Veteran Leader: One Mission

Podcast Transcript

Emily Grimes: Welcome to Learning to Lead, a leadership development podcast by Cleveland Clinic. I'm Emily Grimes, and today, in honor of Veteran's Day, we're thinking about our military veterans, and how their experience in the military impacts the way they lead. Our GLLI colleague and Marine veteran, Colleen Carroll sat down with Dr. Ralph Turner, Chief Operating Officer of Cleveland Clinic Indian River to discuss what makes our military leaders so effective, and how this translates to leading in healthcare, and at Cleveland Clinic.

Colleen Carroll: Thanks for being here today for our veterans edition of the Cleveland Clinic Mandel GLLI, Learning to Lead podcast.

Ralph D. Turner, DBA: Thank you so much for having me. I'm glad to be here.

Colleen Carroll: Awesome. So if it's all right with you, I'll just go ahead and dive in with some questions to start us off and we'll see where the conversation takes us.

Ralph D. Turner, DBA: Sounds good.

Colleen Carroll: We'd really like to hear some perspectives on your military experience, leadership and just lessons learned along the way. So first things first for our listeners out there Ralph, could you just share what you do at Cleveland Clinic?

Ralph D. Turner, DBA: Yeah, sure, sure. So Colleen, I am Dr. Ralph D. Turner. Been with the clinic now since January of 2017. I currently serve as the Chief Operating Officer for Cleveland Clinic Indian River Hospital down in Vero Beach, Florida. When I first joined the clinic, I was Executive Director of Patient Support Services under Bill Peacock, there at Cleveland Clinic Main Campus. So, I had the opportunity to come down to Florida March of last year, 2019, and who could say no to come to sunny Florida. So it's been a wonderful transition.

Colleen Carroll: Florida is definitely a hard one to turn down.

Ralph D. Turner, DBA: Yes, yes.

Colleen Carroll: So that leads me to my next question. Being our veterans edition, what branch of the military were you in and what did you do? Can you just share a little bit about your military career?

Ralph D. Turner, DBA: Yes, yes, gladly. So I served in the United States Army, joined the army October of 1986 and served 21 years, four months and 14 days, but who's counting, right? And it blew by, I entered the military as a Private First Class and retired as a Chief Warrant Officer Four. Chief warrant officers sort of serve in a unique niche in the armed services. We are considered to be the subject matter experts in certain fields. So my field was Health Service Maintenance. I was responsible for servicing all medical equipment in hospitals, be it deployable hospitals, or hospitals that were in garrison fixed facilities.

And the more senior I became, the more responsibility I earned across support services in health care facilities. So by the time I retired at Walter Reed Army Medical Center in 2008, I was serving as the lead for many departments in support services. So facilities management, environmental services, clinical engineering, property management, which set me up great for a transition to the civilian world. And it was a wonderful career. I really enjoyed it.

Colleen Carroll: That is an incredible military career, Ralph. Not only for your accomplishments serving as a Chief Warrant Officer, but also serving at Walter Reed, one of the most renown joint military medical centers in the world. So talking about your transition to the civilian world, what was that like for you? Was it a transition directly to a leadership role? Were you leading people? Was it tough? Just to share a little bit about what was that like?

Ralph D. Turner, DBA: Well, Colleen it was one that serving in the National Capital Region at Walter Reed. I had about 680 staff members that work with me and 80% of those were civilian and 20% military. So the transition was really set up well, because I learned. I had four years of working with civilian staff and not only working with civilian staff, but unionized civilian staff. So when I retired, I was lucky enough to grab an executive role at MedStar Washington Hospital Center as Vice President of Facilities and Support Services who also was a unionized shop.

And a lot of the lessons I had learned in the military, I took over to Washington Hospital Center with me to set up partnerships. Walter Reed really set me up well for retirement at that time.

Colleen Carroll: Yeah, it's great that you were able to have that preparation where you were already leading civilians and getting comfortable at world.

Ralph D. Turner, DBA: Yes. Very important. Especially when you're leading in health care, because you have to have a good pulse on how to work with people in healthcare.

Colleen Carroll: When you think about your time in the army, leading soldiers, leading civilians, what really stands out to you as one of the hardest lessons you learned around being a leader?

Ralph D. Turner, DBA: One of the easiest lessons I've learned is to always be yourself, even in the military. So people here when I retire and I spent 21 years in the military and I'm coming to take over a leadership role in their healthcare organization, the first thing they think of is that you're autocratic, do as I say, this how it's going to be kind of, what if I tell you to go charge the hill, go charge the hill, don't ask no questions. It's never been how I lead. I've totally understood my level of responsibility that I've carried, but I've always made decision in a participative style, even in the military. It is always been a consensus because if I'm going to make a decision that impacts somebody's daily responsibility in how they do their job, I think that should have some say so in how they accomplish that mission.

So in the military, it's how they accomplish the mission. Civilian world, it's how you do your daily duties. So that's one of the things that I can always say that it's always been a participative style decision making process, understanding that once that final decision is made, I carry the ultimate responsibility of ensuring that is implemented, but it's never been an autocratic. This is how I do it. And no matter what happens, even in the military and that transitioned right along with me over to the civilian side of things, because that's just the way I was raised. I was always raised to treat people the way I would want to be treated. And I would not want to have my day dictated on a daily basis of this is what I have to do day after day. If I know there's a way to do it better, let me have the opportunity to give you some input. So I've always managed in that perspective.

Colleen Carroll: Yes, great response - it's really the golden rule right? Treating others as you would like to be treated. It goes a long way. Moving to our next question - the military really cultivates this environment to perform under pressure. How do you think that's shaped how you deal with stress in your day-to-day work or how you deal with difficult situations now? All the things that you've been through.

Ralph D. Turner, DBA: That's an excellent question, Colleen. I think I deal with stress. Well, because of just physical fitness, all way though out the military, they always preach staying in shape and they always say, "The more you sweat in peace time, the less you bleed in war." And I think the same thing with when you're in leadership roles, because, and especially I'm learning here at the Chief Operating Officer level. I'm responsible for this entire house of operations. When there's any glitch, I'm the bullseye. You start taking the shots. Recently. We just rolled out Epic and rolling out Epic, that's an operational transition, totally, that people are not used to. I mean, we are going from eClinical works on ambulatory side, that is a system that's truly just made for ambulatory operations management. Epic is not just made for ambulatory operations management. So there are other parts you have to add on to Epic, which takes away some of the efficiencies because now caregivers have to learn other duties that they may not have been doing. Duties may shift that they were doing before that not go to some other responsibility, a clinical responsibility becoming an administrative responsibility. They get fire walled because the clinical side did not have immediate access to the administrative side. So if I signed it as a clinical user, I can't just sign in and go to administrative functions. I have to have security, give me that access. So it totally disrupts the normal operating rhythm and caregivers become entrenched in trying to keep just that operational process, moving with scheduling referrals, authorizations, to where they are not answering the phones. So our phones don't work in there, so now it's, why are you not answering your phones? And now we're starting to hear from our local community, and our patients and our beneficiaries, "Oh, what you guys are doing are terrible." And as the operational leader, that's me as I'm the operational leader, I own this. Yes.

And every morning I get up and I ride about 15 to 20 miles on my bicycle. What I could get out of the weather, if not I have a trainer that I hooked the bicycle to, and I ride in the garage and I do workouts. So, I think being physically fit, and am I in the best shape ever? No. But it's that every day, every morning, getting up, getting the rhythm going, getting your body used to thinking nimbly, that means you just can't roll out bed and jump into the action. You got to get up and get yourself started. You got to get prepared, you got to get the heart rate up, because if the heart rate goes up from stress, that's usually the wrong kind of elevated heart rate, you want. You want to be able to control it. And so I attribute a lot of my ability to deal with stress, to just working out every morning and staying active.

Colleen Carroll: It's great that you have that. That's definitely something important. When I think about my time in the military that I took away is that physical activity, it's not something that's negotiable, it's a non-negotiable for me, that is just part of life.

Ralph D. Turner, DBA: I totally agree. And for a lot of other people, really took that attitude... NFL started this thing Play 360, just give me an hour a day. Get out and get active just for an hour a day. You will be amazed at how much your physical fitness can help your quality of life. So, yeah. I totally agree.

Colleen Carroll: So, one other thing I've been thinking about, I find myself on this question quite a bit. There are countless books, articles, TED talks, you name it about how the military produces great leaders. I'll just ask you point blank. Why do you think that is to you? What is it? What's the secret sauce?

Ralph D. Turner, DBA: Well, I would say that most of the great leaders you read about the military come out of West Point, come out of our military academies, especially if the army is West Point for a Marine Corps, a Navy it's Annapolis, for the air force it's Colorado Springs Air Force Academy. When you see marquis leaders who are writing books and who are in high profile leadership positions, the General Petraeus's, the Norman Schwarzkopf's.

The Stanley McChrystal, General McChrystal who really coined a phrase, Team of Teams. These guys are West Point graduates. And I say that proudly because my son is a senior at West Point this year, which I got to give him applaud and I am so proud of him. So there are a few leaders who come from the ROTC background, General Colin Powell, who was one of our greatest African-American generals, went to ROTC at a college in New York.

And they are others that have made that way. But when you are learning from a leadership lineage that comes from an entrenched institution, such as a West Point, such as an Annapolis, such as a Colorado Springs Air Force Academy that trickles downhill, other leaders are learning from leaders who spent four years focused on nothing but leadership, and when they come out of that academy, it's their job to ensure that they take leaders who did not go to academy, or they take leaders who are coming into senior roles, or just getting entrenched into their initial leadership role.

It's their job to ensure that there is a leadership lineage, a tool that shows them exactly how to manage in those roles. So they can take care of soldiers and not lose lives in wartime, because that's what we produce in war fighters. That's what academies do they produce leaders to lead war fighters, and their job is to bring as many back home that they take away.

So when you are learning from that lineage of leadership, you are going to take away tools that can be very well applied in the civilian sector. And I tell you our leader that we have, that the reason I came to the Cleveland Clinic, Bill Peacock he went to Annapolis. One of the most revered leaders in the Cleveland Clinic, one of the most respected leaders in the Cleveland Clinic, a man of high integrity, a man of true respect and someone who don't mix words. That's what you get when you are learning from that lineage of leadership. And I can appreciate working with him.

So, it is one of those opportunities that if you're in the military and you're not liking it, and I'll always say it, no matter what situation you in, if you don't like it, you can still learn from it. I just happened to like it while I was in there those 21 years. But even people who have been in it and got out and said, "I just didn't like it." They still learn from it and they learn how to conduct themselves. So, yeah.

Colleen Carroll: Thanks, Ralph. In doing some research on what makes those leaders great, those leaders from the military, one of the things I've come across in multiple articles, from Harvard Business Review was really that the military and the armed forces they create this conscientious obligation to serve in their members. I think that you touched a lot on that. You talked about it's really servant leadership. It's the leader cultivating those younger soldiers, Marines, Airmen and sailors. So how do we create an environment of Cleveland Clinic at Cleveland Clinic? How do you grow that value set?

Ralph D. Turner, DBA: So, and it started with Toby Cosgrove, but Dr. Mihaljevic currently carries the same mantra, "Patient first." You can't cultivate a culture to have an organization be excellent at taking care of people, if you have three or four different things you're aiming for, four or five different... We have a set of values, yes. But our north star, the thing that leads us in patient care is patients first. If you remember nothing else about what the Cleveland Clinic does, it's patient first. So we have a four care pillars; care for the community, care for the patient, care for the organization, and care for the caregiver. But It's patient first and all that care that we're doing, the focus is how can we become a better organization financially to take care of the patient. Patient first, care for the community.

We got to be a part our of community to ensure we teach health and wellness to the community, so they can manage to stay well and not have to come see our services, because we want to focus on the patient first. We need the care for the caregiver to ensure that they have everything they need to take care of the patient because we have to put the patient first. So when you create an environment that has a culture that has one north star that you have to focus on and you make decisions based on that one north star, now you're cultivating a culture that's successful.

And that is the same thing that comes out of the military, no matter what we're doing, we're training war fighters. So everything that takes place on the periphery, the focus is mission objectives, accomplish that, come back home. Everything else takes care of the war fighter. So they got one mission go out and win the battle, come back home. Our one mission take care of the patient first.

Colleen Carroll: I could not agree more. It's definitely inspiring when you have a clear mission like we do in healthcare, and the military absolutely has that as well. So as we begin to wind down our interview today, I want to ask kind of a fun question. What do you miss most about the military?

Ralph D. Turner, DBA: Oh, Colleen, that's a good question. And I laugh because people always say, "You miss the military?" No. I did 21 years. I retired, now it was time to go on and do something different. I would tell you that in my time in the services, as many soldiers that I work with and serve with, there are five. I can count the ones that I still keep in contact with on one hand. And there is one that I talked to pretty much on a daily basis. And you never... It's very rare where you get someone who becomes your confidant, someone who you can talk to about anything. And you can trust to get honest feedback. And I would say that in the military, if I wouldn't have joined, I wouldn't have met my confidant.

That is a true pillar for me to lean on. I miss serving with him, but like I said, we talk just about every day. But as much as I enjoyed the military and I would say another that I do miss is not having to worry about what to put on, on a daily basis. I get up, I'm going to put on my army combat uniform where I would go to work. Now every day, I got to figure out what color tie, what shirt... But, that being said, I wouldn't trade my 21 years, four months and 14 days for anything. It was a great career.

Colleen Carroll: The military does a good job, giving you unmatched camaraderie, I agree. I don’t know anywhere else you can go to find that. And the uniform is definitely one of the highlights that I would have to look back and miss too. Buying clothes, getting dressed for the day, I could definitely leave that.

Ralph D. Turner, DBA: I totally agree. Thank God for my wife. She helps me out.

Colleen Carroll: Okay. We like to end each of our podcasts with just asking for a little bit of advice. So what closing message would you leave our listeners with about leadership? It can be directed towards our veteran caregivers or caregivers in general. What message would you leave with about leadership?

Ralph D. Turner, DBA: Well, first of all, thank you for the opportunity to serve on the podcast and be able to share my thoughts about leadership. I would say to all Cleveland Clinic leaders, servant leadership is what we do. Just keep that in mind. My thought every day is make sure that the caregivers who work at Cleveland Clinic Indian River Hospital, have what they need to take care of patients. Not to have to worry about a gauze, not to have to worry about sutures, not to have to worry about a tray to put equipment on and roll it to the OR, not to have to worry about the place being hot or cold, but knowing they can come to work and have what they need to take care of patients. To me, that's the servant-leader mindset that all Cleveland Clinic leaders should have. And if they can carry that mindset, we will be number one and put Mayo in our rear window. So, I thank you again for this opportunity and I look forward to chatting with you some other time.

Colleen Carroll: Sounds good. Thank you so much, Ralph, for being here and taking the time to chat with us on Learning to Lead.

Ralph D. Turner, DBA: Take care. Talk to you soon. Bye.

Emily Grimes: That's our episode today. Thanks so much for joining this conversation with our military veterans and Cleveland Clinic leaders, Colleen Carroll and Dr. Ralph Turner. We thank them both for their time, and most importantly, for their service to our country. To those of you listening who served or are actively serving, thank you for serving and leading by example. 

That's it for all of us at GLLI! Stay curious and keep learning!