The Riner Group Newsletter
Ranger Ron on Leadership
October 2023

by Ronald N. Riner, MD, FACC

“If you climb in the saddle, be ready fer the ride.”

Purpose – An Old Idea?

After a moderate hiatus in publication, by popular request, Ranger Ron is back in the saddle with this newsletter initiating the next set of leadership lessons emphasized in our executive coaching and leadership training programs. I thought I would open with a reminder to the readers that this ranger was born in Rapid City, South Dakota. Some of you might not know where it is or may not have even heard of it. My father and some of my kin were docs years back in South Dakota serving in Rapid City and on the Indian reservation in the Black Hills.

            Historically, Rapid City was born on the 25th day of February 1876 and consisted of 6 blocks in the center of a mile square plot of land. The town was founded as a mining community and eventually it received regular running stage service provided by the Pierre Stage Line. Big times came when the post office opened on April 18, 1877. Life was tough for the early settlers and many passed on “over the Great Divide” because of illness, poor health, and some even passed on ‘cause they pushed their limits by becoming thugs, thieves, and outlaws. The city, like many Old West cities, developed a “Hangman’s Hill” to accommodate said folks.

Cognizant of all of this, I hear ya askin’, “Where is today’s leadership lesson?” Well, varmints and people bending the law or taking advantage of a situation have existed for a long time – longer than this ranger’s been ridin’. I’m not here to debate rights, wrongs, or proper outcomes of justice – though some justice was questionable in those days, as it is today. Fast forward to the present. As a physician who has practiced and overseen healthcare delivery in many places and for quite a few years, I think it is a special kind of business where our purpose is to focus on and care for people, set out to cure ‘em if possible, and relieve sufferin’ anytime we can. Heck, some even refer to nursin’ and doctorin’ as a “callin’” not a business. Then, as now, one’s name and reputation were associated with that calling and back then, and even more so today, we need to revisit the importance of reputation and character. Honesty, integrity, and the willingness to stand by one’s word are important for all professions, but especially for those workin’ in healthcare. Those of us who are in or aspire to be in leadership positions, need to pass that spirit on to those we mentor and work with. Our coinage and glue in our activities are character, trust, and trustworthiness.

However, a quick glance at the headlines today shows that as a profession we are deeply challenged.

• NY PHYSICIAN ASSISTANT IS REPRESENTING HIMSELF IN A MURDER TRIAL IN WHICH HE IS ACCUSED OF KILLING A PHYSICIAN ASSISTANT

• UNIVERSITY GYNECOLOGIST HAD HUNDREDS MORE SEX-ABUSE VICTIMS, LAWSUIT CLAIMS

• NH PHYSICIAN INDICTED ON CHARGES THAT HE WROTE PRESCRIPTIONS FOR FENTANYL AND OTHER DRUGS WITHOUT LEGITIMATE MEDICAL NEED

• NY CARDIOLOGIST TO PAY $6.5M TO SETTLE ALLEGATIONS THAT HE PAID MILLIONS IN KICKBACKS TO OTHER DOCTORS IN THEIR PRACTICES FOR PATIENT REFERRALS

• AND MANY MORE - too many to list. It’s true that all docs, nurses, and healthcare executives are people with their sets of problems, just like all people.

            But perhaps we have forgotten or just pay lip service to the “callin’” aspect of what people do in healthcare – yup, it might have turned into just another business. (A business with great spreadsheets, dashboards, payment methodologies – some of which are so complicated you need a degree, a computer, or to have a fulltime army of people on the payroll to figure out how you get paid or what to charge for an office visit!) Hopefully we can salvage some of the meaningful, purposeful past that we had front and center in our care delivery. Not sure if it’s possible with all the “gold rush” of some of the new Fellers comin’ into healthcare – time will tell. I suspect the heart of healthcare delivery’s future needs some emphasis on purposeful basics, sprinkled vigorously and watchfully with prudence, honesty, integrity, and a steadfastness to ideals that have been passed down through the ages. If done right, it should provide a decent way to make a living and an earned life – a life when the choices, risks, and effort we make on behalf of those we care for align appropriately with OUR overarching, professional PURPOSE.

“Never give the devil a ride. He will always want the reins.”  -Adrian Rogers, minister