I’ve read a number of articles on the Iceberg of Ignorance, originally published in 1989 by Sidney Yoshida, reporting that top leaders only understand about 4% of what is going on in their companies. Does this sound right to you? If you are a CEO, you may not believe it, but do we really know? If you are a manager or supervisor, you may believe this about your bosses, but not yourselves. If you aren’t a manager or supervisor, but report to one, you may completely agree with this statistic!

While no leader in a large organization can truly know everything that happens on the front line, what are the best practices we can employ to ensure that we stay in touch with our staff? With our busy meeting schedules, how do we get in touch with what is really happening in our organizations?

I have used a few tactics over the years. Besides rounding on patients and staff, which I truly enjoy, I love to be present at as many recognition events as possible - quarterly leadership awards, patient experience milestones, annual tributes to Nurses, Doctors, Allied Health, etc. “Lunch with Lee Ann” is monthly event that I started years ago with both managers and staff.

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I was honored as a Girl Scouts of Western Ohio Woman of Distinction a few years ago, and I was asked to share some of the lessons or “words of wisdom” that I’ve learned through my own experiences and through others. As I reflect, the Five Key Ways that Girl Scouts help young adults thrive, are applicable and transferrable to every rising leader in general.

Girl Scouts is proven to help girls thrive in five key ways as they:

1. Develop a strong sense of self.
2. Seek challenges and learn from setbacks.
3. Display positive values.
4. Form and maintain healthy relationships.
5. Identify and solve problems in the community.

Read the Girl Scout Difference here .

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This article published recently in the The Atlantic points out that unexpected, large hospital bills can happen to anyone. This caregiver was hounded by collectors, one even inviting them to connect on LinkedIn! As healthcare administrators, we have a good understanding of our average reimbursement and collection rates, as a percentage of the gross, billed charges. But do we really know what happens when the uncollected charges are turned over to collection agencies? Are we aware when and if they are then turned over or “sold” to other debt buyers? To me, poor treatment by collection agencies and debt buyers is still a reflection on the health system where the patient received their care. Can health systems and doctors afford this type of reputational risk?

I turned to a colleague, a revenue cycle professional and expert - the best I’ve ever worked with in the business. They provided a more balanced perspective:

There are two sides to this dilemma depending whether you are a patient or provider. From the patient perspective, medical debt is increasing and in too many cases crippling, often leading to financial ruin, depression and shattered lives. Statistics show the percent of total bankruptcy, because of medical debt, at over 50% and employers shifting costs through deductibles, now on average over $1,300 and growing, according to the Kaiser Foundation. On top of that, healthcare spending as a percent of GDP is approaching 20%; an unsustainable trajectory. Bottom line, patients and families are harmed by unaffordable medical debt and there is no solution in sight.

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