Talent hits a target no one else can hit; Genius hits a target no one else can see.  Arthur Schopenhauer

   Through the magic power of the retroscope, it is easy to see why Wall Street was struck by disaster. In a stunning display of the power of greed, the "money people" pursued a seemingly endless series of short term targets. "Share holder value" became such an obsession that other fundamental values were abandoned with abandon.
   The same kind of risk confronts hospitals and charities. Hospital organizations once run by dedicated caregivers have, for the most part, been taken over by executives just as obsessed with the bottom line as have been so many of American corporations.
   In the rush for fat profits and high bond ratings, America's hospital executives have routinely shoved the role of mission to the background. They have replaced the goal of charity with a terrible mantra: "No margin, no mission." This mantra, innocent enough at first reading, has been used to justify a dangerous pre-occupation with financial performance at the expense of staff morale and the crucial role of loving care.
   As a long time hospital and health system CEO, I have seen this issue up close. I have also been apart of it. The temptation of high salaries, free cars and big offices has overtaken me at certain points in my career. Finally, I adopted a guideline: "No executive, including the CEO, should be paid more than ten times the average pay of a first line nurse." Ten years ago, I began following the rule myself.
   This rule was helpful. Unfortunately, few executives around the nation pay any attention. Today, leaders of large, non-profit health systems are paid as much as $2 million annually, more than forty times a first line nurse who may be lucky to make $45-50,000. CEOs may have lots of overall responsibility. But if they view their job as a calling, one forth of the above amount should be more than enough. After all, it's the first line staff who are doing the hardest work.  
   So why does this matter? The problem is that high salaries and plush benefits tend to insulate executives from the core mission of charitable work. Upon promotion to executive status, nurses doff their scrubs and don business suits. This signals their difference, their "higher status" than first line nurses. It's a short step from "higher status" to the belief by executives that they are more important than first line staff. Loving caregiving suffers.
   I don't mean to sound self righteous about this. It was a mistake for me to occupy a large office when I was head of the OhioHealth system. In part, I counteracted it by working alongside first line staff each month. But, this does not justify the wretched excess I promoted by occupying my "imperial" office. 

   Now, I argue for balance.
   It's time for executives to learn from the grave errors of Wall Street. Obsessive focus on bottom line targets and "beating the competition" can result in short term success for some talented executives. Talent can hit targets. Only genius can hit the target others may not even see. It is the goal of creating a loving culture.
   The great Mozart understood that "Love, love, love is the soul of genius." That is a secret each person may discover. Meanwhile, charities are vulnerable to destruction by leaders who treat their mission of Love as a meaningless slogan.

   What do you think?

-Erie Chapman