Ep 15: Meet Your January Host

with Joanne Conroy, M.D.

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Joanne Conroy, M.D.
President and CEO, Dartmouth-Hitchcock and Dartmouth-Hitchcock Health

Joanne M. Conroy, M.D., serves as CEO and President of Dartmouth-Hitchcock and Dartmouth-Hitchcock Health, the largest private employer in the state of New Hampshire. Dartmouth-Hitchcock is a nonprofit academic health system that includes: Dartmouth-Hitchcock Medical Center, which is the system’s 429-bed flagship teaching hospital; the Dartmouth-Hitchcock Clinic (a multi-specialty group practice employing more than 1,500 physicians), the Norris Cotton Cancer Center; the Children’s Hospital at Dartmouth-Hitchcock; four affiliate hospitals (New London Hospital, Mt. Ascutney Hospital and Health Center, Cheshire Medical Center, and Alice Peck Day Memorial Hospital); the Visiting Nurse and Hospice for New Hampshire and Vermont; and 24 ambulatory care clinics.

Dartmouth-Hitchcock is New Hampshire’s only academic health system and only Level 1 trauma center and is the largest provider of healthcare in the state and the second largest in Vermont.

Prior to arriving at Dartmouth-Hitchcock, Dr. Conroy served as CEO of Lahey Hospital and Medical Center (formerly the Lahey Clinic), part of Lahey Health, a large, integrated delivery system with more than 1,400 physicians, 18,000 employees, $4 million in grant funding for medical research and $2.0 billion in annual revenue.

From 2008 to 2014, she served as Chief Health Care Officer of the Association of American Medical Colleges (AAMC), focusing on the interface between the health care delivery system and academic medicine. From 2001 to 2008, she served as Executive Vice President of Atlantic Health, Chief Operating Officer/ President of Morristown Memorial Hospital, a 695-bed flagship teaching hospital. From 1986 to 2001, Dr. Conroy served many roles at the Medical University of South Carolina, including Vice President for Medical Affairs, Chair of Anesthesiology, and Senior Associate Dean of the College of Medicine.

Women spend too much time pleasing other people and not asking for what we want. It will not come to us unless we ask.

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Joanne Conroy  0:03

I trained in the South. At a time when I was going to medical school, fewer than 10% of my class were women. There were so many opportunities there because they hadn’t seen a lot of women in leadership positions, that it was almost like a vacuum that I moved into.

 

Lan Nguyen  0:18

That was Dr. Joanne Conroy, President and CEO of Dartmouth Hitchcock and Dartmouth Hitchcock Health.

 

Joanne Conroy  0:24

What I learned about playing golf for business is that most of the conversations happen on the tee box. So I said, “I’m always going to hit from the whites, then I just swing,” and then they stopped talking.

 

Lan Nguyen  0:38

In this conversation, Lynne Chou O’Keefe, Founder and Managing Partner of Define Ventures, introduces Dr. Conroy as our next host. They discuss Dr. Conroy’s trajectory from the early days of clinical practice, to administrative leadership, and her extraordinary resilience and commitment to championing women along the way. So let’s jump into Her Story, a program where we explore the intersection of women, leadership and health care.

 

Lynne Chou O’Keefe  1:11 

Good afternoon, Joanne, thank you so much for meeting with me and really handing the baton and being our next host of Her Story. As many of you might know, Joanne is the CEO of Dartmouth Health System. You trained as an anesthesiologist what inspired your interest in medicine?

 

Joanne Conroy  1:31  

I have a pretty unusual story about how I got into medicine. My father was an executive recruiter. And by the time we were in, I think junior high school, he’d already decided what careers we were best suited for. So he had determined that I had to be a physician, then you spend the next 10 years ignoring it and fighting against it. After I graduated from Dartmouth, I was a sous chef, I dated an NHL hockey player, I did all kinds of things that you really can’t tell your nieces or nephews. But after two years, I said, “I need to use my brain a little bit more than figuring out how to be an Italian sous chef,” and decided to go to medical school. And you know what, I was probably 51% sure that it was the right thing. But I decided that is about as sure as you’re ever going to be in life about anything. And so I went for it. And I never looked back. I just loved the intellectual curiosity and challenge that it gave me. As I started in my clinical service, I really appreciated the physical and emotional demands made on you. It’s the best career in the world.

 

Lynne Chou O’Keefe  2:42  

And you’re probably an amazing cook on top of that. And I find in, at least, in one’s career, sometimes going in really opposite directions give you true appreciation, when you found the career that you’ve kind of gone far and wide. Just as an anesthesiologist, it sounds like, can be, at times, a male dominated specialty, what was it like as you were training and progressing in your career as a clinician?

 

Joanne Conroy  3:09 

I trained in the South at a time, when I was going to medical school, fewer than 10% of my class were women. So it was really a very male dominated, not just specialty, but, really, environment in Charleston, South Carolina. There were good things and bad things about it. I would say there were some very strange questions that were always asked on my interviews about having a family and why did such a good looking woman want to go into medicine, I still got those. But you know what, there were so many opportunities there because they hadn’t seen a lot of women in leadership positions that it was almost like a vacuum that I moved into. I do remember one specific story, though, was when I was young chair, I was presenting at a national meeting, we had a breakout group and another chair, a male chair, and I, were doing a report out, he referred to me as Vanna White, in front of 180 chairs. And anesthesiologists used to make a joke about what’s called the ether screen, that sheet that separates the surgical field from where the anesthesiologist works. And we call it the blood-brain barrier. And so I held up a big piece of poster paper and said, this is the blood-brain barrier, decide what part of that I am standing on. And the entire room erupted in applause. And that was just a little bit of revenge right there for an incredibly idiotic statement.

 

Lynne Chou O’Keefe  4:45  

I think we’ve all been in those situations, and I have to say for you to have the answer right then and there, I think so many of us have thought in hindsight, “If I could have only said this, at that time, that perfect comeback,” if you will, to kind of put it in front of people to understand what just happened. What an amazing way to have it right there in front of that audience and put it in its place. So how would you say, would you say, as you started rising in the ranks, were you an accidental or more intentional leader?

 

Joanne Conroy  5:19  

I was an accidental leader. I remember the first time I was actually drawn into leadership. It was Sunday evening, I was on call at the academic institution where I was working, and the business manager showed up at my office in tears. And I asked her what was going on–I was the vice chair at the time–I’d been mentored by a chair that had been there for 30 years and he had retired about a year previously, and we had a new chair–and said, “We can’t make payroll.” And when my old chair had left, we were probably $800,000 in the black in terms of our reserves. And so, I went through the process of really just gathering all the information, I said, “Give me all the spreadsheets you have.” And I looked at them over the weekend, and it was pretty easy to figure out what had happened. And then I had to go actually talk to the chair and talk about the situation we were in, and I realized that he was a very nice man, but really didn’t have a lot of financial training, a lot of financial support, and then working through it with him, and protecting him from the anger of the other members of the department whose livelihood was threatened. I was just drawn into that leadership role. I learned a tremendous amount about the bureaucracies of institutions and how you navigate the politics. But then, when I went to ask for help, people said, “No, we can’t help you because it will undermine your chair.” And I said, “Okay,” I said, “this is something that I’m going to have to navigate with him,” which actually resulted in the probably best result for everybody.

 

Lynne Chou O’Keefe  6:59  

I think what’s so interesting, as many women progress in roles of leadership, when you started at an organization, in this case, more as a clinician, and then that transition, when you are a leader is almost a completely different job description. What led you to make that leap from clinician to more of an administration CEO level? Because your day to day must be drastically different? 

 

Joanne Conroy  7:28 

When I was first chair, and I became chair at the Medical University of South Carolina, I actually managed a full call schedule and actually had a full time practice, in addition to my chair responsibilities for a couple of years, that’s unsustainable. And I backed off to three days a week, but I still took full call, it was kind of a badge of honor. When I went to northern New Jersey, I worked a day week in the operating room. But there is a point that you realize that your clinical involvement is kind of gratuitous for you, does not really benefit the patient, you’re making yourself feel good. And there is a badge of honor about these administrators that are clinicians, and we have some here that are just fabulous, but you can’t do everything. And I realized when I was younger, when I was balancing all of that, I probably wasn’t spending enough time thinking strategically. And you know what, that’s what I get paid to do–anticipate the problems before they’re upon us, to think strategically about how to position the organization. And it’s really difficult to do that, when you’re trying to maintain a foot in both worlds. That was difficult to give it up. I still have a license in many states, but I think I could do a pre- and post-op visit, maybe, but probably not provide anesthesia, it would not be good for patients and not good for me, either. 

 

Lynne Chou O’Keefe  8:55  

You talked about balancing, making choices in your career, and also a lot of events in your life happening in terms of that. How have you navigated that, and some of the more recent events in your life, as you’ve climbed to these upper echelons of leadership?

 

Joanne Conroy  9:15  

I do remember one time when we were going through such a difficult time at the university and I was working with the CEO and the dean in addressing the $77 million deficit across the organization. It was in the late 90s, with the balanced budget act, when we were all in the red. And I do remember having to make some really tough decisions, actually eliminating programs and outsourcing them to the community. And I remember a board meeting that I heard that they were going to talk about one of the big programs that we had to eliminate. And I said well, “I’m happy to fly back from my vacation home in Maine, to attend the meeting.” And the individual who I was talking to said, “No, don’t do that.” And then I heard what went on in the meeting. And it was not their finest moment in terms of standing up for a plan that we had agreed to execute on. But I learned a lot about others’ leadership. And I became a lot more forgiving as a leader. I was originally, maybe, disappointed that they didn’t stand up for me. But I realized how important it was when you are executing on something, to really make sure that your linebackers are tough and they’re going to protect you as you run down the field and not get weak-kneed. And there are a lot of weak-kneed people out there. Not a judgement, just an acknowledgement that you really need to be extra careful when you are doing things that are politically difficult and uncomfortable for a lot of people.

 

Lynne Chou O’Keefe  10:48  

I love this analogy of linebackers not being weak-kneed. I think, as we think of leadership positions, you can create waves, and real change sometimes necessitates those waves. What else do you think has given you edge in your career, as you’ve progressed?

 

Joanne Conroy  11:06 

People would say that I’m a strong and determined person, but I deliver it in a way that is surprisingly easy to accept, somebody said, “You say ‘no’ in just the nicest way.” It is really important to be direct–to be firm. A lot of times I say I’m like Chinese water torture, that I’m very persistent. But you have to be tough. People will take advantage of you, if they know you’re always gonna cave. And there’s certain things you have to stand for. But also, there’s certain things that you need to be able to give on. And it’s understanding when it’s important to stand your ground, and when it’s important to give a little bit.

 

Lynne Chou O’Keefe  11:45  

Interesting what you said of how you deliver something, the thoughtfulness. Does that tie it all to the story? I was reading the story of your father, when you went to the bank, and the lesson he taught you at that moment. I don’t know if that ties in. 

 

Joanne Conroy  12:00  

Really, you mean about entitlement. I was standing in a bank line, and there were 10 or 12 people there. And I was really exasperated. I came home and I said, “You know what, I’m a medical student, I don’t have time for this.” And actually, I was told that the minute I thought I was better than the other people standing in that line, I did not deserve to be a physician. And you know what, that was right. And you just have to appreciate that we are so privileged to have this fabulous career and wonderful training. But with that privilege comes a level of responsibility to the community and humility. It doesn’t make you better than anybody else–maybe makes you have an additional skill that you can contribute to society. But we’re all humans.

 

Lynne Chou O’Keefe  12:49  

And just the empathy, too, I’ve got to believe that all of your experience, all of your training, your leadership that you’ve had with the health system to lead to this moment. What has it been like this year from a leadership perspective, because I’ve got to believe it stretched you in ways that were unimaginable before?

 

Joanne Conroy  13:10  

We had to make a lot of really important decisions, how quickly to shut down the enterprise to create capacity for patients that needed our services. What were we going to do to make our employees feel safe–because everybody was concerned about their job, everybody was concerned about catching the virus, how are we going to work to really reassure our communities that we were going to navigate them through this? It was not just figuring out financially, how to shepherd the organization, or operationally how to fill beds, it was a lot of reassurance to the staff, to the community, and to the leadership team, that we were going to be able to get through this. We were really fortunate in our very quick recovery. We didn’t furlough anybody. We didn’t reduce anybody’s compensation. We didn’t lay anybody off. We told everybody, “Your jobs are secure, because we need you to help us get back to normal.” And that’s been our mantra since then, we’re not seeing the end of normal yet, although hope is on the horizon with a vaccine. But we need every single individual working with us to get us there.

 

Lynne Chou O’Keefe  14:20  

I’ve heard your comments too, about what you believe leadership is and what people need as a leader of an organization. And to your point about job security and what this all means and impact of their roles. It really parlays through to what you just said right there and how you tackled this crisis. If we can comment, too, there’s been a lot personally, that’s happened concurrently for you, during this COVID crisis, how do you work through that, as a leader, personally and professionally?

 

Joanne Conroy  14:53  

My husband died of stage four cholangiocarcinoma at the end of April, like in the middle of the peak of the first surge, and was a very fierce battle. He was diagnosed in December of last year and died five months later. What’s interesting–I’m a very transparent person, so I wrote his obituary, actually, a couple days before he died. And I wrote a long letter to all of the staff that was distributed across the organization. And people were just wonderful with their outpouring of support. But I realized that was good for me and good for them, that they knew what was going on with me, and they felt this connection, and I’m very transparent, I write a journal every single week to everybody. But I also realized that they want their leader to be strong and refreshed. And that they expected me not to curl up in a fetal ball and hide the rest of the pandemic; they needed me to actually be strong and be there with them. And the organization was incredibly supportive. I actually came right back to the hospital the next week, and resumed my daily activities. But being here actually gave me that family that you really look for. The year got even more difficult. Two weeks after my husband died, my mother had a stroke in South Carolina, and I had to extract her and bring her up here, where she went through rehab, my husband laughed as he was dying, though, and he said, “You know what, this house is going to be a home for wayward women after I am gone,” he goes, “I just know it.” And wouldn’t you know, every single one of my bedrooms is filled with a woman either caring for my mother, or friends that are visiting. And my husband’s prediction actually came true.

 

Lynne Chou O’Keefe  16:48  

Well, it’s full of life, it sounds like the home. I’ve got to believe also in COVID, like, that’s what we’ve all, like, we’re blending our lives, here I am in my home, to you, our work and our life is blended in such a way that we are human beings at the core of what we’re doing and who we are and who we are as leaders. So thank you for sharing that. It’s, it’s incredible the strength that you have, and the leadership you’re giving, and how you’re helping so many people in your community, and the whole, New Hampshire, everywhere, like it’s just, it’s so impressive. One thing that I will always remember is, you’ve also been just a huge champion of women, period, and you’ve started your own group called Women of Impact, I’d love to hear what generated that.

 

Joanne Conroy  17:37  

I actually went to a very unusual leadership retreat, probably in 2011. And it was talking about actually building your legacy. And most retreats or leadership development programs you go to, you know, they maybe build a skill here or there. But this was really a program that said, “If you are at the height of your influence, what are you going to do to put that influence to use to actually create a greater impact?” Women often do tasks that are put in front of them, instead of doing things with a purpose and for a purpose. And how do you actually have a very purposeful way of making decisions in your life and also living into the future that you imagine for yourself? So this is really an imagination exercise that women leaders go through. Now, I was the only healthcare woman there I was with women from Microsoft and Dutch Oil, Shell, and Google and I thought, “Wow, I bet I could pull together a group of women that want to think about fixing healthcare as much as I do.” So I wrote to the Robert Wood Johnson Foundation, we got a small grant to actually bring 23 women together in 2013, calling ourselves Women of Impact. And these women went through this imagination exercise. These are national leaders, they said, is the first time they had ever thought about their careers in that way. And it was transformative for many of them. And they have all stayed incredible friends. And actually, we said, How can we actually increase the number of women that could experience this?” So we’ve had four cohorts s bar. Now, we don’t want to be a really large organization. But right now, we have about 70 women that have gone through the legacy exercise. And we meet–we’re actually on the phone about every three weeks talking about how we’re going to create greater impact, but we’re all focused on really contributing to fixing healthcare, because we all have different perspectives. 

 

Lynne Chou O’Keefe  19:47  

Absolutely. I referenced frequently that 80% of healthcare decisions are made by women, we are the Chief Medical Officers of our home and to bring that leadership together in the way for the impact that what you’re talking about, can be transformative. So if you had a book, and you titled that book, what would the title of that book be?

 

Joanne Conroy  20:09  

The title is, Man, That Woman’s Like Chinese Water Torture. Because I am very persistent in the nicest way.

 

Lynne Chou O’Keefe  20:17  

I’ve heard you say, always say, “hitting from the whites,” and I just love this analogy. Describe that. I know you’re a big golfer, what do you mean by that?

 

Joanne Conroy  20:27  

So I started golfing in New Jersey when I was working in a hospital system and realized that I was the only one working on Mondays between April and October and everybody was out golfing. So I went and I called the church of golf, I took lessons every single Sunday at 8am at a small nine holer. And, actually, my coach I found out later was Sergio Garcia’s Swing Coach, so I just lucked into this incredible coach and worked really hard on my game. It takes about two years until you feel like you have some way you’re contributing to a scramble or a golf outing. And I’ve started really being very diligent about my golf game and I go to golf school, I bring six women every single year down to a fabulous female pro in Bluffton, South Carolina. But this is what I learned about playing golf for business is that most of the conversations happen on the tee box. And if you were the only woman–and I often was the only woman, sometimes in the entire outing–if you’re the only woman there and you have to run up to the red tees to hit, you are missing all the important conversations. And so I said, “I’m hitting for the whites, I’m always going to hit from the whites.” And you know, it is fascinating that I have put my tee in the ground there and have had men say, “Oh, your tee’s are up there.” And then I just swing. And I have a pretty good drive. And then they stop talking. And it’s all good.

 

Lynne Chou O’Keefe  22:04 

I love it. So just a final question. What is the one piece of advice you give your younger self?

 

Joanne Conroy  22:11  

Ask for what you want. Women do not ask for what they want. Sometimes we spend too much time pleasing other people and not asking for what we want, and it will not come to us unless we ask.

 

Lynne Chou O’Keefe  22:23  

That’s awesome advice. Joanne, your leadership, professionally, in the community, in your organization that you’re leading, is so vital to our humanity right now. Thank you so much for joining me and talking and leading this next portion of Her Story.

 

Joanne Conroy  22:40  

Thank you so much Lynne. It’s been great.

 

Lan Nguyen  22:42

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