On Leadership

The transformative power of bold leadership in healthcare

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With reproductive rights and LGBTQ+ rights under attack in so many states, it was good to see the Summer 2023 Issue of the Brigham magazine in the mail this week. This issue is titled “Care for Every Body – Embracing Inclusive Medicine”. As a former VP and donor to Brigham and Women’s, I receive the paper copy to read. You can access it online here.

The main articles include:

  • Sex & Gender Glossary – essential terms and definitions for understanding sex, gender, and well-being.
  • Pro-Care. Pro-Patient. – describing how the Department of Obstetrics and Gynecology is working toward reproductive justice for all patients. An alarming data point: If all abortions in the U.S. were to stop, 24% more people would die from pregnancy complications and 39% more non-Hispanic Black people would die.
  • Soul Meets Body – describing how the Center for Transgender Health is breaking barriers and providing state-of-the-art, life changing care for trans and gender diverse people. An alarming data point: 46 states have proposed 491 anti-transgender laws in 2023, more than the previous four years combined.
  • Women ≠ Tiny Men – describing how physician-researchers are working to balance the scales for women’s health.

These articles and the programs described represent bold leadership in healthcare and what we should expect from healthcare providers.

Just as the Winter 2022 Issue titled “Standing Tall for Justice – Cultivating Equity and Inclusion in Medicine” was bold leadership as it covered racial equity in healthcare. And just as Michael Dowling, President and CEO at Northwell Health in New York, regularly shows us what bold leadership means. He doesn’t shy away from controversial issues as he addresses the issue of gun violence and calls for civility and decency in our public discourse.

Dr. Robert Higgins, President, Brigham and Women’s Hospital and EVP, Mass General Brigham comments in the introduction to the Summer 20223 Issue – “While forging the road toward a more inclusive healthcare systems is not an easy or immediately achievable goal, it is a vital commitment we must make. Our sense of humanity depends on it.”

Are you uncomfortable being a bold leader? Do you embrace or shy away from the DEI discussion? The DEI Committee of CHIME is hosting a webinar this Friday, June 30, at 12PM EDT that I highly recommend. It is titled “DE&I in Healthcare 2.0 – Getting Comfortable Being Uncomfortable in a Safe Space Zone”. Please follow this link to register if you want to learn how to stay DEI focused in an anti-DEI climate.

In a recent podcast interview, I was asked about some of the unique challenges and opportunities of being a CIO in the healthcare sector compared to other industries. I commented on how being in healthcare is mission driven and how we can make a difference in people’s lives. Leaders of our nation’s leading healthcare systems being willing to address the difficult issues and care for every person is one of the reasons I am passionate about working in healthcare.

What we do matters.

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Towards a more civil society

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Unlocking the power of time: insights from an inspiring leader

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Today is the longest day of the year and the official start of summer. This longest day leads me to reflect on how we spend our time.

I recently had the pleasure of interviewing Saad Chaudhry, Chief Digital and Information Officer at Luminis Health, for a Townhall episode on This Week Health. Saad is an inspiring leader on so many levels so preparing interview questions was easy. I had heard Saad talk in the past about what he calls his Manifesto of Time, so I wanted to make sure we discussed it in the interview. For Saad, looking at the number of hours the average person has in their lifetime means looking at how we choose to spend it and whether we give or take time from others.

As a health IT leader, he says we are in the business of time. He is committed to giving time back to staff and patients. He asks in his manifesto – “Does a process/technology/policy steal time from a fellow human? Is there a better alternative to simplify the experience?” He challenges us to make systems and processes easier for patients and staff, giving time back rather than taking more time from them.

I can’t say it nearly as well as Saad, so I encourage you to read The Manifesto of Time and listen to the short clip on time from our interview – Spending Time: Why It’s Important to Maximize Giving Back Our Most Valuable Commodity. We covered much more in the full interview if you are interested and willing to spend 30 minutes of your time listening – A Realigned Role, Generational Diversity, and Giving Back Time.

I know your time is precious – thanks for reading and listening!

Ted Lasso leadership lessons

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I was late to the “Ted Lasso” series so there were some seasons of binge watching. From its earliest days on Apple TV, I kept hearing about this show from my colleague at StarBridge Advisors, David Muntz. He loved it! My husband and I finally started watching some time last year and saw the season 3 finale last week along with all the other devoted fans.

There are so many lessons to share from this incredibly upbeat soccer coach who we came to know and love. Here are a couple pieces worth reading whether you are a fan or not – no spoilers:

If you haven’t already clicked through to the Becker’s article link above to read perspectives on the lessons from well-known healthcare leaders, please do. In the meantime, here are the lessons:

  1. Lead with empathy.
  2. Being vulnerable doesn’t make you weak.
  3. Optimism is infectious.
  4. Doing the right thing is never the wrong thing.
  5. Winning and losing aren’t everything.
  6. Optimists take more chances.
  7. Everyone differs from everyone else.
  8. Embrace change.
  9. Empowerment breeds confidence.
  10. Winning is an attitude.
  11. Humor cuts through tension.
  12. Courage is the willingness to attempt.
  13. Nobody is bigger than the team.
  14. Be self-aware and genuine. A truly authentic leader doesn’t have the time or the inclination to be anyone but themselves.
  15. Don’t dwell on mistakes or let them define you.
  16. Stay teachable.

I like all of them but 1, 4, and 13 are favorites. Continue reading →

Amplifying the voice of nurses

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May 6-12 is National Nurses Week. Nursing has been the most trusted profession for the past 20 years according to a Gallup Poll. That’s no surprise when you think about the nurses you have interacted with as a patient or as a colleague.

I’ve written a post about nurses almost every year since I started this blog. Do I have anything truly new to say this year? Yes, in that I want to highlight how the past three years has taken a toll on all our clinicians, in particular nurses. The public health emergency is expiring. Health care providers are adapting their policies as they continue to deliver care. We have entered a new phase for healthcare organizations, staff, patients, and families.

Staffing challenges are at the top of the list of concerns for many health executives – staff shortages and clinician burnout. There are no easy solutions. The toll of the past few years on our nurses was highlighted in a May 2nd NPR article by Jaclyn Diaz – “Nearly a third of nurses nationwide say they are likely to leave the profession“. The article starts with some sobering findings from the 2023 Survey of Registered Nurses conducted by AMN Healthcare. The survey examined the impact of COVID-19 on the career plans, job satisfaction, and mental health and wellness of more than 18,000 RNs. Key findings:

  • Close to 1/3 of nurses nationwide say they are likely to leave the profession for another career due to the pandemic. This level is up 7 points since 2021.
  • 89% of RNs said the nursing shortage is worse than five years ago, 80% expect that to get much worse in another five years.
  • Younger generations of nurses are also less satisfied with their jobs compared to their older counterparts.
  • 80% of nurses experience high levels of stress at work, an increase of 16 points from 2021.
  • 77% of nurses reported feeling emotionally drained, up from 62% in 2021.

Of all the blog posts I’ve written about nurses, this one from five years ago has the strongest message – “Celebrate nurses, but more importantly listen to them”.  This is true now more than ever. From the bedside to the boardroom we need to listen, amplify, and prioritize the voice of nurses.

IT leaders won’t solve the staffing challenges. But we have a role to play. The systems and solutions we provide and support as health IT leaders and vendors must help nurses do their job more easily and efficiently, not make it harder. We need to reduce the burden on nurses and ensure they are integrally involved in decision making, prioritization, and design processes.

What advice would you give your younger self?

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I love this question. It was one of the questions for a panel I was supposed to be on this week. The NEHIMSS chapter has an annual Women in IT conference, and I was one of four invited panelists for the three-hour event. But 40 miles into my 100-mile drive to the venue, cruising fast on the freeway, my left front tire totally blew out – down to the rim. Scary yes, but I got myself over to the shoulder and called AAA. My second call was to the panel moderator explaining I wouldn’t be able to make it. An hour and a half later I was again on the road with the spare tire that is designed for maximum 50 MPH taking the back roads home to avoid freeway speeds.

I was looking forward to the event and the panel. I love sharing stories with next generation leaders so this was going to be a fun night. I was ready after the usual panel prep call to cover the range of questions we had agreed on.

While I didn’t get to do the panel, I don’t want this question to go to waste – here’s what I was ready to say when asked what advice I would give my younger self:

  • Know your big rocks – I’ve written on this in the past, “Do you know your big rocks?”. It comes from Stephen Covey and it is a spot-on analogy. Our families and closest friends are our big rocks. Don’t let all the little stuff take up your space first leaving no room for your big rocks.
  • Don’t take crap from anyone – In my 30s, two of my peer managers seemed out to get me. One even threatened me. I was the only woman on the management team for a 5-year period. After a lot of stress and wasted energy processing it all at night talking to my incredibly supportive husband, I decided enough was enough. I let our boss know what was going on and told him that I would let him know of any further incidents. He was going to have to deal with it because I couldn’t. In another situation where a male manager from another department got overly friendly with sexual advances, I reported it to compliance. Hard as reporting something may be, it is necessary to stop the behavior if you can’t stop it yourself.
  • Have a strong support system – Whether it is family or friends, everyone needs a support system they can turn to. I could tell plenty of stories about my incredibly supportive husband and how he has been there for me back when I was a young working mother in management and going to school at night for my MBA as well as the decades since (our 47th wedding anniversary is in a few weeks).
  • Accept that you can make choices – One of my staff wanted to consider coming back from maternity leave after she had her first child in a part-time role but worried about how it would stall her career. She was a project leader on a management track. We talked about her options and I encouraged her to keep in mind that she had choices. After a period of part-time work, she eventually came back full-time, picked up again in a leadership role and then had two more children a few years later. She made choices right for her and balanced growing a family with growing her career.
  • Own your own career and be open to the possibilities – Before I left my CIO position at Brigham and Women’s Hospital for a similar role at Michigan Medicine, we were going through major staffing changes in IT. My staff were concerned about their future in supporting legacy systems vs the new EHR coming in. I told them they had to own their own career and be open to the possibilities. When I make that second point now, I emphasize that there are jobs today that no one heard of 5 or 10 years ago and there will be new ones in the future we can’t even imagine now.

There you go – I had plenty more to say on the panel given the other great questions we were going to discuss but wanted to at least share this one.

And after this car experience, my parting advice is keep your AAA membership current and keep your cell phone charged.

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Confidence gap, wage gap, and more

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We have much progress to celebrate as women but sad to say that in 2023, there is still so much more to do. I’ve seen many excellent pieces recently that illustrate the gender gaps that exist in the workplace.

Have you ever heard of “Tall Poppy Syndrome”? I hadn’t. I saw this post on LinkedIn from Women of Influence+ on a study they conducted of over 4,700 women around the world. From the post, their research shows that almost 90% of women worldwide are belittled and undermined because of their success at work. As they say, “The Tallest Poppy, our groundbreaking study, reveals an eye-opening story about how Tall Poppy Syndrome (TPS) negatively impacts ambitious, high-performing women, and what this means for organizations”. Here is the press release summarizing the results and a link to access their white paper.

It’s no wonder that many women get “imposter syndrome”, even women in executive level positions. As Becker’s reported in this short article, “75% of female executives get imposter syndrome”, imposter syndrome is doubting one’s abilities and feeling like a fraud. The article notes that women expect lower pay than men, are subject to condescension and have less faith they will be treated equally. This all leads to lowered confidence.

As Becker’s reported in this short article, “The gender ‘confidence gap’ is wide in the workplace”, the confidence gap and wage gap continue. And we are now seeing the promotions gap more clearly. Continue reading →

#EmbraceEquity

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Today is International Women’s Day (IWD) and March is Women’s History Month. The International Women’s Day 2023 campaign theme is #EmbraceEquity. As their website says, “The aim of the IWD 2023 #EmbraceEquity campaign theme is to get the world talking about Why equal opportunities aren’t enough. People start from different places, so true inclusion and belonging require equitable action. International Women’s Day is a global day celebrating the social, economic, cultural, and political achievements of women. The day also marks a call to action for accelerating women’s equality.”

Yes, we have much progress to celebrate but sad to say that in 2023, there is still so much more to do. Especially with our current political climate and Diversity, Equity and Inclusion (DEI) programs being under attack in some states. Take Florida for example where the governor announced in February that he intends to ban state universities from spending money on diversity, equity and inclusion initiatives, calling them discriminatory.

I continue to participate in CHIME’s Diversity, Equity and Inclusion committee as we start another year of programming for all CHIME members. As leaders, raising awareness and finding ways to take positive and meaningful action for our employees and our patients is what this work is about. This Friday as part of the DE&I Dialogues series, we will host a live webinar entitled, “Why DE&I: Defining Health Disparity, Inequity, and Inequality”. The webinar will cover why DE&I is important in your healthcare organization and how it impacts patient care. Featured speakers are Andrea Daugherty, CIO at Dell Medical School at the University of Texas at Austin, Cletis Earle, SVP and CIO at Penn State Health, and Dr. Eric Quinones, Chief Healthcare Advisor at World Wide Technology. You can register here for the March 10, 12PM ET webinar. I hope you will join us this Friday and for future DE&I Dialogues as we continue to learn and work together in 2023.

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Leadership means being bold and taking on the tough issues

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As a leader, do you shy away from issues that may be considered too controversial or too political? What if those issues are at the core of delivering healthcare to your community and supporting your team? In our current political environment with the level of discourse so negative and uncivil, it can be hard to take a stand on something. But true leaders do just that.

Michael Dowling, President and CEO at Northwell Health in New York, is the kind of leader who doesn’t shy away from controversial issues. He should be a role model for all of us. I have mentioned him in previous posts on the need for civility and on preventing gun violence. This week I want to highlight his unwavering commitment and national leadership to prevent gun violence.

Under Dowling’s leadership, Northwell Health hosted the 4th Annual Gun Violence Prevention Forum this week. It was an in-person event in New York but open for virtual registration. I can’t tell how many were in the room but in his opening remarks he said there were over 2000 registered virtually.

His opening comments were inspiring. He said we were gathered to learn, to share, to strengthen our commitment to work together in unison, and to hold hands as we march down the road bending the curve of gun violence. He challenged us to each rethink and reimagine the obligation and responsibility of leadership. As health systems, to ask who are we, what do we stand for and believe in. He said we need to inspire others that this is health. That we can’t improve health unless we go upstream. And that health is more than medicine. Whether inside the organization or outside, to take on difficult topics. To make sure others get involved and feel bad about not doing so. He talked about the progress made. He reminded us that big issues and big successes are the result of a constellation of small things. And he encouraged us to be optimistic, that people follow optimistic leaders. He asked us to be proud, committed and fearlessly optimistic.

He talked about the National Health Care CEO Council on Gun Violence Prevention and Safety taking the pledge to prioritize the health and safety of our communities. 50 health system CEOs have signed the pledge and are united to fight gun violence. He talked about how even a few years ago he couldn’t get anyone to sign something like this. The response he got back then was it’s too political, their board wouldn’t like it, there were NRA members on their board, and so on. 50 is progress and we can hope that in the future it will be hundreds. Continue reading →

Leadership lessons at sea

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How do you handle or deal with unmet expectations or changes that are outside your control? Do you complain and spread negative energy or accept it and make the most of it? More importantly, as a leader, how do you stay calm, instill confidence, and take care of the people impacted?

My husband and I are just back from a 13-day Viking cruise called “In Search of the Northern Lights”. Did we see them? Yes, check. Did we see and do everything that was promised in the itinerary when we booked the cruise? No.

A few hours into our first night at sea the captain announced that there was a medical emergency onboard and that we were heading back to our port of origin, Bergen, Norway. Within an hour he announced that there would be a medical evacuation by helicopter instead. A sign that the guest’s medical situation had worsened. He and his team handled it effectively as they were trained to do.

For the rest of us, the next few days were sailing north of the Arctic Circle with stunning scenery plus tours and excursions on land in Alta and Tromso, learning more about Norway’s history, culture, social systems, the impact of climate change in the Arctic, and the life of indigenous Norwegians, the Sami people.

On day 7, the captain announced the bad news that would affect all of us. Due to a weather system with hurricane level winds, we were going to stay in our current port, Tromso, an extra day, skip the next two ports altogether (Narvik, Norway and Amsterdam), and have an extra day at sea once we could safely start to sail again. So, we were faced with three sailing days from Tromso heading straight to London where we were to disembark. On the first of the three sea days, the captain gave us more bad news. We weren’t surprised, we physically felt what was happening on the sea.

We had left Tromso when there was a break in the storm but ended up at sea in very high winds. We later learned that the winds were up to 60-70 miles an hour and the waves were up to 25-40 feet. That meant very slow going. Continue reading →

Considering a career move?

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The start of the new year is often a career transition time for people. We’ve heard much in the recent period about the great resignation, silent quitting, and remote work options being in demand. And we’ve seen significant layoffs in the tech industry and to an extent in healthcare providers dealing with significant financial challenges. If you or a colleague are considering a job change, some of my previous posts may be useful to revisit.

Career advice revisited is a list of posts providing career advice that I wrote prior to May 2021. I consider many of them “classics” that are still useful – they cover dealing with a competitive market, questions to ask yourself, interviewing and resume tips, and more.

Two more recent posts since that time provide additional perspective and advice. I wrote Reflections on recent career conversations after talking with many colleagues at the 2022 CHIME Fall Forum. And the post Paying it forward with career advice from late summer 2022 includes links to useful articles and tools for comparing opportunities and deciding whether to stay or go.

For more focused posts here are two more to check out – STEM or not, own your career and Know someone interested in a nursing career?

If you are looking for a career coach to help you through a transition, the post, When to use a career coach, could be helpful. I am happy to talk about how I might assist you.

Note – I am taking a short break from writing new posts the next few weeks. With all the blog posts I’ve written over the past 8 years, I’m using this break to share some of my “classics”. Thank you for being a subscriber – I hope you will encourage your colleagues to subscribe in the coming year.