Commentary: Smaller, independent health systems can use size to their advantage

As CEO of an independent, not-for-profit health system in California’s Bay Area, where healthcare giants are many, I am well aware of the assumption that smaller players are at an inherent disadvantage. But my experience tells me the opposite is true.

Smaller, independent systems have unique strengths, like being highly nimble and highly integrated. Not only can these strengths lead to better patient outcomes, they can also be harnessed to fuel innovation faster and support more fulfilling career growth for your employees. For other leaders at smaller healthcare organizations, the following is my best advice:

Get to know, trust and listen to your employees

At larger organizations, it is not uncommon for people to feel like a cog in a giant machine, but at smaller workplaces, strong culture is critical to enabling staff to work more effectively as a team. This starts from the top; taking the time to get to know your employees—no matter their job title or seniority—should be a high priority.

Leaders should also ensure that reliable communication channels are available. At El Camino Health, we conduct town halls multiple times per year with senior management presenting—and always have direct lines of communication open for employees to share feedback with managers and company executives year-round. Our staff is never cut off from providing suggestions for improvement. Creating a safe and supportive environment for employees to share ideas can also empower individuals to look upward in their career trajectory.

Not only has this open communication approach been critical in building a culture of trust, it has also allowed employees to feel more accountable to one another. Employees prioritize supporting fellow team members just as much as providing quality patient care. I believe this mentality is a large part of what creates more fulfilling careers that inspire greater dedication. While larger organizations can aim for the same approach, smaller teams have the inherent advantage of tight-knit work settings.

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Help jump-start career development

Another advantage for smaller health systems is the ability to create attractive opportunities for career growth. El Camino Health’s chief nursing officer, Cheryl Reinking, started as a nurse here in the ‘80s and worked her way up to the C-suite. You can inspire your own employees by providing high-quality training opportunities on an ongoing basis.

There is also immense value to be gained from creating programs that foster new graduates, allowing them to continue learning and specialize in new areas. Not only can this ensure the organization has a steady flow of new talent coming into the system, it also helps program members envision a promising career path by sticking around. We also offer nursing and pharmacy residency programs and even a clinical research arm, which allows our physicians to explore and innovate. In 2020, our own Dr. Ganesh Krishna helped begin a trial that led to the creation of Pfizer’s COVID-19 pill, Paxlovid. El Camino Health was the first organization in the world to enroll a patient in that trial.

While we provide pay and benefits packages that are competitive to larger organizations, this may not be possible for every independent health system. Faster career growth, more frequent promotions and superior educational opportunities can help make up for that difference.