This episode of Bottom Line Faith features Randy Oostra, the President and CEO of ProMedica Health System.
Ray: Well, hello, everyone. This is Ray Hilbert, your co-host of the Bottom Line Faith audio podcast. It is your weekly look into the lives and hearts of high capacity, high-performance Christian leaders from the world of business, entertainment, and athletics, as well as non-profit leaders. As mentioned, I am your co-host, Ray Hilbert. Our other co-host, Adam Ritz, is out of town and traveling this week. So, I get the pleasure of conducting this week’s interview. And I am really excited about our special guest today because this guest has a broad sense of experience, particularly in an industry that is rapidly changing and that is under a lot of pressure and a lot of constraints that are being placed on it in the marketplace. Well folks, our guest this week is Mr. Randy Oostra. He is the President and CEO of ProMedica, here in the Toledo, Ohio area. Randy, welcome to the Bottom Line Faith podcast.
Randy: Oh, thank you. Great to be with you.
Ray: Randy, tell us a little bit about your background. We’re going to have plenty of time to jump into the questions on leadership and challenges.
Ray: But, just help our audience understand a little bit about you and your background, where you grew up, and all those good things.
Randy: Yeah, great. Well, I appreciate that. Well, you know, Oostra is a Dutch name. So, I actually grew up in northwest Iowa. If you look at how the Dutch immigrated and settled across the United States, there’s different groups across the country. And there’s a group in northwest Iowa farm country, grew up in a family. My mom immigrated with her parents. My father and, shortly after, his parents immigrated. He was the first generation. He was the oldest of 14 kids.
Randy: Neither of them had the opportunity to go to school. If you asked them about it, they would have said that, you know, maybe second or third grade, but they were the oldest. So, they worked. I had these great Christian parents, Dutch, grew up in the Christian Reformed Church. You know, my wife grew up in the Reformed Church of America. And you know, we were families that you didn’t miss church, you didn’t miss Sunday school, you went to everything. My wife’s family was a little better. She actually had perfect attendance, I think, through high school for Sunday school. So that tells you a lot; but I had this great blessing of Christian parents. I had the opportunity; in those days, they let you go from school to go to catechism, both the Christian school and the public school. So really, kind of a unique place and a unique time. Great, faith-based community.
And I just had the luxury of having Christian parents, Christian friends, and a great Christian atmosphere to grow up in. And I was blessed. I went to school, went to a small church college right there in Orange City, Iowa called Northwestern, or Northwestern College that is part of the Reformed College of America. And that was a place where I just had some great mentors, people that took you under their wing and kind of helped mold you. I had an older brother and sister, and they were both teachers. I kind of thought that way for a while; but, I had a great professor that kind of guided my career. And I think the same thing for my wife. She was in mathematics and had somebody guide her career. And just, you know, it’s a great place to grow up. My wife and I met a few years later. After college, (we’d gone to the same college, but didn’t really interact so much) we met. She was working for Bibles for the World. And I was taking a break after graduate school, trying to make a little money to keep going to school. We met, got married, and then changed our lives. So, went a little different course.
Ray: I want to hear more about the story of how you ended up in the healthcare field. But tell us a little bit about ProMedica.
Randy: Sure. ProMedica is what we would call an integrated delivery system. So, what that means is it’s the kind of something that came out of the 70s where the idea was that you take care of people, kind of cradle to the grave, and you have all these integrated services. So, you see a lot of these systems. It has hospitals. We have 13 hospitals, Northwest Ohio, Southeast Michigan. We employ doctors. We have about 900 employed different kind of providers. We work with about 2,500. We have an insurance company. It’s called Paramount. It’s got about 325,000 members. We do a lot of things around a hospital, post-acute type services, long-term care, those sorts of things. When you roll that up, we have about 17,000 employees, around 3 billion in revenue. So, you know, a fairly large regional healthcare system. We’re based here in Toledo, Ohio. A lot of it has focused on how far can you go away from any community and get people to travel there for care. If you look at a map, it’s pretty logical that it’s Southeast Michigan counties and Northwest Ohio.
Ray: That’s terrific. And did you always know you wanted to get into healthcare? How did that come about?
Randy: You know, when I started out my brother and sister were teachers. I was going to teach, be a coach. I was interested, played football in high school and college, small college football. I always thought about that. Then I got there. And I thought, “Boy, I don’t want to do this the rest of my life.” Between student teaching and biology, and then playing football, I decided that really wasn’t right for me. I decided to become a physical therapist for a while; again, with this kind of sports ID in mind. Then a professor from Northwestern really started to talk to me a lot about my future and where I should go. And He really kind of convinced me to teach in college. So, they thought that would be a good path. He was a medical technologist. So, he had some additional lab training. I did that and then went to graduate school to teach. And the idea was to get a doctorate in microbiology.
After I got a Master’s, I took a break because, as I mentioned, I needed to earn a little money. I met my wife, and I got a job working for a company that was based in Sioux Falls, South Dakota. It was owned and run by a group of physicians, and they provided services to small hospitals across the Midwest. And I spent a fair amount of time traveling through the Dakotas, Nebraska, Iowa, Minnesota. I’ve probably been in every small town in all those states. I spent some time going to Public Health Service hospitals on the Indian reservations. It had a tremendous impact on me, what that experience was. One day we were flying, and the President of the company asked me what I was going to be doing when I was 50 years old. At the time, I’m 28, and it was kind of one of those things. We flew single engine planes, very noisy. So, I’m kind of yelling at him, like, what did you say? And he said, “What are you going to be doing when you’re 50 years old? You won’t be doing this.” That precipitated a bunch of discussion. I went through a process of deciding where we should go in life. I looked at Christian counseling, took the outsets. I decided that maybe I should be a lawyer and also continue to think about healthcare administration. I won’t bore you with the details, but I ended up going back to the University of Minnesota at 30 years of age. My wife and I quit our jobs, sold our house, and sold our cars.
Randy: We went back to school, took a complete pivot in life. We worked our way through the money we had put away. So, we’re going to live on what we made. We cleaned our apartment building for free rent. I cleaned a bank at night. My wife did income taxes. We had a two bedroom apartment and two little kids. And we started over in life. What was interesting was that the reason he was asking me what I was going to be doing at 50 years old, was that the company was in the process of being sold. And shortly after I made it to the University of Minnesota, they were sold, and they don’t exist today. So, a little grace of God there about pushing in the right direction.
Ray: That’s really an amazing story. And I also see many, many strong indications of that good old Dutch Reformed work ethic.
Randy: Exactly right, exactly right.
Ray: We’re going to get it done one way or another.
Randy: Going to get it done. Exactly right.
Ray: Yes, that is fantastic. We’re going to talk in just a moment about leadership, lessons learned, and so forth. But take a moment and just give us a synopsis of, from your viewpoint, the healthcare field. Obviously, rapid changes going on. All kinds of tension and pressure is there. What’s that like?
Randy: Yeah, you know, it’s an interesting case study. People look at healthcare, and they go, “How did we get to this point in life?” If you look at where we are today, we’re a $4 trillion industry consuming almost 20% of the gross domestic product, and it’s going to continue to go up. So now they’re talking $5 trillion and 25%, we really can’t afford it. You go back in history, and a couple things happened. Post-World War II, post-Depression, we passed something called the Hill-Burton Act, and it was a really well-intentioned, it was a job creator. And after the war and depression, the hospitals were in bad shape. A lot of clinical advances in World War Two. If you can imagine, it’s an interesting look at life events. So I think it was Truman who decided we’re going to put veterans back to work. We’re going to build hospitals; we built 195,000 beds.
So that’s 4,000 50-bed hospitals in this country. And so we built this big structure, it was thought to be a job creator, great thing to do for communities, it was. 1965, we passed Medicare and great thing to do, we were trying to provide care for seniors that needed health insurance. But the problem was, we didn’t put any controls on it. So what grew out of that was an industry, and in those days, Medicare also paid your capital costs, their share of it. So there was no reason not to build dramatically. And so we built up this huge industry that is less focused on preventative care, primary care, mental health services that we see in Europe, and so now we have a model that we can’t afford, but no political will to change it. The Affordable Care Act did some nice things, in that it put some money in innovation. It also, you know, added a number of people to the insurance roles, somewhere between 20, 25 million, that’s a good, moral thing to do, but it did nothing for the cost curve, even though they are paying us a little differently, more for value. So it’s a mess, and we would like it to move to more of a social determinant sort of role, but that’s probably a long discussion for another day.
Ray: That would probably be if our program was an hour long.
Randy: Yeah, we can talk a lot about it. It’s fascinating, but it’s a bit of a mess. And we need to change the model, and, you know, I think it’s going to change when finances make a change, and that’s usually what happens.
Ray: Yeah, absolutely. Thank you for that background, not only personally and spiritually, but you know, from a career standpoint. So I’d like to just dig into some of the meat and substance of our program. What I’d love to kind of maybe kick off the conversation with, Randy, is this question. Thinking back over the course of your career, we all make mistakes, we all have failures, what would you say is a big mistake or a failure that you went through, and what did you learn from it?
Randy: Yeah, I think the hardest things that at least I felt my career was the decisions that impact people. So when you get yourself in a situation where you have to actually think about laying people off or impacting people’s lives, I ran a bankrupt hospital and a hospital that actually was, they were bankrupt, no doubt about it. And we had to lay off 60 people in a small town in Michigan, and went through a process. I was new there, and what was interesting was just, you know, just dealing with the impact of people. What happened, the result of management actions, and not taking good steps along the way, got this hospital in a situation where they needed to lay people off. And as much as I tried to change it, I couldn’t. You look back at those days, and you think well, if I had done this, had I done that, could I have saved more jobs, and, you know, protected people’s lives?
So those are the things that kind of, you know, haunt you a little bit, you know, you always wonder if you’re doing the right thing, if you did the right thing along the way. I think the point there is just, you know, really, I think it’s a good, you know, motivator for just good solid management, and for those folks in management to do the right things, to get up every day, to work hard, to really analyze situations from all aspects and make the decisions you need to. It’s that whole notion, I think, of creating urgency in companies. So when I look at the times that I think I’ve failed, it’s on some of those issues where, you know, you get yourself in an economic position, you have to impact people’s lives.
Ray: Sometimes that’s inevitable, right? And I don’t care how many times you go through it, and how many people have to be a part of that, it still hurts, and it’s not an easy thing to do. And if it ever doesn’t bother us, we might want to check ourselves, right?
Randy: No, exactly right. Exactly right.
Ray: Yeah, these are real lives, and we’re working through here. So let’s talk a little bit about your philosophy in terms of how do you attempt to live out your faith in your leadership down and through your organization? How did those biblical principles come to life in your leadership?
Randy: Well, you know, there, I think there’s a couple cuts. So I don’t, I’ve worked in faith-based healthcare before. And right now, I’m in an organization that’s not faith-based, although some of our hospitals have roots in different type of churches and things. And I think it’s a, you know, I think, as a person of faith, as a Christian, it can’t help but impact your lives. And, you know, I think the thing that’s to me most interesting is the example of Christ. So how Christ, you know, his life on earth. So you look at everything from his vision, the vision he was casting, what he was trying to do, you know, the time he spent with his disciples. And, you know, to me, it’s fascinating. He didn’t surround himself with CEOs, he didn’t surround himself with college professors, there were no professional athletes, and he surrounded themselves with people. And yet he, those disciples were the people that he mentored and guided every day.
And then it’s just the empathy he had for people. I mean, just the opportunities, you know, to cast a stone at somebody, and just to lift people up. And I think it’s that grace, and it’s the, we would call it emotional intelligence. But I think it’s grace, where he looked at people that had less than perfect lives and said, send them over, and I think those are the sort of things I look at, you know, just what Christ did, how he developed his disciples, how he cast a vision, and he was the ultimate changer of our world. And he did that by creating urgency. And there’s a lot of things in his life, whether it’s, you know, overturning the tables in the temple, or whatever he did, he was to create some urgency to change. And I think you look at those biblical, you know, principles in life, you think about how Christ lived this life, and then just how he approached people, whether it was children, whether it was the poorest of the poor, and I think it, really I think, as leaders, rather than chasing a professional sports, you know, athlete and thinking about what their vision of life, not, not to say that’s not at all good. But I think it’s just, you look at that, and you think about that example for our lives and our management style. And I think those are the sort of things you really want to model to people.
Ray: Yeah, really check and see who we’re wanting to model ourselves after, and the difference they’re making. Yeah, and obviously, Jesus is the ultimate role model there. Tell me a little bit about your philosophy and approach to mentoring leaders who are coming behind you, that next gen of leader, how do you go about that?
Randy: Sure. Well, you know, there’s done it different ways throughout my career, and it’s a little different right now than it has been in the past, I think it’s really taking the time, you know, to really talk to young leaders, mentor young leaders. For example, in our executive group, we have invited guests that we invite into our executive group every year. We have one to two young leaders with us, and so the deal is, you’re going to be part of our group for one to two years, and you’re going to be with us, you’re going to go to every meeting and be part of every discussion, and then at the end, you’re going to go back to your job. So we’ve done that with, you know, having what we call residents or fellows or interns, and then we’ve also been done it with our mid-management people, to allow them to come in. I do a colloquium. Don’t ask; I didn’t pick the name for that, but it’s where I usually spend some time with 30, given the size of our organization, 30 leaders. I think we’ve done that four or five times. We talk to them about writing their own view of leadership.
There’s a great article from the Harvard Business Review, “The Incomplete Leader.” And so the notion is we’re all incomplete leaders; we know that because of our faith and sin. And so each and every day, it’s about being more complete leaders. So I think it’s that; I think it’s this constant focus on young people. Mentoring, you know, one thing, I spent a lot of time having a cup of coffee with people. So several times a week, I’ll sit down with people, they don’t report to me. What I’ve come to do a lot is I text people and and just check in. And usually I’m saying, hey, you know, Ray, I’m just checking in, how are things going? And I usually get a page back. And I think it’s just letting people know, and then I’ve been able to engage people a whole lot. So I think it’s just everybody figures out a way to do it for them. But I think between structured programs and formal programs with letting people hang with you to kind of that one-on-one feedback; I think those are all sort of things that I think for each one of us can work differently for each leader.
Ray: Yeah, what I hear in that is, there’s a lot of intentionality. You know, John Maxwell says that leaders are, of course they’re born, but there’s also made, right? And that there’s intentionality in investing and so forth. And so who was it who invested in you? Who helped you, when you were a young leader, understand those issues, those challenges, those pressures, and demands? Who brought you along as a young leader?
Randy: You know, I had a boss when I got into healthcare administration, my first boss, and the first, when I went to work for him, he told me very clearly said, I’m going to invite you to all my meetings. I want you to wear, you know, your best, you know, suit and tie, I want you to pull up to the table, put your forearms on the table and I want you to look engaged and keep your mouth shut. And I will tell you when you can open your mouth. And after every meeting, we would talk, and he would say, what’d you see? What’d you hear? Did you see Ray in the corner? What was Ray’s body language? And you know, early on, it was like, who’s Ray? And then I had a boss in Grand Rapids, Michigan, a guy named Terry O’Rourke. And he had a just a phenomenal business sense, you know, we would call that probably critical business thinking skills, and was really based on business plans. So I probably get 100 business plans. I always told him, I’m going to create a business plan that you’re going to tell me you have no questions. And of course, that never happened. But it was really just good training. It was like, how do you conduct yourself? How do you observe people? Both of those gentlemen were the last to talk. And to this day, I listen to discussions; I write questions in the corner, I ask everybody, and then if I talk, I talk about at the end. And it’s just allowing that discussion to happen. And again, I’d like to say I created that. I didn’t; I just had a couple good mentors along the way. And again, when you learn from, and you start to work that way yourself, you want to be able to kind of take what you learn from those folks and pass it on as we all want to do in life.
Ray: That’s terrific. Folks, this is your co-host of Bottom Line Faith, Ray Hilbert. I am speaking with Randy Oostra, the president and CEO of ProMedica. Randy, let me ask you this. Tell us a little bit about maybe some of your principles of leadership, success of leadership. What’s really important for you to model and demonstrate and teach?
Randy: Well, you know, I think a lot of it’s, yeah, I have to admit, it changes from time to time, you know, I think, you know, credibility is, it’s got to be number one. Because if you lost credibility, people don’t have trust in you. People don’t believe in you as a person; they’re not going to follow you, no matter what you say. So, I think it’s always that constant of watching out, you know, you look at people that have, we all get, when we get blessed in life, that it’s easy to be tempted to take, you know, advantage of institutions and opportunities. I think you just have to constantly be aware of that. So I think credibility is number one. And then I think it’s just, you know, making sure that you kind of move organizations forward and move people forward and move whatever part of the organization and that’s different things for different people. So I look at my job a lot in yes, making sure that and maybe it’s my age speaking, but making sure that you’re presenting yourself in a really trustworthy manner and being credible. And then the other thing is just creating urgency.
So I spent a lot of time I tell, when people ask me what my job is, is either say, create urgency and get out of the way or create urgency and tell them it’s going to be okay, one of those two. And I think that said, because a lot of it’s still I go back to my mentors, it’s creating good solid plans, creating urgency. And I’m always surprised when I ask, Ray, I need a plan for XYZ, can you do that? Yeah, I can do that. When can you do it by? Can you get that done in 30 days, 60 days? Oh, I can get that done in 60 days. I know they can’t. But every single time they commit to it, and what it really does, it allows you to kind of elevate the organization, I think. So I look at it in those contexts about, and each area is different, each person is different, each part of our organization is different. There are parts of our organization I would give an A- to, and there are parts I’d give a C- to, and it’s working on the C- issues. Next year, there’ll be other C- issues, and I think for any person and organization, it’s really trying to move yourself forward. And I think along the way, just as, you know, conduct yourself, as you hopefully you’re a model to other people, it’s how you live your life. It’s what you say, it goes back to that trust and credibility notion. And again, just as Christians, we know, that’s going to witness to others as people know your faith.
Ray: Yeah, thank you. Very, very good. Very good insights. So, CEO, President, I think you said, 17,000 employees, is that correct?
Ray: And married, you’ve talked about your marriage, family, church, community, lots and lots of things on your plate. There’s probably a listener right now, leader who’s really struggling right now, with just the business of life and demands of their schedule. And they’re wondering how they’re going to balance it all and get it all done. How do you do it? How do you get it all done?
Randy: Well, you know, you got to get good people for one thing. So I have lots of great people. So that helps a lot. And I think the other thing is, you know, you just; I’ve seen people that allow those sort of issues to get to them mentally, physically. And I think I just, you know, you again, I go back to my parents, and the opportunities in life. And the way I look at it is, you tie your top button if you wear a suit, and you go to work every day, you do the best you can, and you do what you can. And then at the end, you, you know, you keep your priorities straight. And so, if you have your faith, your family, and then your work life, and you keep some balance here, it works out great. What’s interesting is when you talk to people who work in a hospice, at the end of your life, you talk about two things. And it’s real clear, you’re going to talk about your faith and your family. And so no one’s going to say at the end of their life, you know, you’ve heard this before, I wish I spent more time in the office. But I think as we look at, you know, the decisions we make in life, those are the decisions that are important.
My father passed away two years ago in Iowa, and he let his cable TV go, the Wi-Fi in the building wasn’t working, he didn’t have a newspaper, and I couldn’t get internet connection. So I talked to him for two days, probably about three, four months before he passed. And all we talked about was family. And we went over our family over and over again; that’s what we talked about. And I think that, you know, is kind of the lesson in life, you know, the decisions we make today on our family and our faith is really those lifelong, you know, balances in life. So when you start with that, and then I think it’s just, you know, trying to be the good community citizen, that we all should be, and it’s being involved in our church, it’s being involved in our community, trying to make things better, you know, it’s easy to complain these days. We see that a lot, we see it modeled everywhere, and we can’t do that. And so if we get up every day, and try to make our communities better, the type of place that we want, you know, our kids want to live in, our grandkids, we think about that. It’s like, well, we need to create that in our own area, our sphere of influence and we all can do something wherever we’re at in life. And I think that’s the point each and every day; we get up; we do the best we can.
Ray: Day by day, right? One day at a time.
Ray: It is hard to believe that we are already approaching the end of our 30-minute program here this week on Bottom Line Faith. And so Randy, we’ve got a question that I’ll take just a moment and set the stage for the question. We call this 4:23 question. And it’s based out of Proverbs 4:23, the words of Solomon, says, “Above all else, guard your heart, for it determines the course of your life.” I’ve done a little bit of reading on this, and our regular listeners to the program know this is the last question we ask every guest, so join the club. You’re part of the family now. But there are many biblical scholars who believe that these were perhaps among the last words that Solomon wrote before he passed. In fact, some even believe he may have penned these words from his deathbed. So we could have this picture of Solomon, the wisest man who ever lived, had all these pearls of wisdom to share and wrote the Psalms and those sorts of things, to say that maybe he gathered his family and friends, his associates, his loved ones, gathered them around and says, now, I’ve shared all this with you. Now, this one thing, above all else, guard your heart. That was what he wanted to share. So Randy, let’s now fast forward the clock, and let’s say it’s the end of your time this side of eternity on earth, and you’ve gathered your family, your friends, your loved ones, key associates, those who are most important to you in your life, and you’re going to dispense your above all else. advice, fill in the blank, folks, above all else…
Randy: At the end of your life, you will talk about two things. You will talk about your faith and you will talk about your family.
Ray: And keep those in mind.
Randy: And keep those in mind. And if every day, when you get a little confused, and you’re thinking about your priorities and your stresses in life, if you think about your faith and you think about your family, and you’re focused on those issues first, and get up every day and work hard and to serve God and serve your family, I think you’ve done well in life.
Ray: That’s an absolutely stellar response and it’s perspective, right. And I once had a friend say to me to always consider in life giving priority to those who will probably be weeping at your funeral. And that’s really what you’re talking about are those important family members, but also keeping your faith at the center of life.
Randy: Some would say, are you building a resume or are you building your eulogy?
Ray: I love that. I love that. Oh, that’s really good. Can I write that down?
Randy: I know I read that somewhere. I don’t think that’s original.
Ray: I’m going to give you credit for it. That’s really good. So as we wrap up here, any closing words of comment, encouragement, or advice you’d like to pass along?
Randy: No, I think just, you know, just the thing I’ve been focused on lately is, you know, we look at Christ’s life and you know, it’s easy to get caught up in secular writers, business leaders, and it always amazes me that we focused on those books and yet the answer is right in front of us in Scripture and the life of Christ and what better place to go and focus on than that?
Ray: Fantastic. Well, folks, we are wrapping up on another edition of the Bottom Line Faith podcast. Our guest has been Randy Oostra, the president and CEO of ProMedica. Randy, if any of our listeners want to learn more about the company, what’s your website?
Randy: It’s, well, you can send it to me directly. It’s promedica.org. So if you just Google promedica, and my address is firstname.lastname@example.org, and happy to have anyone send me an email.