO to Scripps' president and CEO in June 2000.
Greater cross-departmental teamwork generated cost savings of $240 million. Profits soared by more than 1,200% in Van Gorder's early years at the helm as the Scripps Health CEO.
Scripps Health CEO: Handle Communication Breakdowns
Van Gorder met with initial resistance from doctors. During his first round of meetings with them — when Scripps had only 55 days of cash on hand — they demanded more authority.
"We got rid of the last CEO and we can get rid of you too," one of the doctors told him. But Van Gorder rejected their bid for more power.
"I did not have any authority to take power from the board and give it to them," he said. "But I told them they already had power, informal power, and that's more powerful than any formal power I could give them."
"If we have all this informal power, we want $4 million more for physicians to take ER (emergency room) call," a doctor replied.
"Fine," Van Gorder countered. "But I'll have to tell the nurses that we can't give them a salary increase this year because physicians have taken all the available money."
When the doctor protested, Van Gorder explained, "It's very easy to be on the outside and demand more and more resources. But we can only spend a dollar once."
Invite Decision Input From Others
Then Van Gorder invited the physicians to join him in making resource decisions. He opened the books and let them study the financials "so they could see our reality," he says.
As a result, the doctors agreed to more modest demands — around $2 million — and said, "We can sell this to our nurses."
That's when he knew they had started to think like CEOs and take responsibility for helping lead Scripps back from the brink.
"Fast-forward almost 24 years and we have accepted 100% of the recommendations from the Physician Leadership Cabinet," he said. "That proves my original hypothesis that if we can find a way to fill the gap of information, people with the same information would make the same or similar decisions."
Scripps Health CEO: Field Questions From The Rank-And-File
To enhance internal communication and spur professional development, Van Gorder created three "leadership academies" for support staff, front-line employees and rising managers. He leads informal Q&A sessions with the groups.
He forthrightly addresses all inquiries with three exceptions: He won't violate HIPAA (a federal rule that protects individual privacy), discuss personnel issues or divulge information about a current business transaction or other matter involving a nondisclosure agreement.
"All else is fair game, like how my compensation is decided," he tells them. His goal is to demystify the "why." He seeks to explain the basis for "why we do what we do," he says.
After these Q&A meetings, some participants asked Van Gorder to give them talking points that they could in turn share with their co-workers. He refused.
"I want you to use your own words when talking to them, because that will be honest," he responded. "You can take notes, but you won't get notes from me on what to say to them."
Unify Far-Flung Teams
As a former police officer, Van Gorder knows all about on-the-job stress. He learned at a young age to control his emotions.
"You can't exhibit fear," he said. "A leader has to show a calm demeanor, even in the most difficult of times. If you look like you're angry, no one's going to approach you."
His leadership team appreciates his steadiness under fire.
In 2020, Van Gorder led Scripps through a restructuring, the early chaotic months of the pandemic and a cyberattack.
"It was a very stressful time," said Dr. Ghazala Sharieff, Scripps' chief medical officer, acute care. "Chris was right there with us the whole time with the calm he brings."
By forcefully addressing internal controversies, Van Gorder clears the air and fosters teamwork. For example, Scripps runs a diverse mix of hospitals and clinics in both wealthy and poor areas of California.
"In the past, there was this North-South issue where some (employees in Southern California) wondered why the North always gets all the money," said June Komar, Scripps' chief of staff. "Those who worked in less affluent areas said they didn't feel as valued. But Chris, who's always a truthful, prolific communicator, said that in order to keep open in underserved areas, we need to make investments in areas where there's growth and a favorable payer mix."
Build Understanding Like The Scripps Health CEO
The divisiveness gave way to understanding. And that bred more trust across departmental and regional lines.
"It had an amazing impact on people's willingness to work together," Komar said. "When Covid hit, that sense that we were already working together as a team enabled us to share information and transfer patients, nurses and supplies from one hospital to another" when it mattered most.
Scripps Health CEO Chris Van Gorder's Keys:
- President and CEO of Scripps Health, a San Diego-based integrated health care system.
- Lesson: Plug the information gap by opening the books and inviting workers and other key contributors to help allocate resources effectively.
- "You can't exhibit fear. A leader has to show a calm demeanor, even in the most difficult of times."
