What are the elements of success for a Health Director?
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Manage Finances
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Manage People
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Manage relationship to tribal authority (Council and Tribal Administration)
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Manage outside partnerships
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Manage contractors
What are common pitfalls?
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Poor oversight of spending or revenue cycle.
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Poor organizational structure results in neglect of staff, both neglect in support and neglect in supervision (compliance with job description and professionalism)
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Failure to 'crack the code' of performance improvement
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Failure to develop a respectful relationship with Tribal Council
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Failure to select quality contractors with clear objectives.
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Allowing indecision on 'means' to leave critical tasks 'undone'.
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Neglect 'outside' changes in the health policy environment.
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Allowing attention to outside environment to lead to neglect of management.
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Difficult staff benefit from turnover in management and will undermine management
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If removal of tribal members is not an option other options do exist such as pay without leave; failure to use other options promotes bad behavior.
Why do majority of newly hired Health Directors seldom serve longer than 2 years?
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In Alaska the saying is if key staff last 3 years they will stay-it's those first 3 critical years.
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The search for the perfect Director who can be and do all things is a fool's pursuit.
The critique of one or more aspect of a Director's performance can lead to their demise.
Relatedly, the refusal to allow Director to 'shore up' their weaknesses and utilize their strengths is just as foolish as hoping for the perfect Director.