Ep. 101: Be Brave, Be Fearless

Gary Bisbee, P.h.D.: Well, good afternoon, Carladenise and welcome.

Carladenise Edwards, Ph.D.: Thank you. Thank you.

Gary Bisbee, P.h.D.: Why don’t we get to know you a little bit better and let me just ask about your early life. What was life like growing up for you, Carladenise.

Carladenise Edwards, Ph.D.: Well, I’m a military brat. I’m a proud daughter of a US Marine, and so we moved around Gary every two or three years. My family was packing up, going somewhere new. . It was when we got to San Diego and I went to high school and my parents bought a house for the first time in the neighborhood, in the community, and everybody lived there their whole life. All the kids had gone to the same elementary school, the same middle school, and now we’re at the same high school. And so this was probably the most transformational experience for me is learning a, that not everybody moved every two or three years and people actually lived in homes for the majority of their life and didn’t move from their neighborhood. But also that I was for the first time recognizing that for most of my childhood in life, we had always been the only black. because other kids were coming into the community to go to our school. And I was creating relationships with people of different cultures and communities I’d never done before. My childhood was pretty happy, pretty go-lucky. And fortunate, I think I was very privileged. I think it was very, very privileged.

Gary Bisbee, P.h.D.: Well, I’m smiling a bit here because my father was a minister and we moved every several years as well. So it was always the preacher’s kids and the military brats, or the new ones in school. The good news was it really allowed you to get to meet people. Did you take that away from your back?

Carladenise Edwards, Ph.D.: Thank you, and I don’t think there’s a place in the US that I can’t go and find somebody I know and know well. To, sleep in their guest room or on their couch. And that is something that we picked up, which is how to feel, feel family, or create family really quickly and to build bonds that last a lifetime despite the distance. And this is before cell phones and text messaging and FaceTime.

Gary Bisbee, P.h.D.: Well, what did the young Carladenise think about leadership?

Carladenise Edwards, Ph.D.: I really thought about it in terms of change and being impactful and as I prepared for this interview, I was really thinking deeply about that. My daughter is applying to college right now and she was writing one of her college essays in a question, the Prompt. Gary was named a historical event or something that’s happened in history that’s inspired. And she started to write the story of my great, my great-grandfather, her great-great-grandfather who was a minister, and he was run out of the country by the Klan for preaching racial equality and solidarity. And an Episcopal priest found him hanging from a tree in Miami, rescued him, and they ran off to The Bahamas. And so my stories of leadership and my vision of leadership is a great-grandfather and a grandfather and a father who exemplified incredible courage. And who are in essence fearless about executing on their values and their core value is equity. Their core value is that everyone should have an equal opportunity to fail, my father would say, and to be successful. So as a leader, I think your role and your job is to bring out the best of every person. So that they can fulfill their purpose and hopefully their purpose leads us all to being a better society, right? Better citizens, better occupants of the planet.

Gary Bisbee, P.h.D.: Terrific. Background. Thank you for sharing that with us. Thinking about your career, gosh what a marvelous career. You’ve been a health sy large health system executive. You’ve been an entrepreneur, an advisor you’re a director. You’ve been both at the federal government, the state government level. What’s driven you to be. Broad in how you view positions your, your role in healthcare.

Carladenise Edwards, Ph.D.: think I’m a student at heart and so I absolutely follow opportunities that enable me to continue learning. and the data points I’ve been looking for have been to fulfill this thesis that I have around how this country and how this nation can actually create a system of care that actually enables health to be achieved and for people to be rewarded for that, for individuals to actually make money. To achieve some level of profitability and productivity off of health as opposed to sickness. The other part of my transitions, Gary, and this is full transparency and candor, is I have a really hard time when people call me saying no. When someone asks me to do something that I think is compelling and has an irresistible value proposition, I struggle right to say no. Even when it’s in the. . Because I think when you’re called, sometimes people see your skillsets and talents in ways that you don’t see them yourself. And I have been really fortunate that leaders like a Rodd Hawkman and a Wright Lasseter, and a Jeb Bush, and Rhonda Meadows and others have said to me, Carl Denise, you could help us.

Gary Bisbee, P.h.D.: What would you say over the course? Your 20 years of experiences in healthcare, what are the major lessons that you’ve learned?

Carladenise Edwards, Ph.D.: one is not to take yourself too seriously. And I really, I really mean that. I, I remember a leader saying to me, don’t believe the headlines. And at the time they were saying it because, negative press . But I also think it’s true when there’s good press, don’t always believe the headlines. Don’t take yourself so seriously. The second one is work is actually really hard. If you actually are working, you’re trying to use energy to produce something that has. and work is not, vacation work is hard, and the energy that it takes to do that in solo or in partnership and collaboration means that you’re pushing uphill to produce something that has value and you have to keep work in context. Because it is not vacation. I love it when people say, oh, if you love what you do, you never worked a day in your life. You probably didn’t. You weren’t working. You were just taking up space. You’re taking up space. But if you really are working, you go home, you’re tired, you’re exhausted, maybe you’re even frustrated and. But when you wake up the next morning, you should be able to look back and say, I produce something and it has value that’s sustainable. That will have meaning beyond me, right? Even after I’m gone. So that’s my number two. So one, don’t take yourself too seriously. Two, work is really, really hard and it should produce value. And then I think number three, what I’ve learned is, We collectively can do great things if we work together as community, right? If we really have faith in one another and why we have the purpose or the calling that we have and have respect for that. , we can do great things. I don’t think anything is insurmountable If we collectively want to make change and we do it in community.

Gary Bisbee, P.h.D.: Let’s get back to your point about the workforce and particularly physicians for a moment. And then we can cover the nurses. But in terms of physicians if we have a million active practicing physicians in the country, the, some estimates are 500,000 of ’em are 400,000 of ’em are employed by health systems. We’ve probably got another now couple hundred thousand employed by the Optums and, and CVSs and Walgreens of the world. How do you think that’s changing the practice of medicine where our physicians are increasingly employed by these large entities?

Carladenise Edwards, Ph.D.: Yeah. Well, I think that’s variable in community because in some places it’s always been the case where physicians have been employed, right? I That’s been a natural tendency. And in other cases, this is new. I think what’s particularly new is those physicians who are now employed by private entities that sit in a vertical. That are not a hospital based health system or an i p a, an independent physician, association or organization. It is the Walgreens or even the private equity or VC company that’s come in and included a cardiovascular group that is for-profit full of, a cardiologist. So what it’s doing, it’s changing the landscape in a couple ways. One, I think there’s some good in this and it’s particularly when I talk to and I’ll bring this up and it may sound awkward. Hopefully it doesn’t come off poorly for the audience. Women who practice medicine, who have struggled to try to be all things to all people in their family. Being employed and having some predictability in your paycheck, your income, and your schedule has actually enabled some women to make that transition into medicine and manage a lifestyle that’s a lot more reasonable than in the past where you were trying to run your practice, manage your practice, practice medicine, and then when you’re not running a business, go home and manage your family. So I actually think it’s been very helpful for some women who’ve always wanted to be doctors, but didn’t have the energy or the wherewithal to run a practice and be a doctor. They can be employed The other way, I think that it’s been interesting and transformative is from the health system perspective. Health systems and hospitals have to be on their a game. We have to create the irresistible value prop for those practices to wanna be affiliated with us. If I use the collective, we as somebody who’s been a part of health systems for a long time, right? It’s not an automation. They’re not just coming to us cuz we’re the only game in town. Right? , right? When all this money comes into these practices that are now businesses that are employed, employing doctors, in some cases owned by the doctors, cuz they’re getting equity right, or they’re getting some share or piece of the pie, now the health system has to convince them that there’s some value to being affiliated with them. It really changes the dynamic in the market.

Gary Bisbee, P.h.D.: Yeah, you made the interesting point that employment may give women physicians. An opportunity to have have a family life in addition of practice medicine. Let’s turn to health systems for a moment. We’re both obviously familiar with that and, and some of the statistics that we’ve gathered through time says roughly 20% of the leaders in health systems are women. If that, and question for you, Carladenise is. , how do you see that changing? What is it that’s going to to change? Because a little bit of, we’re still now on the inside trying to change things. H how’s that gonna change over time, do you think?

Carladenise Edwards, Ph.D.: I think as nonprofit hospitals and health systems continue to struggle with profitability. There will be more opportunities for women and minorities to take on leadership roles, and this has played out in every other industry. As cities started to crumble and it was really difficult to maintain population bases and tax bases in cities, we start to see a lot more African American mayors and female mayors in. And so my fear or my concern is that the opportunities will continue to proliferate as long as the industry is continuing to suffer. Because it’s not the hot place to be anymore. It’s not the place to be where you’re gonna make huge margins, huge profits, and huge incentive bonus. And so there will be what has happened, like very similar to geography white flight. That is my fear. Now is that necessarily a bad thing? Maybe not necessarily because maybe at some point we will recognize the fact that these institutions aren’t gonna go anywhere. So even if people don’t continue to support them from a leadership perspective. and we’re struggling to fund them from a financial perspective. Covid led us to realize that we need them and somewhere, somehow we will have to have some kind of infusion of either public support or private support to ensure that they continue to survive. But I do see more women being able to take on opportunities. Honestly, majority doesn’t want, I’m telling you the candid answer.

Gary Bisbee, P.h.D.: Yeah, well, Think that’s right. There’s one bit of good news in, in this, and that is now 50% of the, of the medical students are women.

Carladenise Edwards, Ph.D.: Yes, yes.

Gary Bisbee, P.h.D.: you’ve got an inside group there moving through the process That presumably will be helpful to us in that regard. One point that I was talking to, Dr. Joanne Conroy, the Dartmouth c e o and about, about some of these issues. And Joanne was making a point that when she advises young up and coming women leaders, one thing she talks to them about is the risks inherent in. Leadership and tries to make sure that they’ve thought their way through that as they move up into these leadership positions. How do you think about that, Carladenise?

Carladenise Edwards, Ph.D.: Women struggle with imposter syndrome and I think it’s so important for women to recognize that you are good enough and you do have enough. And you’re worthy of that promotion, the leadership role and the compensation that goes with it. We will often try to convince people to give us a chance. Because we don’t think we’re worthy. We think, well, they’re taking a chance on us. Well, no, you actually took a chance on the other guy. I’m actually proven You the opportunities present. So yeah, the other risk, and this is a hard one as much as I wanna believe that, I have egalitarian values and thought process, I still. Experience the gender differentials in the country, and even in my own family, I do not take out the trash or put gas in my car, so I just don’t, my husband does that. It’s difficult to get a husband like that to move right When, when the new opportunity presents and I say, oh, I got this great phone call and I can, have this great opportunity for a new leadership role. Babe, it’s time for us to pack up and move. It’s hard. . It’s hard for a man’s ego. It’s hard for the family dynamic, right? And so for women, oftentimes we have to make a sacrifice or a choice between our families, our spouses, our relationships, and our jobs. , I have many sisters who’ve had to make choices between husbands and jobs who’ve had to make choices between, family and a promotion. And I think it’s really unfortunate and uncomfortable that still exists today. I’m blessed. I have a husband who, when he married me, my father made it pretty clear to. That my husband would do what? I said, , he does it always. But my father tried to put the fear of God in him. If you marry this chick better be ready to do what she says. But that’s not.

Gary Bisbee, P.h.D.: The benefits of a marine Father,

Carladenise Edwards, Ph.D.: I put the fear of God in my husband before we got married. But yeah, there’s a huge risk in being a leader, and I’ll tell you, I regret the birthdays that I’ve missed, the recitals that I’ve missed, the soccer practices that I missed. I do, because there are some days when I’ve woken up and I’m like, oh, I made the wrong choice. They could have lived without me in that meeting. , but I didn’t think they could, cause I was so fearful that I would lose my position or my clout or my place if I said I need to take the day off to be mommy.

Gary Bisbee, P.h.D.: How can men in the work environment at least be more supportive of women?

Carladenise Edwards, Ph.D.: Yeah. And, and to be really clear too, I think whether your, your spouse, your significant other is a male or a female, right? You’re in a same sex or heterosexual relationship. There’s this dynamic of making difficult choices that. Ultimately support the desire and the wills of both persons in that relationship and that relationship at home is not much different than the relationship at work. Gary, to answer your question, I think in the work environment, men can serve as sponsors and allies of women who want to be promoted, who are sitting at that leadership table and need to have a voice. And often have an internal struggle of what decisions to make when you are one up or your peer says to you, Hey, I know your kids have a recital tomorrow. I got you. I got your back. Go. Oh my gosh. As opposed to, I don’t understand. What do you mean you can’t be here tomorrow at, 6:00 AM it’s a very different dynamic. Men or leaders, I should say male or female, should practice being empathetic, compassionate, and genuinely concerned about the whole person. Genuinely concerned about the whole person. , and I don’t care if that leader is a male or a female and they’re dealing with a male or a female. I think a leader should be genuinely concerned about the whole person, the intersectionality of being an African American woman leader. And for a good part of my career until now in these gray hairs popped up a young one at that. Has been incredibly challenging and there are oftentimes you don’t feel like you have community. Remember, I grew up being the only black child in the only black family. My professional career, I’ve grown up being the only black female. , my I’ve had many favorite jobs, but one of my favorite jobs was being the chief negotiator for Providence, right? So I ran all of payer contracting for Providence Health and Services, and I’d go into the negotiations on behalf of the provider side with the payers. I was always the only female and always the only African American until I ran into one person whose name I’ll drop is Cheryl Peus. And I’ll never forget when we landed in the room and we looked at each other, we made eye contact and then we stopped, right? Because we had to get to business. But they’re not many women. They’re not many African Americans. , right? In these leadership roles. And so I think for men, to answer your question, to be exceptionally curious, I think sensitive and actually genuinely concerned is important. And I say that because we’re typically recruited and sought after. because there’s a commitment to diversity. So follow me, Gary. And so I’ve been told we want you, we are very intentional about wanting to diversify our boardroom, diversify our executive suite. And then I get there and I learn that what they really want is somebody who behaves, thinks, walks, talks just like them. which just has a different demographic. So when you say you want diversity, you really need to mean it. You need to say, I want somebody who thinks differently, walks differently, maybe talks differently, so that I can be constantly open to the fact that the world we live in is very different than the people who are sitting in this. right? That’s what we need from the male who’s in the room, right from the majority individual who’s in the room, because it can go either way. It could be a room full of black folks with one white person in it, room full of white folks with one black person in it. But when you are the majority and there is somebody who is in that minority position, take advantage of the fact that they are actually. and embrace it.

Gary Bisbee, P.h.D.: Unfortunately, we’re gonna have to land here, Carladenise. I hope you’ll come back be with us again. We could go on for days here. At least from my standpoint. This has just been terrific. Love your view of the war. Old. I do have one question to wrap up if we could. What advice do you have for young up and coming leaders in healthcare?

Carladenise Edwards, Ph.D.: Be brave. Be fearless. and actually recognize its work, but it’s absolutely the right work and do it for the right reason, which is you wanna have an impact, you wanna improve the actual health of this community, right? That we are all accountable for. So we can leave something good behind. Yeah, be brave, be fearless.

Gary Bisbee, P.h.D.: Well done, Carladenise. Thank you so much for being with us.

Carladenise Edwards, Ph.D.: Thank you for having me.