Ep 25: Empowering the Frontlines Through Technology

Sanjula Jain  0:03  

Her Story is a program that explores women leadership and healthcare.

 

I’m thrilled to welcome Dr. Geeta Nayyar. Dr. Nayyar’s career has focused on championing how to empower patients and physicians through the use of information and technology. Dr. Nayyar currently serves as the general manager of healthcare and life sciences and the executive medical director of Salesforce. Geeta, welcome to the show. Thanks for spending some time with us.

 

Geeta Nayyar  0:33  

Thank you so much for the opportunity. I really appreciate it.

 

Sanjula Jain  0:36  

You’ve held a wide range of leadership roles, a really impressive career. I thought we could start with a question we ask all of our guests. Do you consider your foray into leadership as more of an accidental or an intentional course?

 

Geeta Nayyar  0:50  

I would say, like everything in life, happenstance. A lot of hard work, but happenstance for sure.

 

Sanjula Jain  0:55  

You’re a rheumatologist by training. You did the clinical route and then you’ve had an impressive lineup of different roles from companies like AppCode, AT&T, provider organizations, and now Salesforce. Could you give us a little bit of a high-level, executive summary of your career path leading up to what you’re doing today?

 

Geeta Nayyar  1:14  

First and foremost, I am a physician at heart. I’m a passionate doc. I believe in empowering patients and I’m still on the front lines of medicine. That’s what drew me into health tech and to the business side of healthcare. On the frontlines you learn very quickly—and we’re seeing that with the pandemic—that there’s only so much you can affect in one-on-one patient care. When you’re able to zoom in and out and bring that perspective to technologies or policy, or whatever element of the healthcare ecosystem,  you’re able to do that much more. That’s been my personal journey.

 

Sanjula Jain  1:54  

You’ve also spent a fair amount of time on the media side, so I know education and bottom-up influence is important to you. How did you find yourself in that realm of things?

 

Geeta Nayyar  2:04  

Again, happenstance. My passion remains on the front lines. One of the biggest roles physicians can play is that of an educator. If you’re a good physician, you’re also a good teacher, and you’re constantly helping your patients understand how they can empower themselves in their own health journey. Again, it was a series of different invitations and opportunities that lead the TopLine MD work, the CNN work. At a time where good information is so critical, I’m happy to be part of the solution. However, I would argue that we have so many folks we need to hear from, and certainly in the brown and black communities. When people look like ourselves, we tend to listen to them, so we need more folks out there talking truth to power.

 

Sanjula Jain  2:53  

Absolutely. As a clinician first, what does your role actually entail? I know Salesforce is a service company. What does your day-to-day actually look like? What are you responsible for in that context?

 

Geeta Nayyar  3:05  

As the general manager of healthcare and life sciences on the provider side, it’s a lot of the things we’re talking about: to inform our business plan, our strategy, our product roadmap from the lens of a clinician and someone who understands our customers (hospitals). We’re at a time when digital engagement and CRM technologies couldn’t be more important, so we’re wanting to make sure that it’s relevant, aligned with what doctors, nurses, hospitals need, and making sure we’re out in the market with a megaphone talking about it and hoping to be part of the solution.

 

Sanjula Jain  3:37  

You view technology, in many ways, as the modern-day stethoscope, which I think is a great analogy. How have you seen medicine as an industry evolve through the course of your career? What are the things that we’re starting to see strides forward in and what are the things that continue to be big gaps?

 

Geeta Nayyar  3:53  

It’s all the things that we’re doing that were primarily jump-started from the pandemic. You talk about virtual health, digital engagement, meeting consumers where they’re at, a consumer who’s feeling more responsible for their own health than ever before, all of these are byproducts of the pandemic. That said, a lot of the problems in the infrastructure remain. A lot of legacy systems on the tech side are holding us back in some regards. A lot of the people and cultural issues are ones we continue to see as the toughest to drive. Again, I think that’s slowly evolving, but that’s one of the biggest pain points in the industry today.

 

Sanjula Jain  4:28  

One of the things you and I’ve talked about is a lot of the folks we work with tend to focus on the clinical side or more of the industry/administrative side and you’re tackling it from both fronts, which I think is so powerful. How do you think about the need to balance the frontline perspective and the systemic perspective? How are you able to do both so well?

 

Geeta Nayyar  4:48  

Everything is a goal, doing things well. We just do our best. I firmly believe, if you are trying to empower the frontlines—which every provider system is trying to do—and drive efficiencies, the best technology and the best administrative tools you can put together are invisible. As physicians, nurses, care team members, we want to see patients. That’s why we went into medicine. We certainly didn’t go into medicine to be bureaucrats or to be shuffling paper around in the back office. If you’re doing the right thing on the back end, then it’s all about the front end and it’s all about not interfering with that clinical care and that clinical touchpoint, so I always say the best technologies are invisible. The frontline shouldn’t even know what is being orchestrated in the background, which I think is where we all want to be as an industry.

 

Sanjula Jain  5:37  

Well said. Shifting a little bit towards what led you on this path, I know you come from a family of physicians. At what point did you decide on medicine? Was it purely family influence? Or what piqued that interest for you?

 

Geeta Nayyar  5:50  

I’ve always been a science nerd and a people person, or someone who likes to chat and talk to people and get to know them, so medicine for me was something I decided on very early. I got into medical school when I was 17 in an accelerated medical program. I do come from a long line of docs (mom, dad, etc), but for me it was such a clear choice. At one point when I wanted to do a Ph.D., I thought about teaching, but that much time on the bench and hidden in the lab was not for me. Medicine is for folks who love science, but love being with people as well.

 

Sanjula Jain  6:27  

At what point in that progression did you have that moment where you said, “Hmm, I’m doing leadership” and started to shift the tune there. What was your first leadership experience?

 

Geeta Nayyar  6:37  

No moment. You just do what you’re passionate about, and you do it well, and then things naturally arrive. It was never a clear and conscious decision that you’d say, “I’m gonna wake up and try to be a leader.” I don’t think that’s the evolution of that. You focus on what your passions are, you do them well and naturally and there are opportunities to move things forward either in your organization, your company, your community, your environment. That is the forefront of leadership.

 

Sanjula Jain  7:05  

As you think about the different professional roles you’ve had, have you had to pursue different skill sets or trainings to prepare yourself for that role? For example, I know that you got your MBA in between some of your roles. What was that thought process like and how did you determine which areas you wanted to address those additional skill sets?

 

Geeta Nayyar  7:25  

I made a conscious decision to do an MBA because what I realized—after many times, butting heads with a hospital administrator about a patient I thought needed to be admitted or needed to stay longer than the nursing administration would allow—it always hinged on business language or business aptitude. Being a physician, you were never given that credibility in the business base. The MBA opened up a whole language, a whole credibility level not just as a physician but a business person, an ability to go toe-to-toe with so many of the business folks that were making the decisions for the hospital and patients. As a physician exec, one of the things I’ve held on to and consciously made an effort to do is to hold on to practice. Many of my colleagues are not able to do that and it is not an easy balance. Last week, I had patients and I don’t leave the clinic or get home until pretty late, usually not before 9, 9:30 because of all the administrative things as well as the things that need to be tidied up because I know the rest of the week will be spent in non-clinical work. It is a balance that I’m always striving to find. Some days are more focused on one thing than the other. It’s true and core to my passion, but it also informs my work at Salesforce and vice versa. It’s an important perspective, particularly in this dynamic environment where healthcare is looking very different every day than what it looked like yesterday.

 

Sanjula Jain  8:58  

You’re a big proponent of “it takes a village” and “there are a lot of people that inform our paths.” What role have mentors played for you as you have navigated each of these different stages of your journey?

 

Geeta Nayyar  9:08  

Oh my goodness. You can never have enough mentors. People say, “I have a mentor.” I have a mentor for almost every different part of my life. Whether it’s motherhood, business, being a doc, media. You can never have enough mentors. I have so many people I’m thankful for, both men and women, physicians and non-physicians. The most important thing is to seek them out, ask for the mentorship, and pay it forward to the next set of folks who will be looking up to you not too far away, Sanjula, as you’re early on in your career. It’s a small world. We all help each other. We’re all part of an industry we should be proud to be a part of at this moment on the globe.

 

Sanjula Jain  9:50  

I’m sure there are so many pearls of wisdom from all of those mentors. Is there a piece of difficult feedback you think back on that made you pause and rethink things? How did you overcome that?

 

Geeta Nayyar  10:01  

That’s a great question. As a doc and as someone in the medical world, a lot of us are perfectionists, a lot of us are alphas. Alpha women, alpha men. I certainly fall into that category, so one of my mentors said to me, “You know, if you try to make everything perfect, you’ll never get anything done. Don’t be so afraid to move forward,” particularly in software where they often release things and then evolve them as they go. It’s very different in medicine, where we like to nail it on the first go because there are lives at stake. I’m learning through that process that making progress includes failures, mistakes, or learning as you go. That is the natural course of business and life. That’s probably one of the biggest learnings that I’ve had.

 

Sanjula Jain  10:48  

Is there a time or a particular scenario that you think back on that made you realize that your leadership journey or experience is different because you were probably one of the few women in the room? Have you ever felt like you were the only one? From a female perspective, do you feel like you faced different things?

 

Geeta Nayyar  11:05  

All the time. I think back on the time when I was pregnant, when I was a young mom, breastfeeding and traveling, and what that looked like. There were many times and there continue to be many times. First of all, it’s very important to have women in these roles. Particularly in healthcare where we have to remember it’s not just about having diversity at the table, but diversity is your customer. It is Dr. Mom that makes all the health care decisions in the household. Even if dad brings home the health insurance, I guarantee you it’s mom making the decision of which pediatrician, which nursing home for the folks, hiring and firing pharmacies. We have to remember that. When we think about where we’re evolving in healthcare, we also think about our frontline workers. A lot of our nursing staff is made up of women. We have to incorporate those perspectives into our business strategy because they directly affect our bottom line. It’s not just because it’s the right thing to do, it is because that is our customer base. I always try to bring it back to that in conversations. A lot of times, from a cultural perspective, we just don’t think about these things, so you have to remind folks. I remember being in a meeting, maybe over a decade ago, and there was a decision we were making. I was the only woman in the room and everyone in the room said, “Well, let’s take a break. Let’s make the final decision over a scotch and cigars.” Of course, I don’t drink scotch nor do I smoke cigars. I’m also a doc, so I don’t smoke cigars. I just chuckled and said, “Well, gentlemen, I think that’s terrific, but how about we do it over a mani pedi.” That was my way of saying, “Hey, I want to be part of this decision, but I’m not going to smoke cigars and talk with you guys, so let’s find something else to do.” I think we have a lot of work to do, but we’ve certainly made a lot of progress as well.

 

Sanjula Jain  12:52  

Absolutely. Until your earlier point, leadership on any given day is tough. In healthcare, it’s even harder given how complex and dynamic the industry is, and you talked about the additional challenges that women face within that. You and I have talked about, being South Asian women, there’s also a third layer of expectations that you face as a leader in your journey and what that actually holds implications and how you’ve thought through things. Talk a little bit about how that experience has shaped your journey.

 

Geeta Nayyar  13:21  

I’m a very proud Asian woman. As I reflect on where I am in my journey, as well as my upbringing— My mom is a doc, my dad is a doc. Both are also very proud South Asians. The South Asian culture is very patriarchal, like many other Asian or Middle Eastern cultures, so this is something that we have to continue to make strides in. One of the reflections I have, I don’t know if my mom would ever say this, but I don’t think I ever appreciated that my father was such a feminist, to raise me as a daughter to support my mom, such admirable qualities. We have to look out for that and also look to make strides in our own culture, in our own upbringings, in our own individual communities. I’m always reminding my daughter of that and making sure she’s very mindful of that.

 

Sanjula Jain  14:07  

Speaking of your daughter, I know that you are great about setting boundaries, like “this is family time” and “this is work time,” which I think is so admirable because not enough people do that. What has it been like trying to juggle motherhood and all the roles that you do? What advice would you have for others? Not that there is such a thing as balance, but for others who are trying to find a healthy normal within that.

 

Geeta Nayyar  14:30  

I was laughing. I put myself on mute because I was laughing quite loudly. I don’t know that I do it very well. I just do my best. The first thing as any mom is we carry a lot of guilt, no matter what. Even if I wasn’t doing half the things I’m doing, I would still feel just as guilty, so number one, being gentle with yourself. That’s also something we’ve learned in this pandemic, to be gentle with ourselves, put on the oxygen mask. If you don’t, again, all the folks that depend on you suffer. The other thing I would say is—and this actually comes from my mom—she would always tell me that you can’t do everything all the time. You can’t be the best at everything all the time. There will be days when you’re a better mom than you are a doc. There will be days when you’re a better executive, and you are a mom. She reminded me that that’s par for the course and that, independent of working or being a doc or any of these things, that’s par for life. Some days you’re a better mom, some days you’re a better daughter, some days you’re a better friend. In today’s modern world, we are doing a lot at one time. The pandemic added all kinds of layers to that. At the beginning of the pandemic, it was non-stop giving children chocolate to get them out of your Zoom so you can do work. Then you pull back and say, “Gosh, this isn’t going away. We need to cut the sugar,” so we’re learning. You should also talk to your kids. I am continuously surprised by how insightful my daughter is. She’s only nine, so she’s not a teenager or anything, but we need to remember that kids are a product of their environment in many ways. You can say many things, but it’s what you do that has the most, lasting impact. It’s the things that you don’t say that they take to heart, good or bad, so remember that. Whether you’re taking a device break, whether you’re exercising, whether you’re figuring out how to deal with conflict, or even saying, “Gosh, I’ve said that so many times. I wish I had spent more time. I wish this or that.” Then she would say, “Well, Mommy, I was fine. I was with my friends. I didn’t even notice.” They will get you off the hook. It’s been a terrific journey. I am doing the best I can, and so many of us are. That’s all we can do.

 

Sanjula Jain  16:45  

Absolutely. To that last point, you had a great story that you were talking about. The bake sale and the cupcakes and then something your daughter said about spending time with her. Could you share that with our audience?

 

Geeta Nayyar  16:55  

We’ve run into these different things with these different obligations in school. There’s so much pressure to be perfect. There’s a silliness of comparing who baked what or that or the other. I and my daughter have fun with these things. Whether we make the cupcakes ourselves or we buy them and put the icing on them, for me and her it’s about building memories and doing activities. That’s what she enjoys. She doesn’t remember the things we do as adults. It’s not the things kids notice. The prettiest room, the prettiest cupcake is not important. It’s that time together. She always reminds me of that and just says, “Mommy, I had so much fun doing this. And who cares? They all end up in your stomach anyway.” I feel very blessed to have the daughter I have. Again, it’s about letting yourself understand that these are struggles we all have. You have an entire podcast dedicated to this. I think that speaks to the fact that every mom-to-be and every mom-not-to-be struggles with this because we’re all just trying to do the best we can, both men and women.

 

Sanjula Jain  17:58  

What do you do for self-care or to decompress from all the stress, particularly COVID? I know you’ve been leading a lot of the vaccine and education discussions down in Miami. How do you find time for yourself? How do you reset? How do you be you?

 

Geeta Nayyar  18:16  

My outlet is I’m a huge lover of tennis. I play tennis pretty regularly. I also try to get outside and move because, in this era of Zooming all day, we forget to stretch, we forget to move. We also forget to take our eyes off the screen. I try to do 10,000 steps a day, to the best of my abilities. That does not always happen, and that’s the other piece to it. If it doesn’t happen, I don’t beat myself up. At the beginning of the pandemic I was like, “Oh my gosh, what am I? Halfway there?” To the point of being a perfectionist, you’ve got to start somewhere, and it doesn’t always end up at 100. All of us are different. Yoga works for some folks, meditation. I struggled with trying both of those things. For me, it’s tennis, and I try to incorporate my daughter into that as well. I’ll hit when she hits or I’ll set up a time for her to play a game when I have a game. We do our best. Her dad will play with her as well, so we have also tried to make it a family thing that we do together. It’s also incorporating exercise into daily routines and life skills as she develops that kind of balance.

 

Sanjula Jain  19:20  

Shifting gears a little bit, you’ve road mapped a lot of your career. As you look back, we all reflect on lessons learned. Is there something you think about that early on in your career you believed and now you say, that’s not actually true?

 

Geeta Nayyar  19:34  

At the end of the day, experience always wins. Look at Dr. Fauci. It’s about the experience. As a rheumatologist, I love old people and I love hearing the stories of so many of my elderly patients. Many of them are not very educated, but they have this glorious experience and this value that is tremendous. One thing I’ve also realized is culturally we have this feeling, particularly in America, that once you’re older, you’re not useful to society. I’m so excited to see so many people that I look up to, whether it’s Dr. Fauci, Jane Fonda, so many folks. Not just 65+ but 75+, 85+, my parents. I think that life is beautiful. You should enjoy the journey along the way and you’ll be surprised how you evolve. I’m also appreciating how life is made up of different chapters. Where you start is not necessarily where you thought you’d be in the middle and not necessarily where you thought you’d be in the end. Those different chapters inform the next, so take the time to have that experience. It’s half of the fun if you stop to do it.

 

Sanjula Jain  20:40  

Building on that, what advice would you give your younger self? Think back to whether it was you in med school or even well before then, what would you tell yourself now?

 

Geeta Nayyar  20:48  

Now in the era of COVID, first of all, I would say travel the world as much as you possibly can. In that spirit, it’s the different perspectives. Sometimes when we sit so long in one place we think there’s only one way to do things. What we’re learning in healthcare is there are many ways to do the same thing. When you travel the world and take in those different experiences, you can appreciate how you can get from A to B. You can get to B in many ways, but perhaps there are seven detours in the middle. My advice to my younger self would be exactly that: slow down, take in the experience, take in a global worldview. The sooner and the younger you do that, the more informed your journey is going to be. This is a really small planet. COVID has shown us that. As vast as the planet is and as small as we’re realizing it is, there’s also a common theme in humanity. When there are conflicts, either personally or professionally, when you come back to the common thread with just humanity, it’s amazing how many bridges you can build with people that you may have otherwise thought you wouldn’t have been able to. I’m seeing that with patients who didn’t want to see a woman doctor and patients who didn’t want to see a woman doctor with black hair and with men who don’t want to report to women. I’m seeing this at different parts of my life where, if you take that piece out and you find that common ground of humanity, it’s amazing how people’s vulnerability will show and you can find that commonality and build a relationship that turns the corner on those different barriers that may have seemed insurmountable before.

 

Sanjula Jain  22:24  

That’s very well said. I would be remiss if I didn’t ask you—as someone who also teaches medical students, and you spent a lot of time doing this—is there a certain capability or wish that you have as you think about the next generation of clinical leaders? What are some of the experiences or training that they should be more intentional about seeking out to be more prepared for the way that healthcare is transforming?

 

Geeta Nayyar  22:47  

It’s not just for medical schools but for business schools because they’re often CEOs coming out of Wharton, Harvard, etc. More than ever, and I say this also as a mom, your emotional intelligence is so much more important than your IQ. There are a lot of smart people on the planet, but the folks that make an impact and are the most intelligent have the highest EQs, so take the time to develop that and speak to some of the things I was mentioning earlier about experience and slowing down. Books are great. I certainly want my child to read as many as she can, but not at the expense of that emotional intelligence and emotional development because, like I said, the thing that’s going to cross the chasm is going to be that common humanity and that common vulnerableness. We’re seeing this in COVID. We’re seeing that we now know our neighbors. We now are part of our community. We’re seeing that every day, and I’m glad to see that it’s refreshing. It shouldn’t have taken this pandemic, but that’s the stuff you can’t find in books. It’s all about EQ, and I’m convinced that the folks who develop that are successful and change the world.

 

Sanjula Jain  24:00  

That’s a great perspective. The final question then. You’re still writing the chapters of your book. You have many more to go and I’m excited to track your career along that path, but if you think about the legacy you want to leave behind as this healthcare leader who’s crossing the chasm from a systemic view and bottoms-up on the clinical side, what would be the title of your autobiography?

 

Geeta Nayyar  24:21  

I Want to Be America’s Doc. Whether it’s in the work that I do at Salesforce, whether it’s in the media work that I do, whether it’s as a mom or showing my daughter and her friends the beauty of science (I teach her science class every year). That’s what drives me, particularly when we think about patient engagement and education. It’s that old adage that you can feed a man a fish for a day, but if you teach them how to fish, they can eat for a lifetime. I believe medicine is that gift, that if you can help people learn how to take care of themselves, then they can be healthy for their lifetime, they can be healthy for their family’s lifetime. There’s nothing else that inspires me more, and that’s the legacy I want to leave behind. To be able to scale that in health tech—not just in my zip code, but around the country and globally—is what inspires me to do what I do every day. I think that’s what it is.

 

Sanjula Jain  25:13  

Maybe you’ll add an author to your list one day.

 

Geeta Nayyar  25:15  

I hope so. Let’s see, let’s see.

 

Sanjula Jain  25:18  

That’s great. Thank you for sharing all that. I appreciate all the work that you’re doing in the industry to keep scaling a lot of that impact. Thanks for spending some time with us today. It was great having you, Dr. Nayyar.

 

Geeta Nayyar  25:29  

Of course, and thank you for doing what you’re doing. I wish forums like this were around when I was your age. It’s terrific to see that. I’m inspired to see more and more women like yourself doing what you’re doing. We’re just here to pass the baton, so make sure you take it in run!

 

Sanjula Jain  25:46  

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