The reality of GMH is that the governor selects the CEO as well as board members . Maybe it ’ s time to let the board have true oversight of GMH .
Insights
The way it works
It was a typical , beautiful morning on Guam . I was a passenger riding with my finance executive from Guam Memorial Hospital to a meeting we had been invited to at the governor ’ s office in Adelup .
At that time , then Gov . Eddie Calvo had a small group of “ advisors ” advising him on the affairs of GMH . This group included the hospital CFO , a physician at the hospital , and a couple of the governor ’ s staff . My inclusion in some of these meetings had only recently occurred . This advisory group for GMH did not include anyone from the GMH Board of Trustees .
I had been in the role of interim CEO at the government-run GMH for a few months . As the hospital had just successfully completed a survey that had restored its regular Joint Commission on Accreditation of Healthcare Organizations accreditation status after being on probation , I had an optimistic outlook on the hospital ’ s ability to continue positive improvements . Part of my optimism came from seeing how invested the Board of Trustees was in improving its knowledge of the hospital ’ s operations and providing positive leadership to the executives and medical staff .
Hospitals are complex organizations , with each having their own unique characteristics . The Joint Commission on the Accreditation of Healthcare Organizations has developed standards and guidelines for a successful hospital organization . A significant part of JCA- HO ’ s prescriptive standards includes the strong involvement of hospital boards on oversight and participation in the direction of the hospital . This includes the selection of the CEO and ensuring that the hospital adequately represents and
addresses the needs of the community it serves .
The experience of traveling along Marine Corps Drive toward Adelup is breathtaking and I was happy to have the opportunity to sit on the vehicle ’ s passenger side in full view of the gorgeous blue and green waters to the right of the roadway . As we were passing Alupang Beach Park , the serenity of my view was shattered by an abrupt and terse conversation that blared extreme warning signs to me .
At our previous group meeting at Adelup , Eddie Calvo , then governor , asked me to hire an individual for a position at GMH . I had replied that I would investigate the individual ’ s qualifications and assess the hospital ’ s needs , but I had not indicated an affirmative to the request .
Now on Marine Corps Drive , I was told by the CFO , in very descriptive language , that the governor had placed me in my position , and that if I didn ’ t follow the governor ’ s requests explicitly , the governor would remove me from my position .
That evening I related my experience of the day to my good friend on the 4th floor balcony at Alupang Beach Condominium . He shared with me his opinion that the chief finance officer was probably just following orders . I asked him why the governor often referred in these meetings to his power and authority over GMH under the “ Organic Act .”
I learned that the Organic Act of 1950 gave Guam great powers to manage the civil affairs of the territory without interference from the federal government . As a result of this power , Guam ’ s governors frequently used the hospital to reward friends , contributors , and family-related businesses with favors , jobs and con-
The reality of GMH is that the governor selects the CEO as well as board members . Maybe it ’ s time to let the board have true oversight of GMH .
tracts .
Now I understood why the governor and his “ advisors ” ignored the board of trustees , considered them an obstacle , and made their own decisions regarding strategies for GMH . When it came to GMH , Adelup thought they knew best .
I had attended my last “ advisors ” meeting at Adelup .
In the forthcoming weeks , I continued to work with the board in attempting improvements to the operations of the hospital . Significant improprieties were discovered and I became a threat to Adelup and the “ advisors .” As a result , I experienced a well-executed effort to eliminate me .
Predictably , the governor requested the board chair to dismiss me . When the board chair refused , the governor demanded his resignation , and my fate was sealed .
Each board member ’ s appointment at GMH is confirmed by the legislature from the governor ’ s recommendation . According to the GMH bylaws , the CEO is to be selected by the board “ with the approval of the governor .”
An important principle in life and within the management of organizations is the relationship of authority and responsibility . Responsibility cannot be assigned without a commensurate amount of authority and authority cannot be utilized without a commensurate amount of responsibility .
I have read recent news reports about Guam related to the current governor ’ s
The opinions expressed here are solely the author ' s and do not reflect the editorial position of the Pacific Island Times .
proposal for a new medical complex and a different GMH hospital location . Many in the medical community are opposed to the proposal .
Some reports have suggested the planning for a new hospital location was done and a proposal made to the legislature without input from most of the hospital ’ s medical staff or communities that utilize the hospital . Now there are angry confrontations occurring between the governor ’ s office and stakeholders of the hospital .
The GMH CEO seems understandably supportive of the governor ’ s “ vision ” despite the strong feelings in the medical community against the proposal .
The current governor of Guam can , as previous governors have , exercise very broad powers as it relates to GMH . Perhaps she is following in her predecessor ’ s footsteps at Adelup , thinking that she knows best , and the opinions of key stakeholders are less relevant .
The reality of GMH is that the governor selects the CEO as well as board members . Maybe it ’ s time to let the board have true oversight of GMH .
Regardless of how things play out , authority and responsibility go hand in hand , and the exercise of great authority will always bring great responsibility .
Theodore Lewis is the former CEO of Guam Memorial Hospital and has a healthcare consulting business in Bridgman , MI . He is collecting stories about lessons learned in life and can be reached at theodorelewis @ yahoo . com .
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