AHLA's Speaking of Health Law
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AHLA's Speaking of Health Law
Career Journeys of Women in Health Law: Dr. Melinda Estes, President and CEO of Saint Luke’s Health System
In honor of International Women’s Day, AHLA’s Women’s Leadership Council is pleased to present this three-part series highlighting the career journeys of female leaders in health law. In the first episode, Jennifer Cottrell, COO/CFO, Pinnacle Healthcare Consulting, speaks with Dr. Melinda Estes, President and CEO of Saint Luke’s Health System and 2020 Chair of the American Hospital Association. Dr. Estes is a board-certified neurologist and neuropathologist. In 2020, Modern Healthcare recognized Dr. Estes on its prestigious list of the “100 Most Influential People in Healthcare,” as well as the “50 Most Influential Clinical Executives.” Sponsored by Pinnacle.
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Support for ALA comes from pinnacle healthcare consulting. Pinnacle works with hospitals, health systems, a surgery centers, physician groups, law firms, and other healthcare organizations. Their team consists of experts in the area of compliance, audit, and risk mitigation, medical, coding, compensation, and business valuation strategy and operations consulting and transaction support. Learn more about pinnacle@wphc.com.
Speaker 2:Good day. I'm Jennifer Coro, CFO, and COO of pinnacle healthcare consulting. This podcast is the first in a series of three episodes exploring the career journeys of women leaders in the healthcare industry. We'll discuss their career trajectories lessons, learn and advice for women leaders. This podcast is brought to you by the a H L a women's leadership council, which promotes the engagement of women, a L a members and supports and advocates for career advancement and representation of women and healthcare leadership positions. The council is comprised of teen, a H L a members from diverse practice areas, geography, and expertise. The council provides a forum for networking advice and mentorship and coordinates and develops educational content of interest to a H L a women members. This podcast series was planned and celebration of national women's day, Tuesday, March 8th, and is proudly sponsored by pinnacle healthcare consulting. Today, I'll be speaking with Dr. Mindy SNI, president and CEO of St. Luke's health system and 2020 chair of the American hospital association. Dr. ES is a board certified neurologist and neuropathologists in 2020 modern healthcare recognized Dr. SIS on his prestigious list of the 100 most influential people in healthcare, as well as among the 50 most influential clinical executives since 2012, she has consistently been named to Becker's hospital review list of leaders to know including women, hospital and health system leaders to know, and physician leaders of hospitals and health systems. Welcome Dr. ES,
Speaker 3:Thank you.
Speaker 2:So let's start by, why don't you just tell me a little bit about yourself, introduce yourself?
Speaker 3:Well, I'm mind ES and, and, uh, I am the president and CEO of the St woods health system in Kansas city. Um, I, um, uh, am an army brat. So I grew up all over, uh, the world, uh, during my, uh, childhood and I'm an only, only child. So, uh, you know, I, uh, I think really learned a lot during that time. One is just to appreciate other cultures and two to be flexible, which I think has, uh, helped me in my, uh, career as I have, uh, gone forward. Um, I had every intention of being an orchestral musician. I, uh, uh, played the piano and the bassoon all through, uh, all through my, uh, my, uh, junior high and high school career, and then went on to college, to study music, uh, where I really realized that, you know, music is, uh, uh, 90% hard work and 10% talent. And if you don't have that full 10% talent, you, you can't work the rest of the, uh, of, of that, uh, of that 10%. So, uh, my dad, who was a wise man said to me, you know, do something you can make a living at. Yes. So I, uh, I thought long and hard, and I really, then I said to him, you know, well, I, I really would like to study Russian and Russian studies. Now you have to realize my dad, uh, was a career military officer, and this was just after the cold war. And he was really having none of that. And he said, I'm not sure you can make a living as a Russian scholar. Um, and I'll leave that to our audience to decide if that's true or not. So then I thought, well, I like biology. So I decided I would, um, take all of the courses in pre-med and ultimately go to medical school, which is, uh, what, what, uh, I did. And then, uh, went on to study both neurology and neuropathology.
Speaker 2:Wow. That is a fascinating background. Thank you very much for sharing. So, so tell us about your, your career path. Um, and, and what, what led do to your current role?
Speaker 3:Well, you know, when I was in medical school, in, in the 1970s, uh, you know, most women, uh, were expected and encouraged to study pediatrics. And, uh, I went to the university of Texas medical branch in Galveston, and it was an interesting time. There were 200 people in my medical school class, fifth of who were women, the class before mine had two women, the class after mine had two women. So we were a bit of a, of an anomaly,
Speaker 2:Not very
Speaker 3:Much so I'm probably too many women to all go into pediatrics. Um, so, you know, as often happens, you are influenced by a mentor. And the she year of neurology was a gentleman named Dr. John Cowley who really made neuroscience and neurology, uh, come, uh, come to life. And as a result, uh, I then went on to study neurology and, uh, and neuropathology, because I, I liked the idea of being a consultant, which you are when you're in neuropathologist, as well as an educator. So I did that and I spent the first, uh, you know, 15 or so years of my career, practicing neurology and neuropathology, uh, largely at the Cleveland clinic. Um, and I was encouraged by a number of men who were mentors of mine to take on, uh, increasing leadership roles. My first leadership role was chair of the library committee. And, uh, you know, what I learned as you, as you take on progressive leadership opportunities is that you learn something from opportunity that you have absolutely. You learn how to chair a meeting. You learn how not to chair a meeting, you learn how to, to, uh, bring, um, uh, different voices to the table. And so, no matter how small those steps are, uh, there's something to, uh, be learned. And so I was really very fortunate to have an, a number of opportunities, uh, at the Cleveland clinic. Uh, ultimately I became the associate chief of staff, uh, for, it was about a 700 physician group then, which was really human resources for doctors. Um, and from there, I went on to, uh, get an MBA and really began to pursue the administrative side of, uh, of, uh, medicine. Um, I practiced medicine, um, uh, at the same time because, uh, you know, I think it was important to, for your credibility to be seen that you understand what's on the front line. So that's how I, uh, that's how I got started.
Speaker 2:Wow. That's great. What, so what, um, through that, you, and you mentioned some mentors, um, that you've had along your way, are there, are there any other role models who have, have impacted your career?
Speaker 3:Well, you know, I've had, I've had a number of, uh, of mentors, uh, in my, uh, in my career. And, uh, you know, I've been very fortunate to, um, to learn from, uh, each one of them. And, you know, I think when you, when you're looking at role models who, who impact, uh, your career, it's, it's interesting, you know, they just don't, they just don't drop into your lap. You really begin, uh, to look for people who you think are not only successful, but you are a, you're impressed with how they go about their practice of medicine, right. How they go about their, their lives, how they go about interacting with, uh, with other people. And so I, I was fortunate at the Cleveland clinic, Dr. Johan, who was the chair of neurosurgery and Dr. Ralph stren, who was the chief of staff of the Cleveland clinic for a long time, uh, uh, a, um, uh, urologic surgeon, both sort of took me under, uh, under their wing. And, you know, I learned a tremendous amount from them. And mostly I learned, you know, how to, how to navigate, uh, complex situations and how to really appreciate, you know, the nuances of an organization, because, you know, as you have more leadership responsibility, it's, it's really, um, reading the body language, if you will, of the entire organization, when to push, when to step back when to understand that the organization needs a deep breath. And, uh, those, those two, uh, two guys, uh, uh, really taught me, uh, how to do that, cuz they did it so well.
Speaker 2:That's wonderful. That's wonderful. So maybe it was, uh, those two individuals or maybe others. What, what would you say is the most of advice or pieces of advice that you have received, um, uh, in your career?
Speaker 3:You know, I think it's often difficult to distill down to just, uh, to just one piece of advice, but, uh, uh, I had the opportunity to be, uh, senior vice president, uh, of medical affairs, chief of staff at the Metro health system in, uh, Cleveland, uh, which is a large, uh, city county, uh, hospital, uh, in Cleveland. And, uh, the CEO is a gentleman named Terry White. Um, and under his leadership, I really, you know, learned an enormous amount, but there are two things that, uh, he told me that have stuck with me and there are pieces of advice that I still use. And there are pieces of advice that I still share with, uh, my colleagues. Uh, the first is, uh, hug the thing that scares you the most, uh, you know, this notion that you need to keep it close to you, so you can learn from, uh, an experience or from a person, um, and until it's not scary anymore. And oftentimes, you know, that really boils down to embracing different viewpoints and to recognizing that dissenting voices are as important, if not more important than the voices, uh, uh, in a agreement. But you know, at the end of the day, certainly from a leadership team perspective, we all have to sing off the same song sheet once we, uh, once we leave, because there is one thing that I have learned that, uh, employees in large organizations know instantly if leadership is not in agreement. And I think the, the second thing that he, uh, that he, uh, um, shared with me that has stuck with me is never let the perfect be the enemy of the good and, you know, I think all of us in particularly in healthcare where, you know, we strive for perfection because obviously people's lives depend on our ability to get it right and get it right all the time. But certainly as we're, as we're making decisions, as we're evaluating strategies, you know, not letting the perfect be the enemy of the good really enables us, I think, to be freed, um, to consider, you know, all kinds of possibilities and really allows you to be more innovative and to chart, perhaps a course that, um, you know, has, uh, has, has not been as tried and true as the one you thought you were gonna do.
Speaker 2:I, I will, uh, I'd like to adopt both of those. So I, I love that hug the thing that scares you the most because, um, I mean, that's all throughout life, right? Not only in your professional career, but in life and, uh, and again, never let the perfect be the enemy of the good, what great piece of the priests of advice that you receive there. Um, so tell us, um, tell us about an important experience that has impacted your career or, or lesson that you have learned.
Speaker 3:Well, you know, I've, I've, uh, been doing this a long time and I've had the opportunity to learn, uh, a lot of lessons. And I think, you know, off times, uh, when you come up short is it's when you learn the most, when everything is going well, um, you know, there, there's certainly learnings there and there's certainly, um, lessons that you can take away, but when things don't go well, or when things that don't happen the way you think they should is when you learn. And one that I, I might relate is, is really, you know, it's this notion of, sometimes of happiness is not getting what you want. Mm. Um, I spent a lot of time at the Cleveland clinic as the associate chief, uh, of staff and enjoyed my time, um, learned all about, uh, multi-specialty group practices. Uh, really, I, I thought learned how to navigate both the human and resource and operational side and thought I was ready to be chief of staff. Uh, when that, uh, when that, uh, opportunity arose, uh, you know, I was considered, I was not, uh, selected, I recall vividly at the time that I didn't really understand the reasons as to why that would have, uh, have been the case. And I was quite disappointed. Um, but nonetheless, uh, you know, in retrospect it really was the best thing that could have happened to me because it enabled me to go do something different and to think about my career in a different way. And, you know, one of the things, uh, another piece of advice from, from Mr. White, that I think is applicable in this sort of situation, is, you know, when you get to the end of a career, you don't wanna look at yourself in the mirror and say, I wish I had taken more risk. Um, you know, as, as you and I have talked previously, a career, um, is not linear it right, really in many respects is like a sailboat race where, where you go in a direction, something changes and you have to be ready to tap, tap
Speaker 2:Back,
Speaker 3:Tap back into a different direction. And sometimes, you know, you may feel you're losing a little bit of ground as you're right, attacking, but not becoming the chief of staff of Cleveland clinic enabled me to go to Metro health, enabled me then to have progressive responsibilities. As I came back to the Cleveland clinic to run Cleveland clinic Florida, and really have the opportunity to be a CEO, um, at multiple organizations. So that was, uh, you know, exp an experience that at the time was, uh, I thought about the most awful thing professionally that could happen to me, but in retrospect was really the best.
Speaker 2:Yeah. And I love that in a, of, uh, of a sailboat, right. Tacking in the wind. And, um, uh, my dad is a sailor and, and it's interesting because I remember as a child, as you went, you know, a against the wind and what a struggle that was right. And yet, somehow, sometimes you had to do that in order to, to get and navigate to that next place. And, uh, again, what a perfect analogy of, of sometimes those struggles, um, oftentimes especially, you know, in, um, I have children, uh, they say failures, and I said, no, no, no, no failure is just an opportunity. Right. Um, and so how you can learn from that. So wonderful, wonderful stories there.
Speaker 3:Well, and you know, that it just, it just highlights that there is sort of no perfect time, right. To make a change or to take on different responsibilities. And I think sometimes, and, and you mentioned your children, I think, um, professional women, um, certainly have often multiple layers of responsibility, not only in the workplace, but, but at home. And I think sometimes when an opportunity presents itself, our first thought is, well, this isn't the best time for me. Right. For a whole variety of a reason of reasons. Um, but you know, I think you have to step back and, and say, you know, it may not be the best time, but, but is this something that, um, I can learn from, is this something I'm qualified to do? Is this something that I want to do? And if so, then how can I, how can I make it work? Right. Uh, what support do I need to do that? Because I do think, you know, a career is a series of, of responsibilities as well, and a series of steps. Some of them small, some of'em big and many of them sort of a leap of faith.
Speaker 2:Yeah. Well, and as you mentioned, it's those risks, right? Oftentimes we are, we, we are faced with those risks and, um, and, and taking those risks really does help to move your career along.
Speaker 3:It does.
Speaker 2:How would, how would you describe yourself as a leader?
Speaker 3:You know, I, I've been asked that many times and, um, you know, I think the word that I might use is courageous. Um, but I would go back really to the Latin root because the word ages comes from the Latin root core C R, which means heart. And so I try to live and work, um, with both courage and heart. I think sometimes people believe that courage is, you know, putting your nickel down, making difficult decisions, moving, um, in a path that, that, uh, um, often has inherent risk. And certainly that's part of it. But I think it's the heart part that really is, uh, is most important in that, uh, courageous, are you, are you recognizing that, particularly in what we do in healthcare, you know, the mission of caring for patients and caring for our community is at the core of everything we do. And it is a privilege to do that. And we care for people at their most vulnerable. They tell, tell us things, they would not tell anybody else. Right. And I think, you know, we really need to always return to that touchstone of why we do what we do. And when you do that, it then makes those decisions much easier. If you recognize, how does it impact our patients, our teams, and our communities.
Speaker 2:You, so you've alluded a little bit to my next question, which is, um, what do you think are, are those soft skills? And I, and I love that again, that reference of the heart in it. You know, I, I always expressed to, um, uh, to my colleagues, you know, of courteous and kindness, right. That we wanna be courteous and kind. Um, um, but what, what other soft skills would you say that you feel are important?
Speaker 3:Well, I think there are a number of soft skills and one, uh, that I will highlight, uh, to start with is, um, one that I think, think, uh, uh, many of us have, uh, experienced over and over during the last, uh, two plus years of this pandemic. And that's the notion of, uh, leading with, uh, imperfect, uh, information, you know, uh, all of us in large organizations and those of us in healthcare in particular, you know, we're planners. And we like to have, uh, committees to, to think about what our next step is. And when we think about what our next step is, then we like to pilot something and our pilots often go way too long. And then we think, well, we probably ought to pilot it again in a different setting. Um, and you know, by the time that's happened, you know, we are 12 months into, uh, into, uh, the, the project. But, you know, throughout the, the crisis, you know, the pandemic, um, did not give us the luxury of, uh, of time. Yeah. And it really wasn't about making this decisions easily, but making the decisions, um, uh, with the information that you have and knowing that you may need to make a new and very possibly different decision tomorrow or the next day. And, and I think that's scary for those of us who, who really like to analyze data and do, and do, uh, do test runs. And it oftentimes brings together groups of people who don't often talk to each other very often. Yeah. And I just give a, a, an example. We stood up, um, our testing, um, facilities sort of overnight, uh, to be able to do COVID testing in the, in the community. And of course we did it outside of the hospital because we didn't want to be bringing people into the hospital setting who might be COVID positive. So we stood it up, we stood it up. Well, we had all, all of the staff, we had all of the PPE, we, we, uh, were ready to go. And then we realized that, um, you know, we needed a tent because it rains in Kansas city.
Speaker 2:Yeah.
Speaker 3:So the next day, the next day we had a tent. Then about three days later, we realized that we didn't necess have all the right people there, but we just made these changes on, on the fly. And I, and I think that's one of the lessons of the pandemic that I hope, uh, we will continue that, you know, we can make good decisions with imperfect information, right. And, and tweak them as we need to going forward. So I think that's definitely a soft skill that has, has been highlighted. Uh, you know, another one I might mention is just, um, transparency and communication. Um, you know, as leaders, uh, you know, the tone in an organization I think does come from the top and I think we have to be as committed to our employees as they are to our patients and to our organization. And so you mentioned kindness, we're very proud at St. Luke's of our culture of kindness and our culture of transparency. Um, and, and, you know, again, we try to overcommunicate and it was really highlighted during the pandemic, recognizing that we had to communicate in all kinds of different ways, whether it was videos, whether it was updates on a daily basis, sometimes a twice daily basis for folks to read. And so I can't overemphasize, and it is a bit of a soft skill of communi and recognizing that people get information in different ways, right. And sometimes how we wish to give it to them is not the best way for them to receive it. And, and finally, I think listening and it's listening to understand, not to act, you know, when you're busy and you're in a hurry, you're listening. And then sometimes you're listening to take an action. Right. But you really need to, to stop and listen, to understand and ask questions to further understand.
Speaker 2:Right. So what if, and tell me more, right.
Speaker 3:Correct. And not to be afraid to change your mind if in fact, the data and the, the conversation suggests that the path you're going down is gonna have more unintended consequences than positive consequences, the
Speaker 2:Positive. Yes, I'm absolutely. So in the, uh, last few moments here of our discussion, um, I'd love you to, I'd love for you to share with me something that, something that you're proud of.
Speaker 3:Well, you know, this, uh, at, at St. Luke's, this is my third opportunity to, um, to be C EO and to lead, uh, an organization. I was at Cleveland clinic, Florida, and then at Fletcher Allen healthcare, which is now the university of Vermont health system. And in each of these three organizations, you know, what I have been most proud of is the tremendous routine, uh, compassion, kindness, and competence of, of our teams. You know, healthcare is a team sport, and I've really been most proud that everywhere I've been, you know, I feel like our teams have, um, embraced the mission that I talked about earlier, which is, is doing, doing the best we can for our patients. Um, and recognizing that, uh, they, uh, they depend on us. And, and so I I've been most, uh, I've been most proud of that. And I've been very privileged to have the opportunity to do that in a variety of, uh, of different settings. But, you know, I think, um, in healthcare, uh, again, if we, if we recognize why we're doing what we're doing and, and always come back to that, then, you know, the rest of it falls, uh, falls into place. And, you know, one of my jobs as a CEO is really to be at that, you know, 30, 50,000 foot level to look forward so that many of our can look down and focus on the business of care on a, a daily basis. And I'm really most proud of all the people that I've had the opportunity to work with.
Speaker 2:That's wonderful. Dr. SIS, any, any final comments that you'd like to share with our audience today?
Speaker 3:Well, I might just share since this is the, uh, healthcare, um, lawyers, uh, association that, um, someone once told me I was an F O L, um, which I've always wanted a t-shirt. Um, and it basically said friend of legal, because I have learned in, in, um, my, my stops in, in multiple organizations and as a, uh, CEO, you know, that the partnership of a CEO and the general council or chief legal officer is really one of the most, uh, important, you know, as you rise in an organization, uh, the Millipore filter that happens in terms of information that comes to you, um, gets smaller and smaller and smaller. And one of the things that I've always been able to depend on is to know that my chief legal officer won't necessarily tell me what I want to hear, but will tell me what I need to hear and will tell me what is possible, and what's not possible and how we can navigate through it. And so I just want our audience to know how much I appreciate the work that all of them, uh, do on, on behalf of, uh, the field of healthcare in general.
Speaker 2:Thank you. That is wonderful. Thank you very much, much for joining us today, Dr. SIS, it has been an absolute pleasure.
Speaker 3:You're very welcome. I appreciate you having me.
Speaker 4:Thank you for listening. If you enjoy this episode, be sure to subscribe to a H L a speaking of health law, wherever you can at your podcasts to learn more about AHL a and the educational resources available to the health law community, visit American health law.org.