Leading by Example: Scripps Health CEO pens book

Scripps Health CEO attributes success to employee and management bond

One of the many important lessons Scripps Health President and CEO Chris Van Gorder has learned during his career as a hospital executive, as he writes in his new book, “The Front-Line Leader,” is that “employees aren’t stupid. They know a ‘fly-by’ when they see it.”

Van Gorder is referring to those hurried, cursory visits an executive makes with cashiers, nursing staff and other workers on the frontline of a company or organization, in which he or she typically feigns interest in the employees and their contributions — despite the power they wield via their daily interactions with customers or, at Scripps Health, patients.

A retired police officer and former hospital security guard, Van Gorder never forgot the time a hospital CEO would not make eye contact with him — a slight that made a lasting impression on him and would come to shape his style as a leader.

In “The Front-Line Leader,” Van Gorder recounts how, during the past 15 years, he’s helped bring Scripps Health back from the brink of bankruptcy and internal strife by employing the opposite strategy — putting people (particularly employees) first and making genuine connections with them.

“When I started at the organization (Scripps, in 2000) I thought it was in great shape, but I found out shortly after that the physicians were angry at the strategic direction of the organization — so much so that they were taking their patients elsewhere,” recalled Van Gorder, age 61. “Employee morale was down and employee turnover was 20 to 25 percent on an annual basis. Pretty much everything that could be going bad was going bad at the time.”

Shortly after Van Gorder’s arrival at Scripps as an executive, a vote of “no confidence” was cast against its leadership team.

Within his first six months, Van Gorder was appointed interim chief executive officer. Thirty days later, he was elected CEO. The first thing he did was to gather the physicians who cast the no-confidence vote and begin sharing more transparent information with them, he said.

“It also gave them the ability of helping guide the organization. It proved the hypothesis that if you share information transparently on both sides of an issue, smart people will reach a similar, if not the same, conclusion,” he said.

Van Gorder next created a “leadership academy” to ease tensions between various Scripps Health facilities.

“Our employees at different hospitals didn’t like each other much,” he recalled. “We spent more time competing against each other than we did combating disease and all the other kinds of things that we were supposed to be doing. It turns out there were a lot of misunderstandings about how our hospitals operated in the south, and how our hospitals operated in the north, but by bringing people together — again, sharing information — we started to change the culture of the organization to what it is today, which is one of the best, most integrated health-care systems around.”

Today, Scripps Health has more than 14,000 employees and 2,600 affiliated physicians, and has been included on Fortune magazine’s “100 Best Companies to Work For” list seven consecutive years. The company is preparing to open its $450 million Prebys Cardiovascular Institute in La Jolla this spring.

For Van Gorder, putting people first means being fully present on the frontlines, getting to know employees, listening to their concerns and bonding with them psychologically, which “produces incredible loyalty,” he said.

“It’s not rocket science,” Van Gorder writes in his book. “When you have employees who feel cared for, they tend to care more for themselves, and for the organization that provides their paycheck.”

He told La Jolla Light, “I’ve often said that a big organization like ours is like a human body, with the frontline employees being the cells. … You’re not going to have a healthy body if your cells aren’t healthy — and the organization is not going to survive and do well either.”

Although it may be a substantial time investment for a busy executive to provide such outreach to employees, Van Gorder said it almost always pays off in the long run.

“I spend probably about a third of my time in my office and probably two-thirds of my time out of the office,” he said, noting he spent two-and-a-half hours that morning fielding questions from middle managers and other leaders. “When I’m done with this phone call I’m going to go back and spend the rest of the day with them,” he said. “Tomorrow, I’m going to spend all day with 50 of our employees, who will be with me for a half a day a month, for six months. … Friday, I’ll be out of my office visiting some of our hospitals and our clinic sites.

“We all have choices of how we spend our time,” Van Gorder said. “That interaction between our doctors and our nurses and our technicians on the frontlines is frankly the reason I even have a job. … I need to be there, so that I can build a relationship with them and understand what’s happening at the frontlines … feeling their stresses and talking to them and understanding where things are going well and where things might not be going as well.”

To further boost morale, under Van Gorder’s watch, Scripps Health instituted a policy of layoffs only as a last resort.

“We decided that we were really going to take care of our people, with the expectation that people were going to take care of the organization, and our patients — and that indeed has happened,” he said.

In his book, Van Gorder recalls the time he sought lessons from housekeeping staff on how to use a floor-polishing machine — and their bemused reaction as he was bucked across the floor. These days, his frontline interactions more often include throwing on scrubs and helping with basic tasks in the emergency room, learning from trauma professionals.

“Sometimes I’ll do that for a full shift, and other times I’ll just come by and spend and hour or two with them,” he said. “When we were working up our Ebola protocols and we got our new protective gear for our staff, I was one of the first people who put on the Ebola protective gear, and worked on the protocol with our disaster team to make sure that our staff would be safe taking them off if they were contaminated.”

Van Gorder was on the ready recently when an off-duty sheriff’s deputy was badly hurt and brought into Mercy Hospital in Hillcrest. “I got a chance to watch some fantastic trauma care for this young man and had a chance to interact with his mother and family,” he said. “I think almost any businessperson can get more satisfaction about why they exist and what they do when they’re at the frontline than they can anytime they’re sitting in a suite or office somewhere.”

Van Gorder’s book is also a tale of triumph over adversity. He writes of having to retire early from a fulfilling law enforcement career after his vehicle was struck head-on by a suspect in a domestic dispute, leaving him with major spinal, neck and internal injuries.

Within a year, he had packed on 75 pounds, was taking antidepressants and parked daily in front of the TV.

Spurred back into action by a work ethic instilled in him by his Depression-era parents (his father worked as a train engineer and milkman, his mother, in a bookstore) Van Gorder got off the couch, started running and applied for a job as security manager at Los Angeles Orthopedic Hospital, where he had received most of his medical care following his accident. He landed the job by convincing management to hire him at minimum wage for 90 days. He eventually went back to school to earn his graduate degree in heath care management, working his way up the corporate health-care ladder in the Los Angeles area, before joining Scripps Health.

Today, Van Gorder satisfies his passion for law enforcement volunteering several times a month with the San Diego County Sheriff’s Department’s search and rescue team, often scouring the back country for lost hikers or crime-scene evidence. Volunteering, Van Gorder suggests, is another way for stodgy CEOs to obtain the people skills needed to understand and engage heavily with their own employees.

“It gets me back to my roots little bit,” he said. “If I was ever angry about anything when I had to retire as a police officer, it’s that I wasn’t ready to do that. ... I think the sheriff’s department has given me something back that turns out to be probably more important than I thought.”

Van Gorder resides in Point Loma with his wife, Rosemary, who volunteers in the pet therapy program at Scripps hospitals.

“The Front-Line Leader” is available at Warwick’s Bookstore in La Jolla or online at and iTunes.

Chris Van Gorder’s 
8 Principles of 
Front-Line Leadership

  1. Connect with your people. Put in the time and energy. You can’t be effective as a distant boss.
  2. Fill the information gap. When people have the same information, they reach similar conclusions.
  3. Tell your stories. Openly share your experiences. Forge those emotional connections.
  4. Always ask, “What if?” Think long term and big picture. Be ready to fall up.
  5. It’s an all or nothing deal. Responsibility and authority must come with accountability.
  6. Leave no one behind. Protect and serve your people. Be their greatest advocate.
  7. Share a piece of yourself. Employees want to know who you are as a person.
  8. Bring your mission to life. Genuine, heartfelt actions speak louder than words.