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	James L. Holly, M.D.

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Your Life Your Health - My Compact with SETMA and My Health

James L. Holly,M.D.

December 06, 2008

Your Life Your Health - The Examiner

(Author's note: The following is "An Open Letter to My Colleagues at SETMA" which I sent to all of SETMA's staff on December 1, 2008, the day on which I returned from my Sabbatical.)

In the past, I have never thought a CME (continuing medical education) or a meeting was over until a summary had been completed with specific changes which I or others would make in our medical practice due to what had been taught or learned at the meeting. This is part of my "personal compact" with SETMA.

As I return to work today (12/1/08) after 42 days away, I realize that my "personal compact" with SETMA and with my colleagues, requires that I give an accounting for my time away. As I thought about this, I noted that the American attitude is, "no one has any right to determine what I do with my time off," and in part that is right. Yet, carried to its logical end this attitude adversely affects the relationship one has with one's company and the productivity of the company, and ultimately that attitude diminishes the value that both employee and employer are to one another. For instance, for the past almost 100 years, the traditional work week in American is divided into five days of work and two days of no work. Stress and strain at work can affect the value of time off and what one does in his/her time off can affect one's work. It is not unusual for an employee to play so hard on the weekend that he/she calls in on Monday and cannot come to work; likewise the stress of work can often affect the quality of time one has away from work.

My "compact" with SETMA requires that I manage my time away from work so that I can maximize my effectiveness while at work. SETMA's compact with me requires the company to make my work such that it adds value to my life beyond financial considerations. This not only makes SETMA more valuable to me but makes me more valuable to SETMA. This does not mean that I can not have "fun" with time off. It does mean that as I see my life a whole, the management of each part must be done with attention to all other parts as well.

As I thought about my concept of "compact," I see that it is much more Oriental than Occidental. It is much more like the Japanese than like the Americans. And, to some extent that is one of the reasons why they are out performing us in certain areas of commerce. The following definition of a personal compact was offered by a business consultant in 1995:

"Employees and organizations have reciprocal obliga¬tions and mutual commitments, both stated and implied, that define their relationship. Those agreements are what I call personal compacts…The formal dimension of a personal compact, is the most familiar aspect of the relationship between employees and their employers. For an employee, it cap¬tures the basic tasks and performance requirements for a job as defined by company documents such as job descriptions, employment contracts, and performance agreements…In return for the commit¬ment to perform, managers convey the authority and resources each individual needs to do his or her job. What isn't explicitly committed to in writing is usually agreed to orally." (Harvard Business Review, 1995)

A "compact" (often this would be referred to in terms such as "commitment," "loyalty", etc.) and a "contract" (often referred to as obligations or responsibilities) are very different. A "contract" defines the specific, measurable and objective elements of a business relationship. A "compact" relates to the intangible, subjective and in some ways emotional aspects of that relationship which we often call a "covenant". In The Fifth Discipline, Peter Senge states:

"Max de Pree, retired CEO of Herman Miller, speaks of a 'covenant' between organization and individual, in contrast to the traditional 'contract' ('an honest day's pay in exchange for an honest day's work'). 'Contracts,' says De Pree, 'are a small part of a relationship. A complete relationship needs a covenant…a covenantal relationship rests on a shared commitment to ideas, to issues, to values, to goals, and to management processes…Covenantal relationships reflect unity and grace and poise. They are expressions of the sacred nature of relationships.'" (p. 145)

It is in the context of this "compact" or "covenant" that I report to you about my six weeks away from SETMA.

The first thing my compact with SETMA requires of me is to make wise choices concerning my personal health - physical, emotional, mental and spiritual. As a result, I invested the largest part of my six weeks in recovering the cardiovascular fitness which West Nile took away in July, 2006. I worked hard at this both in losing weight and in aerobic conditioning. While I am "not there yet," I have made great progress. In June of 2006, I was exercising on the treadmill for sixty minutes five days a week at 5 miles/per at a 6% incline. As of today, I am doing 60 minutes on the treadmill six days a week at 4.8 miles an hour with no incline. Some have said that walking on a treadmill for an hour is boring, but the reality is that I only have to exercise for ten minutes which anyone can do, but I do ten minutes six times in a row and add an additional six minutes at the end!

Emotionally, I spent a great deal of time with my wife and family and visiting those places both physical and mental which bring comfort and fulfillment to me personally. We laughed; we cried; we were talkative and we were quiet, but in it all we were together. This contributes to my fulfilling my compact with SETMA because when I am here, I am able to focus on SETMA and not on what I haven't done elsewhere. While I am not perfect in this regard, my sabbatical helped greatly. One of the best things about persevering in relationships is that the longer those relationships last, the more satisfying and fulfilling they are.

Mentally, I exercised myself my reading extensively, writing and thinking about life, work and the interface between the two, as they are a continuum which are difficult to separate. I read and wrote for more than five hours a day on average. So that this did not interfere with the emotional aspects of my compact with my wife, I "got up early."

Spiritually, I renewed my enthusiasm for the things relating to my personal faith, first by reading through the Bible in the month of November and by seeing afresh how intimately and inextricably my faith and my function at work are joined. It is impossible for me to fulfill the requirements of my faith without practicing and demonstrating the principles of my faith in the workplace. Because my work is an extension of my faith, my faith gives me renewed strength, energy and enthusiasm with which to meet the needs of my work.

Another aspect of my compact with SETMA meant that I continued to think about SETMA. As a result, I attempted to identify a major initiative for SETMA each week that I was off. Several of these initiatives are:

The implementation of the ICD-10 which is a new coding system which we will be using in 2011 as mandated by the Federal government. My goal is for this transition to be seamless for our SETMA providers and for SETMA to derive all of the potential benefit available from this new system.
A new clinic. This required me attending several meetings during my sabbatical but has the potential of expanding the outreach of SETMA and solidifying our future.
A reward system for our employees through which to communicate to them tangibly how valuable they are to our healthcare-delivery efforts.
The definition and development of leadership within SETMA. On November 2, I sent the following note to SETMA's leadership team:

"One goal for my sabbatical is to think about the future of SETMA. As I started my sabbatical yesterday, after two weeks of vacation, I was heartened by the response of each of you to my absence. The reports which have been shared with me are more encouraging than the outstanding financial performance we have been experiencing for the past year...To the end of thinking about SETMA's future and indeed of "re-dreaming the dream," I have purchased for each of your offices a 22" x 28" print entitled, "The Power of a Leader," which state: True leaders are not those who strive to be first but those who are first to strive and who give their all for the success of the team. True leaders are first to see the need, envision the plan, and empower the team for action. By the strength of the leader's commitment, the power of the team is unleashed."

The choices which I made with "my" time off will benefit SETMA because I am prepared to approach the next 14 years with the same enthusiasm, commitment, energy and excitement as I have for the past 14 years. Many things will change between now and 2022. I expect that with flexibility, vision, passion and learning, we (SETMA) will experience the same success in those years as we have in the past years. During this month, I realized that Mrs. Holly and I were married in 1965; we both turned 65 this year and we have been married for 65% of our lives. That symmetry has encouraged me to make certain when 2022 rolls around and we are both 79 years old, that not only will SETMA have been successful that Mrs. Holly and I will be successful also.

Thank you for the time away. I have realized that periodically taking time away is as much a part of my compact, i.e., covenant, with you as is being here and working hard. I am glad to be back and I look forward to working with each one of you to make your future everything that you want it to be.

Finally, I have been very impressed with the work which all of you have done in my absence. The leadership of my partners and particularly of Dr. Aziz in this effort has been exemplary. The work of our hospital service team, our providers, our support staff and our executive management has been outstanding. Thank you all for an excellent job. We truly have a great team.

God bless you.

James L. Holly, MD
CEO, SETMA, LLP

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