Leadership in Healthcare: The Need for Younger Leaders

When Nicholas Tejeda got his first CEO post at the ripe old age of 32, he made a running bet with his assistant.

When Nicholas Tejeda got his first CEO post at the ripe old age of 32, he made a running bet with his assistant.



One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.


When Nicholas Tejeda got his first CEO post at the ripe old age of 32, he made a running bet with his assistant.


“Every time someone new would come into my office and meet me for the first time, our bet was, ‘How long will it take for the person to make a comment about my youth?’ Almost inevitably, it would be seconds, not minutes,” Tejeda remembers.


Now, two promotions later within the Tenet organization, the 36-year-old Tejeda is the CEO of a hospital that hasn’t even opened yet, the Transmountain Campus of The Hospitals of Providence in El Paso, Texas. The comments keep coming, albeit less frequently, and he sees it primarily as a function of working in healthcare.

“Certainly, no one is commenting in the Bay Area on anyone in technology being young when they’re 36,” says Tejeda, a student of history. “Quite the opposite – they’re considered quite aged for the industry at 36. But if you look back in time at what Thomas Jefferson was able to accomplish by the time he was in his early 30s, or Albert Einstein and his miracle year that he had well before his 30s, you realize that it’s a unique function of hospitals to look at youth that way.”


Tejeda says he finds that large health systems are more open to younger leaders than community hospitals or small systems.


“I find that independent hospitals and smaller systems don’t appear to have the luxury or the comfort with taking a risk on people who might be younger,” he says, “and it’s for a couple legitimate reasons. One is that they question the experience relative to the other people who are willing to come there. The other thing that the hospitals question is the young executive’s willingness to remain in the organization for a sustained period of time.”



Some in the industry have questioned whether the changes engendered by the Affordable Care Act have deterred organizations from hiring or promoting young C-suite leaders, but Tejeda doesn’t see that as an impediment.


“I don’t think the ACA has been at all harmful to younger leaders,” he says. “In fact, I believe it has reinforced the need and the recognition by boards of trustees that a different talent set and a new sense of energy and curiosity is needed in leadership to adapt and understand the ACA. What has worked in the past might not work going forward, and so that’s given those in governance a reason to look at new types of leaders.”


A new approach is certainly what Tenet has in mind with the Transmountain Campus which, when finished in 2017, will be the fourth acute care hospital in The Hospitals of Providence health system in El Paso. The new facility is a teaching hospital developed through an academic affiliation agreement with the Texas Tech University Health Sciences Center. El Paso is sorely lacking physicians and the new venture will play a major role in solving this challenge.


“This hospital is a large step in helping address that shortage,” he says. “Studies have shown that physicians are more likely to remain where they train. The relationship between Tenet and Texas Tech is very strong, and I’m intrigued by what we can do in this market.”


Although he left a non-profit system (Catholic Health West, now Dignity) to join for-profit Tenet, he says the differences between the two types of organizations are exaggerated.


“Both want to strengthen clinical quality and safety, improve the patient experience, and remain a financially viable partner for the community. At the end of the day, healthcare is a physician or nurse taking care of a patient, and they don’t care if the parent company has bondholders or shareholders.”


Tejeda has only been in El Paso for about a year. He has moved several times in response to career opportunities.


“I often get asked by early careerists, ‘How have you had such success?’ ” Tejeda says. “There is no shortcut to hard work, diligence, risk-taking and luck. But one thing I can’t overemphasize is mobility, and for me, mobility comes with a strong supporting partner, my wife. We have moved several times.


“We just moved from California, where we lived next to her parents – and we have their only grandchildren. Yet she supported the move to a community that we didn’t know, where we’d never been, and where we didn’t have any family because she knew this was a wonderful opportunity for us.”


As to hard work and luck, Tejeda grew up in Wichita, Kan., and he and his siblings worked in his father’s pharmacy from a young age.


“It was my dad’s expectation that my sisters and I would know the customers’ names by the third time they came in. He’d remind us that the customers never wanted to be in the pharmacy, because they were sick and sometimes grumpy. But he said, ‘Imagine what you’ve won if they leave the pharmacy with a smile because of how you’ve treated them.’ I’ve never forgotten that.”


Luck intervened when the college-age Tejeda found a university and a part-time job close to his girlfriend Elena, who is now his wife. He stumbled into a job working in patient registration at St. Rose Hospital in Hayward, Calif. It was there that he had a chance encounter with the hospital CEO, Michael Mahoney. The two had an instant connection, as St. Rose was owned by a parent company in Wichita, Tejeda’s home town. They spent an hour talking, with Mahoney telling him to look him up after college if he wanted a job. Tejeda did.


The rest, of course, is history, albeit a short history. He is, after all, just 36.



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