Ep 67: Impacting Healthcare, from Bedside to Boardroom

[00:00:18] Sanjula Jain, Ph.D.: Well, welcome back to Her Story. My name is Sanjula Jain. I am the Chief Research Officer at Trilliant Health and a member of the Her Story advisory counsel. And today it’s my pleasure to welcome Mary Rotunno to the show. Mary is currently the general counsel at El Camino Health and also the chair of the board of a nonprofit behavior health provider, as well as holds many other board seats at pharma companies. Mary, thanks so much for spending some time with me today.

[00:00:44] Mary Rotunno: Thank you. I’m really excited to be here and I appreciate the opportunity to share my story.

[00:00:50] Sanjula Jain, Ph.D.: You’ve really established yourself as an accomplished leader at a very interesting intersection of nursing to law to now serving on a couple different boards. As you think about your foray into healthcare leadership, do you consider your path to be accidental or intentional?

[00:01:06] Mary Rotunno: Well, I guess I can say I started out as an accidental leader. I was a nurse. I was working in Chicago, where I grew up and went to school, and I decided that I wanted to travel and see different parts of the country and live in different parts of the country. And so, at that time they had only like one or two traveling nurse companies and I signed up with both of them and I would pick positions based on the geographic location. So I went to New Orleans, Atlanta, Florida, the Jersey Shore depending on the weather and the location. And each of those positions I would take not really thinking about the position, just thinking about the geographic location. But most of those positions ended up to be supervisory roles and they were charge nurse roles. So that’s really how I got my first experience in leadership. And wasn’t really looking for a leadership role, but it was accidental. Over the course of my career, I think I’ve become more intentional about it. And particularly, I’d say, the last 8 to 10 years, I’ve been very intentional. When I went from my in-house role at Dignity Health to El Camino Health, that was because I wanted to be general counsel. That was my career goal. And then more recently in the last couple years, when I’ve started joining the boards of various healthcare companies, that’s been very intentional.

[00:02:29] Sanjula Jain, Ph.D.: Wow. So you have a very non-traditional path, which I’m really excited to unpack with you today. So let’s start with, how did your family, your kind of early influences, kind of inspire your professional ambitions, like early on in Mary’s life story?

[00:02:43] Mary Rotunno: So, I guess my mother was always focused on the value of education. And so I really took that very seriously. And then my father, his value was your work ethic. He always worked two jobs and was constantly working, it seemed like, from my perspective as a child. But I really got really good work ethic. And so I think the combination of those two has really helped me to move forward in my career and to be able to change careers because I just feel like, with an education and a strong work ethic, you can do anything.

[00:03:20] Sanjula Jain, Ph.D.: So then what prompted the decision to kind of train as a nurse first?

[00:03:25] Mary Rotunno: So I wanted to be a nurse ever since I was, I can’t even remember, probably like six or seven years old. My father had back problems and was in the hospital quite frequently. Back in those days, they used to put you in traction for like two weeks at a time. So I remember going to visit him and the nurses were so impactful, right? And they were always at the bedside and always helping you and he was confined to bed. So I think that really impressed me and I just, I really wanted to help people. So I’m a helper by nature and I just felt like nursing was the way to help people.

[00:03:58] Sanjula Jain, Ph.D.: So then you mentioned earlier that you had this aspiration to be general counsel and there are a couple steps in between, but how did you go from, I’m seeing patients, I’m at the bedside, kind of this passion for nursing to say, huh, now I think I wanna go to law school?

[00:04:14] Mary Rotunno: So originally I was thinking about getting my master’s in nursing and I was working in pediatric oncology. And so I was gonna get my master’s in pediatric oncology. And that was at a time in the healthcare system where they were changing the reimbursement methodology. And so hospitals were cutting back on the clinical specialist positions. So a lot of my colleagues were graduating from their master’s programs, but not able to find clinical specialists or advanced nursing positions. So I kind of decided to pivot and think about what else, and I was ready to go back to graduate school. I started thinking about what else might I look in into? And I had taken a legal implications of nursing class in my undergraduate program. So I connected with a couple of the teachers from that class, and it was taught by nurse attorneys practicing. And that’s when I decided to pursue law school.

[00:05:05] Sanjula Jain, Ph.D.: So I don’t want to gloss over that because I think that’s a really important thing to emphasize for our audience. That’s a big career shift that you made. Kind of get us in the mindset of like what you were thinking through at that time. Were you met with any resistance? Did your colleagues, like Mary, what are you doing? Like what was that like for you?

[00:05:22] Mary Rotunno: I’ve always been open to opportunities and I’ve always felt like I could do anything. I think that came from my mother as well. She always told me you can do anything you put your mind to. And so when I felt like I was ready to go to graduate school, I wanted to do something kind of more and have more impact than bedside nursing because, by that point, I’d been a nurse for, I guess, four or five years. And I realized that, bedside nursing, you have an impact on someone’s life every day, right, with your patients. But I also saw the broader impact in healthcare that you could have with other positions. And so that’s kind why I was interested in graduate school. And so I guess to me, law school, like I said, that class was interesting. And so I thought that, if I put my mind to it, I could do it.

[00:06:11] Sanjula Jain, Ph.D.: So then, coming out of law school, at that point in time, what did you set out to do next? And then how did that kind of take you, I know there were a couple things you did in the middle, but how did that find yourself at El Camino Health?

[00:06:24] Mary Rotunno: So when I first was graduating from law school, I had been involved with, there’s an American Association of Nurse Attorneys. And so I had networked with people there. And a lot of people seemed to be pigeonholed into medical malpractice, and I did not want to do that. I was working part-time during law school in medical malpractice because they need someone with a clinical background. That’s a perfect fit for that type of litigation. And I wanted to do litigation. So I decided to join a large law firm and I joined a large law firm in San Francisco, and wanted to get a variety of litigation experience. So I did environmental litigation, employment litigation, commercial business litigation. And that gave me a really, I think, good understanding of different industries and different businesses. But then I gravitated towards healthcare law because that was really where my passion was. And so one of our clients at the law firm was a large company that owned over a thousand skilled nursing facilities. I was working with them as outside counsel and they had an opportunity that opened up for regional counsel in the Southeast. But it was located in Arkansas. And so I had no desire to go to Arkansas. And as I said before, I was always driven, where I lived was driven by where I went to school, even, in San Francisco was driven by where I wanted to live. So I had this dilemma. Do I take this position and go someplace where I have no desire to live or do I just keep looking for something else? Well, I decided that, and this was kind of like maybe where I started with my intentional you know, more intentional, leadership. I decided that this would be a really good position. It was regional counsel and was a leadership position. And so I decided to, my husband and I moved to Arkansas. And luckily he worked for a software company and was able to work remotely. So that all worked out. But that was really what started my healthcare law career. And I think the lesson I learned from that was that, sometimes, you have to go live someplace you don’t wanna live for a couple of years to get the experience that you need to launch something else. And so with that experience, I was able to move back to San Francisco and then continue my health career, health law career. And from there, I went to a medical device manufacturer and then ended up back on the provider side because that, again, was where my passion was, working with clinical leadership. And I worked at Dignity Health for a little over 11 years as regional counsel in the Bay Area. That was probably the most influential time of my career. And then that’s when I decided that I really wanted to have the challenge of being general counsel and then took the position at El Camino.

[00:09:14] Sanjula Jain, Ph.D.: Wow. So your point on geography is particularly interesting in today’s environment, kind of post-COVID and work from home. We have a lot of folks who are asking themselves the same questions, but I think there does come a point, exactly to what you just said, about sometimes there’s a unique opportunity that you have move for. So I’m kind of curious to see how that plays out over the next couple of years with the new crop of leaders. But I know in our conversations you’ve mentioned to me that you view your role as general counsel, in many ways, like a guardian organization. You have such a broad scope and you get brought into so many different conversations and strategic initiatives. I’m curious not only in your general counsel role, but all your other roles leading up to it, what skills or things did you have to do to kind of prepare, yourself, or kind of bring yourself up to speed, for those types of discussions and, different topic domains and competencies and all of that in the middle.

[00:10:09] Mary Rotunno: I guess, in terms of skills, I think empathy is a really important skill and really caring about the people and the industry that you’re working with. And that’s why healthcare has always been my passion. And so I really care about helping the clinical leaders and business leaders who are making the decisions and operating the health system, right? And so I’m supporting them and that empathy is really important for that relationship and to be able to make decisions for the organization. Otherwise, I think flexibility. You know, my job, I never know what’s gonna happen from day to day. I mean, that’s one of the reasons I scheduled this interview so early in the morning was because, once the hospital’s up and people are back in the office, I’m getting calls and I never know what’s gonna happen. And that’s one of the things I love about the job is all the different issues and problems that people come to me with problems. And so having flexibility, and resilience being able to stay calm in a crisis and give a different perspective. Sometimes it might be a perspective that people don’t necessarily wanna hear. But that’s, I feel like that’s one of the things as the guardian of the organization, I have to be the voice that maybe people don’t wanna hear. And give the advice that I think is in the best interest of the organization.

[00:11:32] Sanjula Jain, Ph.D.: Given your broad portfolio, I know you’re also very passionate about kind of giving back to the community. And so you spend a lot of time dedicating port service. Given you’ve got this demanding day job and you’re doing a lot of different things, how do you determine where to spend your time, as you’re thinking about where else to allocate your expertise and contributions?

[00:11:53] Mary Rotunno: So, for me, I allocate my time where I feel like I can fill the greatest need and have the greatest impact. When I was asked to join the board at Momentum for Health, which is a behavioral healthcare provider, a nonprofit, and they’re the largest provider of behavioral health services in Santa Clara county. Their client base is the underserved Medicaid and uninsured population. At that time, I was concerned about my bandwidth, but I felt like the need was there. And the CEO at the time, Dave Mineta, he’s still the CEO. He was trying to get more diverse perspectives on the board. And so I felt like this was like a call to action. And it’s actually one of the best decisions I ever made because I feel like I’ve had a really, really great impact on guiding the strategy of the organization, guiding them through COVID for the last two years. And I was actually asked to be the Chair of the Board after I’d only been on the board about a year. And I felt like I’m still learning the organization. But again, the CEO convinced me that he really needed my skills, and since I was an executive at El Camino, I was kind of going through some of the same issues that Momentum was going through. So I try to fill the need and, have impact. That’s what drives me.

[00:13:14] Sanjula Jain, Ph.D.: Yeah, I think your passion is very apparent. And you touched on this a little earlier, but I’m curious how you think your clinical training has kind of prepared you or served you well in both kind of your board roles, but also your role as general counsel.

[00:13:29] Mary Rotunno: So I think my clinical training helps me with empathy. I think that’s where I really developed empathy. And then also it helps me to understand the healthcare industry from the bedside. So I can relate to the clinical staff and the clinical leaders, and also the business leaders, and really understand the organization because, as an advisor, both as general counsel and on boards, you really need to understand the industry. And my clinical experience served that.

[00:14:01] Sanjula Jain, Ph.D.: Have you found that, and I’m making a little bit of a generalization, but based off some of the data that I’ve seen, probably in nursing, you start off your career, being around a lot of other female professionals to now being in more senior leadership roles, serving on boards where women are not as fully represented. And so how has A, I guess, that shift for you kind of shaped your approach to leadership. But then also, what advice do you have for other women who are kind of like one of the few in leadership?

[00:14:33] Mary Rotunno: It is an adjustment, that shift. Definitely. And I think for me, I’ve just always been kind of true to myself and put the interest and goals of the organization first. But I’ve also been a really strong advocate for women and have taken an active role in mentoring women and promoting women in meetings and whenever I can to give women opportunities.

[00:15:00] Sanjula Jain, Ph.D.: Along the way, so you’ve got a very impressive journey and you’ve made a couple of different career pivots, and I feel like all these experiences are kind of building on each other. You’ve had to make a lot of decisions, and I’m sure many tough decisions, but is there one particular kind of trade off or difficult decision that you feel like you’ve had to make in the course of your career?

[00:15:19] Mary Rotunno: So the decision to move to Arkansas was probably the first one. More recently, the decision to leave Dignity Health and go to El Camino, because I was really, really, I loved my job at Dignity. I was really connected with the mission at Dignity. But yet I wanted to be general counsel and I didn’t see that happening at Dignity. So that was probably, in terms of career decision, that was probably the pivotal decision. But then again, that then changed my career, both in terms of being general counsel, because being general counsel led me to board service. Being in the board room all the time as general counsel with the various boards that we have at El Camino and the various subsidiaries, I realized how much impact the board has. And I learned more about board service and that was the impetus for me to get involved in board service.

[00:16:12] Sanjula Jain, Ph.D.: So in addition to wearing many of your professional hats, you’re also a wife and a mother. This is always a tricky question, but what advice do you have for other leaders who are similarly juggling, and I deliberately am using the word juggling, you know, demanding work and personal lives.

[00:16:31] Mary Rotunno: Well, I mean, fortunately now my children are adults. They’re 23 and 25. So I’ve moved from a mom role to more of a coach and consultant role, which is a lot less time consuming. But looking back on when my children were younger, I think the best piece of advice I have is to ask for help and don’t think you have to do everything. And also sometimes, it’s good enough. It doesn’t have to be perfect. And I think I struggled with perfectionism when I was younger and having children. That kind of helped me get over that because I realized none of this is gonna be perfect when you’re juggling a lot of things and, sometimes, some things are just good enough and that’s fine.

[00:17:17] Sanjula Jain, Ph.D.: That’s really well said. So on the personal front, you clearly are a early riser, from what I can tell, being on the west coast right now, the time of day that we’re doing this interview. But we all have personal routines that kind of help us feel productive or make the most of every day. What’s like your morning ritual or something that you do for you day to day?

[00:17:38] Mary Rotunno: So I used to go to an exercise class. Especially when the kids were little, I would get up and go to an exercise class before they woke up. And that was kind of the way that I got energized and going for the day. Now during COVID, I actually started doing pilates on the Peloton app. And then I also do a daily meditation that I signed up for that you get an email every day. And so typically the first thing I do is that daily meditation. And then after I have my coffee, do 10 or 20 minutes of pilates.

[00:18:09] Sanjula Jain, Ph.D.: I haven’t tried the pilates one on Peloton. I’m gonna have to give that one a go. So Mary, this has just been phenomenal, just a couple of final questions as we wrap up. So as you’re reflecting on this journey, what is something that you believed early on in your career, it could be something that you believed yourself or was told to you, that you no longer believe?

[00:18:30] Mary Rotunno: I used to feel like your career was linear and that, when I started out as a nurse, I never thought I would do anything else, but be a nurse. And so I think that what I’ve learned is that your life is not linear and being open to opportunities, pivoting when opportunities present themselves, and just being open to new things is the way to live life. And it’s funny because, recently I was reading Jodi Picoult’s latest book and she had a quote in there, I’ve gotta pull it up because I wrote it down. It says, “you can’t plan your life because then you have a plan and not a life.”

[00:19:12] Sanjula Jain, Ph.D.: Ah,

[00:19:12] Mary Rotunno: That really resonated with me.

[00:19:16] Sanjula Jain, Ph.D.: Yeah that’s a really good one. That’s a frame worthy one. So you have just continued to have tremendous impact on the industry and you still have many more chapters of your book to write as you continue to dedicate your time to service, to make health and wellness better in our industry. But as you think about the legacy that you personally would like to leave behind, when you think about the time when the autobiography is gonna be written about you, what would you title it?

[00:19:44] Mary Rotunno: I think I would title it something along the lines of, “Servant Leadership in Pursuit of Meaning and Impact: From Nursing to the Boardroom”.

[00:19:58] Sanjula Jain, Ph.D.: I like that. That’ll be the book that we all read when others are pulling out quotes like you just did for us. So, Mary, this has just been a phenomenal conversation. Thank you so much for being so willing to kind of share and reflect with us. We have a lot to learn from you.

[00:20:12] Mary Rotunno: Thank you. I’ve really enjoyed being here.