When Leadership Shapes Care

How the Hankamer School of Business is preparing healthcare administrators to navigate the system’s toughest decisions.

No patient enters a hospital at their strongest moment. With illness comes a loss of certainty, leaving people dependent on decisions made by others – often by leaders they will never meet. In those moments, healthcare is no longer an abstract policy debate. The quality of care can reflect something more immediate: the judgment and character of the people guiding the system.

Are ethical principles applied consistently? Are guiding values in place? Does the patient truly come first? In recent years, the political climate surrounding healthcare has made those questions harder to answer. Responsibility for guiding the system increasingly moves with shifting tides of power. Yet beyond that push-and-pull lies another path forward. Instead of throwing up their hands and waiting for someone else – or some policy miracle – to solve the problems, educators and students at Baylor University’s Hankamer School of Business (HSB) are stepping into the work of preparing leaders who will shape healthcare from within. Their focus is not merely on administrative skill, but on cultivating administrators equipped with the ethical framework necessary to navigate the complexity of our healthcare system.

The scale of the challenge is sobering. The United States spends approximately $4.3 trillion annually on healthcare – nearly 18 percent of its gross domestic product – while remaining the only developed country without universal coverage.

“In addition, there is an unacceptable amount of preventable harm that takes place within our healthcare system,” said Dr. Forest Kim, executive director of HSB’s Robbins Institute for Health Policy and Leadership. “We need leaders that are aware of those contextual issues with a deep understanding that those in need of healthcare are the most vulnerable.”

Dr. Kim also points out the reactive nature of today’s model.

“Our healthcare system is designed to treat people when they get sick, not to keep them healthy,” he said, describing the lack of emphasis on wellness and prevention. At the same time, leaders operate under intense financial pressures such as shrinking reimbursement rates, rising costs and increasingly complex regulatory environments. In that environment, the incentives “don’t always align themselves with providing quality patient care,” Dr. Kim said.

These competing pressures are exactly where ethical leadership becomes most visible, because someone must do what is right by the patient and decide what matters most.

As the former CEO of Baylor Scott & White Health, Joel Allison, the senior advisor in the Robbins Institute, can speak to that pressure.

“Many who enter healthcare do so because they want to help, to heal, to serve,” Allison said. “The question becomes not simply whether a choice is profitable or efficient, but if it is the right thing to do for the right reasons.”

The ideals of mission, values and accountability also guide HSB’s approach to leadership development in healthcare administration. Dr. Kim describes the motto of the Robbins Healthcare MBA as developing “the next generation of servant leaders for healthcare.” Servant leadership, he explains, emphasizes empathy, compassion and the willingness to put others before oneself. It is modeled by faculty and staff, many of whom bring decades of military and healthcare leadership experience, and then reinforced through guest speakers who have led major health systems. Ultimately, the students experience the tension themselves through situational simulations that present real-world issues they will encounter in the field.

These are the same types of decision-making scenarios that can cause well-intentioned leaders to falter.

“I don’t believe most people who work in healthcare wake up in the morning and say, ‘How can I work the system?’” Dr. Kim said. “They are there because they want to serve. It’s because of the pressures people take shortcuts.”

By placing students inside difficult management scenarios where financial, legal and human considerations collide, the program seeks to form decision makers who recognize those pressures and respond with discipline.

Through global health immersions in countries such as Chile and Germany, students can take this formation outside of the classroom. These opportunities offer in-person views of alternative models of care and consider how policy structures shape access and outcomes. Other destinations are closer to home. In an inaugural mission trip to rural Appalachia this summer, students encountered communities where limited access to care has generational consequences. Exposure to those realities can reshape perspectives and place leadership within a deeply human context, Dr. Kim said.

At the Army-Baylor MHA/MBA program, directed by Lt. Col. Mike Frankel, students arrive having already faced the kinds of pressures that shape a leader’s judgment. The program prepares mid-career military officers – clinicians and administrators alike – for senior roles within the Military Health System. Part of the curriculum includes two courses in healthcare and business ethics. Students also spend a year in residency to experience how classroom lessons play out in military and civilian environments alike.

In environments where leaders are regularly forced to evaluate contracts, reduce services and balance operational realities with patient care priorities, Frankel describes decisions in which the easiest path is to “let the dollar drive the chain.” Instead, future leaders are asked to understand and provide reasonable scenarios for how to protect safe, effective care first. Ethical leadership, Frankel said, begins with “having the patient front of mind for everything we do.” For students preparing to lead complex health systems, that principle becomes both practical and moral. This balance is provided with a chaplain and an ethicist on staff. The priority is always for students to have the resources they need as they learn to navigate business decisions with values intact.

For Baylor alumna Maria Morales-Menendez, MBA ’20, market COO for Palm Beach Health Network at St. Mary’s Medical Center, ethical leadership plays out in the daily realities of hospital operations. Responsible for overseeing complex systems of care, she regularly faces decisions about how scarce resources are allocated – ICU beds, physician manpower capacity, staffing levels – all while maintaining safe and effective care for patients.

“In healthcare and hospital operations, it’s about managing within the resource constraints we have while not compromising on patient care,” she said. “Especially in a crisis situation, the patients will keep coming, even if you’re not getting more doctors, more nurses or more supplies. You must work within that constraint to provide the best care possible.”

Morales-Menendez stepped into those responsibilities at an extraordinary moment. She graduated from Baylor’s Robbins Healthcare MBA program in May 2020, just as hospitals across the country were confronting the first surge of COVID-19 patients.

The ethics courses, scenario planning and case competitions in the program had already placed students inside difficult leadership scenarios – from disaster response to hospital resource shortages. That preparation proved immediately relevant for Morales-Menendez.

“High-quality, safe patient care is the star for us,” she said. “The question is how to create an efficient system that serves patients and physicians without compromising the quality of care.”

Allison returns repeatedly to decision-making frameworks. As a healthcare CEO, he asked: Does this align with our mission? Does it reflect our values? Will it make care safer and more compassionate? Those questions, he asserts, must precede any financial calculation. When he works with Baylor students today, he repeatedly counsels, “Be sure you have an understanding of who you are, what your values are and what you are going to use as a framework.”

Even with their breadth of specialty, each Baylor business program reflects a shared conviction that healthcare leadership is a moral endeavor. The Robbins Healthcare MBA integrates ethics and leadership across coursework and an administrative residency. The Army-Baylor MHA/MBA embeds ethical instruction within both didactic study and real-world residency. The Dallas Executive MBA for Healthcare Administration further challenges seasoned professionals to redesign healthcare systems with equity and sustainability in mind. Beginning in spring 2027, an Online MBA certificate and concentration in healthcare will expand access to this formation model for working professionals across the country.

“Great leaders lead by example,” Allison said. He encourages students to know the people on their teams – not just superficially. “Leaders do not simply sit behind desks. They cultivate cultures where service is valued and where employees feel called rather than merely employed. When leaders love what they do, that passion becomes visible. It gives hope.”

Healthcare will continue to face strain, and policy debates will persist. Rising costs and competing pressures are not likely to disappear. If healthcare is to become more equitable, compassionate and trustworthy, it will happen because people who dedicate their careers to healthcare have been prepared to step into the pressure with clarity of purpose and strength of principle.

At the Hankamer School of Business, training leaders for that responsibility is not just a future goal. The daily work is already shaping leaders whose influence will extend far beyond the walls of the hospital.