Oct 17, 2022 4 min read

Recently, I saw in a local newspaper that two “hometown professionals” were selected for leadership positions in their organizations. It was nice to see two local folks being recognized and rewarded for their work and talent.

The question all local board members and decision makers should constantly ask themselves is one that explores not only their own level of knowledge but also their understanding of what it really takes to do the job for that organization. Too often there seems to be a personal belief that local people aren’t good enough. At the same time, we’ve produced national office holders, leaders of major government agencies, and presidents of national companies who were born, raised and educated here.

After being told in 1992 that the hospital where I was a vice president was being sold, I applied at and was turned down for employment by three other local hospitals. Even though I had gone back to school again and again for certifications, degrees, and fellowships, my capabilities at that time were not deemed to be good enough to be considered locally. Almost ironically, I then became one of the finalists for a CEO position at Boys Town National Research Hospital in Omaha, Neb. Why was I good enough for a national hospital but not for the area where I was living? Was it because I was from out of town?

Don’t get me wrong. Some jobs require credentials and experience that are far beyond those of the individuals who apply locally, but what if they aren’t? What causes the out-of-towners to win those coveted positions time and time again? What’s the old saying about not being a genius unless you’re from out of town?

It was clear that the former manager of one of the areas’ then after-hours clubs, had some very insightful information that he unabashedly made public. When he would advertise the entertainment for that club in the newspaper, the advertisement always read, “This weekend’s entertainment is ‘Direct from out of town.'” It didn’t seem to matter if they were from Ligonier or Los Angeles, just so they weren’t from that town.

Over the 20-plus years in my hospital work in the late ’80s, ’90s and early 2000s, I watched out-of-towner after out-of-towner come into the various hospitals in the region where I was working. They came as CEOs and vice presidents who lacked knowledge of the area, connectivity, concern, or commitment to the people there. It was primarily a steppingstone on their employment journey.

When we looked at what transpired with many of those leading local businesses and institutions once some of those out-of-towners took over, we saw what in many cases has been a version of piracy that has, excuse the expression, raped and pillaged many local businesses, destroyed the local job base, and under-cut the social fabric of the area.

After watching the institutional devastation that occurred at those organizations, I came to realize that many of these individuals were not just outsiders, some were, in fact, truly carpet-baggers. After they wreaked their damage, they either left in the dark of night or, worse yet, left with major departure bonuses or evergreen contracts that paid them their full salaries for years after they were gone.

It was interesting that, following my retirement from a small rural hospital, I started consulting across the United States, but I didn’t work in hospitals that were small. My consulting was respected enough to take me to places like Cedars Sinai in Los Angeles, Atlantic Health and Hackensack-Meridian in New Jersey. My work also took me to Parkview in Fort Wayne, Indiana, to Chicago, and to Naples/Ft. Myers, Florida. I was “direct from out of town.”

So, congratulations to those who selected local leadership. Sometimes that’s the only way you can be sure the person in charge will actually give a damn about the future of the area.

Nick Jacobs of Windber is a health-care consultant and author of two books.