Ep. 108: Using Your Voice Effectively

Sandra Fenwick: Hello and welcome to her story. This is an opportunity for me to talk to some amazing women and for you to hear about their journey in leadership. I’m Sandy Fenwick. I recently retired as the CEO of Boston Children’s Hospital, and I currently am an independent director on a number of public-private, and nonprofit companies. I’m here with Cathy Jacobson, she is the president and CEO of F Froedtert Health in Milwaukee, Wisconsin. Cathy we’re thrilled to have you here today and I think we’ll just jump right.

Cathy Jacobson: Sounds good..

Sandra Fenwick: Welcome, Cathy. You joined Froedtert. In Milwaukee in 2010 as the executive vice president and chief financial officer and chief strategy officer. And then a year later you were made president and a year after that, the CEO of the whole system. And like you I spent many years in the same place. And as do you before that you were at Rush University Medical Center for 22 years and you. You have sit you sit and you have sat on a number of boards and been recognized as a national woman leader by modern healthcare, not just once, but multiple times. So Cathy, I’m sure there are many people who are waiting to hear from you about your wonderful journey and your career.

Cathy Jacobson: So I get asked a lot of times, how did an accountant, which is my background, you can tell from finance, become the CEO of an academic regional healthcare system. And so many people, that story re really begins, with your family, at home. And from mine it really started. My mother is a registered nurse. She was, she’s retired now and was, and worked at our local hospital in our town, about 70 miles west of Chicago. Think 15,000, 20,000 people, about a hundred bed hospital. And she was a nurse there for the whole time. That we were growing up and anybody that’s grown up in a small town with one hospital and has somebody that works there, we were in and out of there all the time. As kids, whether it was a Christmas party or dropping something off for her at work. And then I eventually actually got my first job in healthcare, working in that hospital. I actually. In the kitchen, in what we call dietary at the time, we now call food and nutrition washing dishes, and did that through high school. And my first couple of years at college lit, progressed a little bit, got to supervise the tray line, all of those types of things. So I have been in every hospital kitchen in my healthcare system. I’m fascinated by them. Love to see how it’s progressed or not, during that time period. And it just really helps me. To our entry level service workers, who are hundreds, thousands of them, throughout our healthcare system, because I actually experienced that. But my mother was a nurse back in the day where they wore whites, if you remember that. And those cute little hats that had to be Bobby pinned into their hair. I, and as a lot of nurses, she had absolutely no hesitation coming. To tell her daughters, when we asked her what bodily fluid stain, was on her wife, she would tell us. And none of us thought that was great. In terms of a future career. So it’s funny, all my three sisters, we’ve all been in healthcare at different points in time. I still have one sister who does still work in healthcare. But none of us went in to be a direct clinician. So I decided to be an accountant and I went to school at Bradley University in central. And took that newly minted degree and went up to Chicago in the mid eighties to work for a big eight accounting firm that will date me because there’s not eight anymore. And went up there to Chicago. And one of the things those big firms do is when you start maybe your first or second day in, they want to match your interest. So they give you this whole. Of industries, that you could potentially work with in terms of clients. And when you’re out of college, you don’t even know, what some of these industries are or what they do, so a lot of people migrate towards retail or consumer products or some headline company that they’ve heard about. And I checked those off. But I also checked off hospitals because I knew hospitals, I’d been around them my whole. And then you find out that a lot of accountants either are familiar with hospitals or comfortable with ’em and they don’t check off hospitals. And so I became part of a relatively small team of professionals who learned healthcare, finance, which at the time was mostly hospitals, that we really worked on. And this is the mid eighties, late eighties where there was an awful lot of change going on in terms of how we got paid our reinforc. Because Medicare was changing the way that they paid us off of cost reimbursement to, what we all have today, which is prospective payment. Managed care was just starting, in terms of contracting understanding your cost so that you could contract. So it was a fascinating time to get into healthcare, finance and really as a finance professional, there are so many fascinating topics for you to get into when. Work for hospitals. Our health systems, not only the reimbursement side, but we build very large buildings. And so there’s all the construction types of things you have to think about. There’s leasing very large buildings, there’s very large investment portfolios. We market municipal bonds. So it’s just a fascinating type of career to get into and I gravitated towards it, mainly for that reason. So I never had an aspiration to be. A accounting partner, I always thought I wanted to be hired by my client and be a controller. Someday be the chief accountant. That would be, my aspirational goal. And sure enough, I got an offer from my largest client which today is known as Rush University Medical Center. I, and I actually started to work with their health plan division. They owned at the time, the second largest health. And the city of Chicago, because they were an early pioneering staff model, HMOs and they had a very large very large health plan. So I actually started out over there. Learned the insurance business doing that. But then got a chance and actually got to run d most of the departments in the insurance side in the time that I was there for eight years. But after I got married and I was having, and I had my first child, they invited me to come and work at the parent, the academic medical center, and worked directly for the CEO and for the C-Suite Mona’s staff role. So I went. Supervising thousands of people, literally in the provider network, and then moving over to a very small team working in the C-Suite to do a number of different things.

Sandra Fenwick: Oh, Cathy what a wonderful set of roles you’ve taken and leadership you’ve provided. Your experience as a woman leader, and especially one in finance. Have you really felt that being a woman has been different and obviously if I had many opportunities, many challenges and the question really is what trade-offs? How did you navigate? What hard decisions did you have to make? I’m sure there’s, this is gonna be rich with with.

Cathy Jacobson: exactly, because we’re, some of the same generation, let’s face it, things are different today than they were in 1985, when I came out of college. But in some ways, they’re not. All that much different. And when I came out of school in the mid eighties and as I became a leader and started really getting into leadership, going into the nineties, quite frankly a lot of what we went out with was, you didn’t want to be different as a woman. You wanted to prove you weren’t any different than anybody else because you were always. And always the only one in the room. Literally all the time, and even more the further up, one might say, the food chain you ran, it became lessen, less, women leaders were there. I think when I was at Rush, it was me, the dean of our C N O and I think our chief information officer at the time was female, which was highly unusual. At the. So there were just not anybody else like us around us, and so we wanted to prove more that we work different, so I never talked about my family when I was at work. I didn’t want them, anybody to think that I was distracted, that I was worried about that, that I was thinking about my family or anything like and so that just never came with me, to work. And after a while, what I found out is that I was becoming immune to it. I was just so used, to being the only person in the room and. We’ve all seen it and heard it. There’s, comments made though. I will never forget a certain chair calling all of his nurses girls, his girls, and we hear that, and everything. And you just, you let it slide, because you’re just move on. What good is it gonna do? You’re the only voice in the room, and you just move on from there. And I remember getting called up. It was probably by that time I was the CFO F at Roche, so it had to be in the two thousands and we were in a finance committee meeting and I had two of, I had four directors at the time. Two were female, two were not. And now there were three of us in the room cuz it literally, there was me and my two, female directors and that was it. And they both came to me after one of the first meetings that they were in and there, and they said, have you notice? That the board members ask us questions about our families and how we’re balancing our families and, how do you work so hard and all of that. She goes, they’re not asking the guys those questions, and that was the first time I think, as a real senior leader that has struck me to say, this isn’t the way we should do this anymore. We have to call out that there is a difference being female. That it’s not bad to be female, it’s not bad to have a family. The guys had a family, they probably wanted to talk about their families too. Type of thing is how do we start being leaders to bring that voice into the room and all of those different types of things. And I think that’s when I really started to become more of a voice at the table for diversity and for recognizing the differences that women had to deal with in their home life. But were quite frankly, If you gave somebody more flexibility in their work schedule, they typically overperformed for you. On the other end of that, I had to personally negotiate and manage that throughout my whole career. So early in my career, work hard, do the best you can. Prove your no different, and prove you’re better than everybody else. And that’s what he did. For probably the first, probably would’ve been close to 10.

Sandra Fenwick: Cathy, you’ve learned a lot from all of that. You’ve learned how important it is to be a woman at the table, to have diverse comments and perspectives and experiences, and I’m sure today you are a way we talk a lot about how. Healthcare is 80% women of the workforce. And yet as we all look around, even in our own organizations, we know that it’s barely 20%. If we’re intentional about it, it may be more than that. What are, what do you think we can do about all of that? What have you learned and what are you doing to try and change? What, what exists?

Cathy Jacobson: That’s a great observation, Sandy. Is that, and it’s, and and it is disappointing. I’ve been a CEO now for almost 11 years and we’re making some progress and there’s some intentionality and there’s a lot of intentionality about that cuz you won’t make progress without intentionality around it. But I still get impatient because it’s moving too slow. So inside our organization you are in a seat of power. So what do you do about that? And one thing I found is. I think women, because of our experiences and especially about being the only in the room and you’ve witnessed, decisions that weren’t maximized because you didn’t have the right stakeholders, you didn’t have the right voices, you didn’t have diversity of thought there. So we become champions for diversity overall because you recognize the value of those diverse thoughts around that table. So what happened is a lot of the things, I have a Fanta, I inherited a fantastic. D and I program here at Frieder when I came here and we’ve just take continued to take it. I’ve worked with those professionals. I’ve been ex, again, exceptionally blessed. I’ve had two leaders in my tenure here who have just built the program and taken it to the next level. And we observe other people and how they’re doing it, but we also believe that we can implement best practice here. So you have to be intentional. There are very professional ways of doing it, and I’d say. Two or three things are some things that we’re doing that are moving the needle along the way. And so we very quickly, we’ve got this in place, gosh, probably almost a decade when two intentional recruiting. And that means, and I have this ability and everybody who’s considered a vice president, and above that you have to have a diverse slate of candidates and you can’t blow that. That’s actually controlled, through, and again, how many of those people are you really recruiting every year? Three or four, even in a bigger organization like ours, it’s manageable. You can do that and you just explain it to your recruiters upfront. This recruit is not going to progress unless we have a diverse slate. And that means not just the interviews, that means who, the resumes, who makes it into an interview and who actually gets. Has to be diverse. And for us, and it was a little bit of a battle that I had to talk through with my executive team. Diverse means women at that level because as Sandy said, we’re 80%, female workforce. I’m only 50% by the time we get to the VPs. And then it even gets lower and lower as we do that to at best, 30% at my most senior level of reporting directly to me. So yes, we. A minority and disproportionately under reserve, underrepresented, especially when you think of the depth and breadth of our workforce. So yes, we are a minority and women count, and that diverse slate when we do that, that took data and that took a lot of talking through with our executive team to be able to make sure that works. But we do that. Number two, we implemented a number of years ago, we call them business resource groups. A lot of other people call them employee resource groups. So the different D pockets of diversity in our organization can find a place to be, whether that’s our black African American group, our Latinx group, our L G B LGBTQ group, veterans, and again, in a second wave. We introduced three to start with, and then we did another two. I said, we need women in leadership because, They’re a minority and underrepresented, given our workforce. Dynamics took a little bit of talking to get there. So we have a V R G specifically around women in leadership and is chaired and sponsored by some of our senior women and our organization. And then probably the third thing is, we at our classic, vp, senior vice presidents, and then up to. And what we have tier, for compensation and development and all those types of things, but what I noticed is my female leaders. We have, we’re sitting just a little bit, they were all my operators, but they weren’t being recognized as senior leaders because they were COOs and running our practice or running a hospital or something like that. They weren’t sitting at the strategy level, or maybe our cfo, F or CIO or C N O, sits at that level. So we created a separate class. There’s both men and women in there to call out. The fact that my up and coming talent is sitting in that. And how do we develop ’em to make sure that they can get up to that group that reports directly to me. So president of a hospital, chief operating officer of a hospital, chief op, operating officer of our medical group. All female, and sitting in that group and it was specifically carved out so that we can start, develop our next level talent, that’s sitting in there. So that’s just a couple of things that we’ve done internally, but I think the other. That we do and again, sometimes people have to poke you to do this, is speak outside and especially when you are bringing a lot of experience to the table and people do start tapping you. Sandy said on different boards, I serve on a public board, a private board. I’ve served on association boards, private charity boards, and you have a different voice than when you’re sitting at that table. It’s maybe a little bit easier in my own community. I’m currently the chair of our, the Milwaukee Metropolitan Chamber of Commerce. First female, ever to do that, ever. Over a hundred years just saying ever to do that. Pretty sure that was a diversity appointment. They figured out, that they needed to do that. But we are a very large employer in this community. We are very well versed in diversity in this community, and the Chamber had just started out a whole new effort around region of choice, and I am a major. For that in the community to promote not only what Froedtert it’s doing, but to really push our community to hit those goals, that we have chosen to do. And I have that voice and people and I show up differently because I am female. When I do that and I can relate different experiences. I know I’ve gotten put on some boards because I am female and they need a female. It’s been explained to me that way in some ways. But that doesn’t mean you’re not qualifi. Because you’re absolutely qualified to be at that table, and you have an obligation to speak when you get to that table around not only your professional expertise, which they want you for, but especially if it’s a board that all boards now with E s G efforts and everything like that, but especially in healthcare because of who we serve, you bring that voice to the table too. So I think, I know I’ve had a couple people talk to me about, oh, I’m only on this board, because I’m female. Okay, fine. But you’re on that board. And now you have a voice and now make sure you use that voice. And so I think that’s what I’ve come to realize is don’t be ticked off cuz you gotta point it cuz you’re female. It gives you the voice. Get in there and use it and demonstrate, just like back in my early career, demonstrate you’re just as good. There’s a real qualified reason, for you to be there. But you’re also the voice of bringing diversity of thought, diversity of stakeholder representation into the group, to be able to do that. I. With the movement in E s G right now that we need woman voices. We need diverse voices at the table. It’s not a numbers game here. It’s really bringing the right thought into the boardrooms to make those organizations better. And there’s data that shows that’s the case. So it’s just making sure people know how to do it more than anything else.

Sandra Fenwick: Cathy, you we’ve talked a little bit about the boards you’ve been on, not just your community boards and your local boards, but you’ve been on. National boards, and you’ve not only been on national boards, you’ve chair. National boards in addition to having a voice, I’m sure like, like I have, there’s so much that you learn. It’s a way I think, of taking care of yourself a little bit, your own learning and your own continuing education. But it’s also, I think, of incredible value for your organization to have you out there. But what else you can bring back? I think. We don’t give enough credit for what it takes on of you, cuz you actually just add that to your work day. You add that to your life. It’s not something you then trade off. Couple words about that. I think.

Cathy Jacobson: Yeah. I, it always for me kinda started with networking. I’ve always joined my professional associations and those types of things, and then I got a chance to be recognized to lead. And you realize a couple things. It’s always been added on. Even when I had, my kids were at home and a family, it was always added on. But it was, it is. It was, quite frankly, back then, probably about the only break I gave myself, to be away and you did get away, and yes, you’re working. But your head is in a different place. You get a different, even if it’s a healthcare board or a healthcare association board, you’re meeting with different people than the ones that you work with every day. You are experiencing different governance. You are learning different aspects of either your industry or a different industry. And I always knew from day one when I got that opportu. That I was bringing back so much more to my organization than I ever could have done before. It made me a better leader in many ways. To chair a volunteer association board. I got the opportunity to chair the Healthcare Financial Management Association National Board and lead Volunteers are not paid, that are trying to give this also as well, people who had much bigger jobs than you did and bring that back. That’s what I. Enjoyed out of that. So you get some professional personal grati, break, in your day and you get some great intellectual curiosity and you are bringing back value, to your organizations. And boy that’s even multiplied 10 times more, with the boards that I’m able to be on now being at Vizient, being at Teladoc the local chamber, that gives greater face and a voice in our c. That we wouldn’t have that oppor opportunity to do, all the colleagues I know on the Wisconsin Hospital Association Board. So I think it’s just it’s invaluable, to be able to do that. I’m very fortunate that my board allows me to do that, but at the same time, I think they have seen, the benefit and just the thinking and the, you just are refreshed. You come back with new ideas and you’re just, thinking about things a different way. So it’s been.

Sandra Fenwick: Any parting thoughts, Cathy, before we wrap up?

Cathy Jacobson: Yeah, the only thing that I would say is, and it might be right, because people say this all the time, the next time you walk into a meeting, I want you, and especially one that has a big table up with the seats around the side. I want you to observe who sits in the seats around the side versus who’s sitting at the table. And you watch it, but you’re gonna find it’s mostly the women that are sitting around the seats. They’re not sitting at the table. And I have started again because I can to tell when I ha hold that meeting, to tell ’em to get at the table. Because if you’ve been invited to a meeting, you’re there for a reason and you’re there to contribute and you can’t contribute as well. When people have their backs to you at the table and you’re sitting against the. Sit at the table, people will hear your voice better, and you belong there and know that you belong there. So sit at the table. That’s one of the things that I would tell you to do.

Sandra Fenwick: Cathy, thank you. This was really very special and appreciate. I know. A crazy week and many things going on. So congratulations on your extraordinary years of experience and journey. So thank you for joining us today.

Cathy Jacobson: Thank you, Sandy, for the opportunity. Thank you so much.