Employment Group Culture

What You Need to Know About the Flea That (Metaphorically) Killed the Medical Center CEO

May 22, 2017

A few days ago, a flea bit and killed the CEO of one of the top-ranked academic medical centers in the nation. Metaphorically speaking, of course.

And the lessons cut both ways for you and your organization, whether it’s a medical group, a hospital, an ASC, or any other sort of business.

In his book, The War of The Flea, the seminal work on guerrilla warfare, Robert Taber wrote about how a small band of guerrilla fighters could emerge victorious in a conflict with a larger, well organized enemy.

“Analogically, the guerrilla fights the war of the flea, and his military enemy suffers the dog’s disadvantages: too much to defend; too small, ubiquitous, and agile an enemy to come to grips with.”

In 2014, Ohio State University concluded a national search for the new leader of its Wexner Medical Center by hiring Sheldon Retchin, M.D. as its CEO. His salary? Close to $1 million per year.

Yet a few days ago, just three letters signed by a handful of the 1,200 physicians that Wexner employs, triggered his resignation.

The first letter, dated May 1, 2017, signed by only 25 physicians, raised complaints about Dr. Retchin’s management style. According to a report in The Lantern, the Ohio State school newspaper, the complaining physicians wrote they had “no confidence” in Dr. Retchin’s leadership. The signers claimed that more than 100 other doctors supported their position, but were afraid to join in the letter.

The two subsequent letters were signed by 6 physicians each.

Even assuming no crossover in the signatories, 37 physicians (yes, some in positions of authority) out of 1,200, that’s only 3%, were able to unseat the king.

Dr. Retchin, the front man for a high and mighty organization, and, one can argue, the organization itself, became the latest victims in the war of the flea.

What’s this mean for your organization and for you, personally?

From the organizational perspective, as in a guerrilla war, change within the organization, as well as within a domain in which the organization interacts, can occur as a result of agitation by a vocal minority. Just as no vote was required for a dictator like Casto to take over Cuba, no medical staff vote, no survey by Press Ganey, no long and drawn out process among “stakeholders,” is required to topple the status quo.

What you think is permanent is only temporary. How temporary is the question.

What you do, and how you do it, within your organization, and how you project it to essential third parties (e.g., hospital-based medical group to hospital) is all-important in maintaining relationships, contracts, and even existence. That’s the flea collar.

And, just the same, from the perspective of the individual, the small, the “out group,” the “flea,” a steadfast, vocal, and somewhat intransigent minority, can kill the dog. The large group can be made irrelevant. The hospital CEO can be forced out. The small organization can ingest the larger. Yes, the dog bites back. No win is guaranteed.

Many say that the world is a tough place. Maybe it is, because it’s not just dog-eat-dog. In Dr. Retchin and Wexner’s world, it’s flea-kills-dog as well.

Whether you’re the metaphorical dog or the metaphorical flea, the same applies to you.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss


Leave a Reply