Ep. 80: The Power of Partnerships

[00:01:00] Joanne Conroy, M.D.: Hello, I’m Joanne Conroy, president and CEO of Dartmouth health. And welcome to her story. It is my great pleasure today to be able to interview Dora Ann Mills, who is the head of main health care improvement team. She has an incredible background, 15 years as the chief health officer for the state of Maine, led the clinical programs at the university of new England many years of public service, both in the us as well as internationally. And I think she’s got some incredible advice for future women leaders and an interesting fun fact about Dora is she’s sister to the governor of the state of Maine. So we’re gonna ask her some questions about what it’s like to move from being the center of attention as. Health commissioner for the state to being in the total fishbowl as sister of the governor. And I’m sure she’s got some inside baseball advice for all of you. If you are thinking about running for a public office. So welcome Dora.

[00:02:07] Dora Mills, M.D.: Thank you so much, Joanne. I really appreciate being here. It’s an honor to be here with you. Thank you.

[00:02:12] Dr. Joanne Conroy: This is really gonna be a fun half hour. Let’s talk a little bit about your career. Half of our listeners are actually young women that are embarking on their career journey and about half of our listeners are seasoned executives that just like to hear about other people’s careers. Talk about how you made your decisions to pursue pediatrics and go do international care, you were in Los Angeles for a while as well. What brought you back to Maine?

[00:02:40] Dr. Dora Mills: Yes. I grew up in rural Maine, so in rural Western Maine and I had some quiet aspirations, I think when I was in middle school and high school, I, I thought about maybe going into medicine, but there were no physicians in my family. And there were no women physicians in my home area. I mean, knew none. And some of the young men I was growing up with had expressed interest in medicine and they quickly got gobbled up by some of the local doctors to, oh, come job shadow with us and all that. And it just didn’t seem like that was gonna be an opportunity for me. So I didn’t go to college thinking I was gonna be a doctor. I went to Bowden shortly after it became co-ed. So there weren’t a lot of women there, but I was so fortunate to have some great mentors. And in particularly I was studying Russian actually, and taking some science classes. I’m the youngest of five kids and the other four said, if you’re not sure what you wanna major in a language, cause you could always get a job with it. So at that time I had no connections to Russia, but it was kinda a interesting, it was a good, they also said teachers don’t take courses. And the teachers in the Russian department were supposed to be fabulous. So I started taking Russian. But my second semester, sophomore year, I got stopped in the hallway by the head of the biology department. Who had, I was, had taken some science classes and including one of his, and he said, what are you thinking of doing? And I said, oh I don’t know. And he says, you should think about medical school. That was the first time anybody had actually said that, or even hinted at it, but it gave me the confidence. I needed somebody in a position of authority who knew what they were talking about to say, you should consider this. So I would suggest for young women starting out that, don’t wait as I did I think you should pursue it. Be a little bit bolder about it. If you’re interested in something, start seeking out opportunities, experts and people to talk with about it. I was lucky that the head of the biology department happened to stop me in the hallway and gave me some encouraging advice.

[00:04:42] Dr. Joanne Conroy: You are absolutely right. Probably for a lot of women leaders, there’s this affirming experience and it doesn’t usually come from your family. We both have new England families, so that’s a whole different podcast on the new England stoicism. But yeah, when you have somebody that affirms that you’re actually really good at what you do and you should set your sites higher, it has a real impact.

[00:05:09] Dr. Dora Mills: It does. So I encourage those of us who are seasoned to do that more. I know I try to do as much mentoring as I can. I know that it had played such an important role, a critical role in my own career but At the same time, I also encourage young women to not wait around for somebody to affirm you, but go seeking mentors, seek advice and. Seek your own story, your own goals, your own aspirations. But anyway, so I was very fortunate to get on that journey of medicine. I worked abroad for a while. I did my residency in Los Angeles. Came back to Maine. My heart was always in Maine, even when the years I lived abroad and out west. So it came back to Maine in 1992. And and then was very fortunate to get the job at the state in 96. I practiced my hometown during those four years in 92 to 96, which is an unusual experience these days to practice medicine in your hometown. But actually really excited me about public health because I started connecting the dots between all the patients I was seeing and then realizing I knew a lot more about them just knowing the communities where they were from knowing some of their extended family members, the address that they lived in, that kind of thing. Those social determinants of health that we now know so well about, but we didn’t really recognize them as much in the nineties. So I commuted to Harvard to get my MPH. And then, I got the job as a state health officer in 96, which I held almost 15 years under governors, Angus King and John Baldacci. And that was a job that I felt like I was an imposter for a while because I had never led anything big. I’d taken a management course at Harvard, but yeah, I really didn’t know…

[00:06:45] Dr. Joanne Conroy: That was a big job.

[00:06:46] Dr. Dora Mills: It was a big job, but, again, I had great mentors. I had great people, gave advice, including an aunt of mine, who was a leader in her own field of library science. And she said, you’ve got so much common sense. And so much of leadership and managing is really using your intellect, your common sense, your intuition. Don’t sell yourself short, just cuz you don’t have an MBA or something. So that was also, I think some of the best advice I got was from my aunt Enger, who’s no longer alive, but you know, she, she gave me also that confidence to say, okay, I, I have a lot of life experiences that are worth something. Even if I haven’t led something yet.

[00:07:25] Dr. Joanne Conroy: Talk about the hardest thing you had to do as head of the main health depart.

[00:07:32] Dr. Dora Mills: Definitely, I would say some of the hardest parts of leading are making those really tough decisions and including firing people who, letting people go terminating people who just did not belong on the bus, as we say. They just Had done something wrong. It’s a terrible feeling to let somebody go, cuz you know, that it’s impacting not only their own lives, but their entire families. That was pretty tough. But those are the decisions that people look up to you to do if you are a leader. It’s wonderful to be collaborative and to to be the bear of good news and to Forge ahead into new areas that are innovative and be successful. But sometimes those hard times are really when you have to make a really tough decision that you know, that it’s impacting people’s lives in a negative way, but also in the long term positive because they don’t belong on the bus. And you’ve got other people who are on the bus are on your team with you, who need to have people who are behaving in a better way around them.

[00:08:31] Dr. Joanne Conroy: Now you accomplish a lot as head of healthcare in the state of Maine. What is your kind of signature accomplishment?

[00:08:38] Dr. Dora Mills: Oh,

[00:08:39] Dr. Joanne Conroy: Do you think when you look back at everything you did over 15 years, you did it.

[00:08:42] Dr. Dora Mills: I see, Several things I’m gonna, I’m a systems person. So I think one of the things very proud of is that I worked with a team of literally thousands to build a statewide public health infrastructure in Maine. We were one of the few states didn’t have one. That was something that I think has had a long lasting effect. I cut my teeth on tobacco in the first few years where in the early mid nineties, and we got rid of smoking in restaurants and bars and all workplaces. And we were one of the first days to do that. And and then of course the H1N1 one pandemic, which was just a precursor to a much bigger pandemic. That we’ve experienced the last two and a half years, but H1N1 pandemic, I led our efforts there in Maine through that. And I, and we were quite successful. We had the the highest vaccination rates in the country and we had, we were the only state that did not have a child who died of it, even though H1N1 was really a pediatric influenza pandemic. But when we got the vaccine, we went immediately into the schools and vaccinated, and we were the first state to do that. We vaccinated in every single school system in the state, and we rolled out all kinds of retired nurses and public health nurses, and many others to to get into the schools. And we did that quickly and early and as a result, I think we saved a lot of lives in illness. But again, all of it was a team sport. So I was just fortunate to, to help lead the team.

[00:09:58] Dr. Joanne Conroy: Now as you kind of launched into the pandemic, and I know you’re at Maine Health and you’re at the head of improvement for Maine Health, a lot of that infrastructure was still in place. And but what kind of concerns did you have as you were kind of on the front line of the most recent pandemic?

[00:10:17] Dr. Dora Mills: Some of our public health infrastructure had deteriorated in the last few weeks. So that was a concern. But , I always said even when I was at Maine CDC directing it I always said, Maine’s community based public health infrastructure is really a major part of it are there are statewide network of nonprofit community hospitals. So I’ve been fortunate enough to be at Maine health, which has 12 hospitals including all nonprofit hospitals around the mostly the Southern three quarters of the state. We partnered with a number of people and we actually have one of the highest vaccination rates in the country, along with Vermont. And I think new Hampshire’s pretty close behind us too. But again, it was about partnership. The hospitals, we all worked together with the state. But we also had interesting partnerships, including for instance, with our major employers in this state. So LLBean for instance Unim, some other major employers gave us employees for several months. We had employees who directly reported to us every day. They were on loan to us for several months at a time to help us with the vaccine clinic. Yeah, so we had a workforce that we, tripled overnight just by having these partnerships with our major employers. Because it was hard to, train volunteers who were gonna come in for a day a week. We said, we really need people who are gonna be here for four or five months. So our large employer stepped up and gave us employees and their business was down a bit, retail business. So they were able to do that for us. When the vaccine Demand dropped off a bit, and that was about May and June of last year, we started partnering with a number of other businesses. I contacted somebody who’s very involved with our breweries. Maine is known as big brewery state and she thought, oh my goodness, that’s a great idea. Can we partner with you? When I reached out to her, so we did about 50 vaccine clinics last spring and summer in in breweries across the state. And they usually gave out free beer and sometimes meals for people to come in, young people to come in and get vaccinated. And we also partnered with a number of restaurants diners who also provided free muffins and coffee for instance, or free meal if people came in and got vaccinated. And we went on a site with large employers as well and small employers for that matter, too. So it was really about partnership and helping to figure out those connections, connecting the dots that aren’t always obvious. It was kind of figuring out for instance where are the young people? Where are they hanging out? Where can we go and get them in deliver vaccines to where they’re at? Or who’s got a lot of people we might be able to use to help staff the vaccine clinics. So that was kinda connecting those dots and thinking creatively and developing those relationships.

[00:12:41] Dr. Joanne Conroy: I think Maine and certainly Maine Health has been a standout in appreciating that no one organization, no matter how well financed can actually achieve kind of a societal shift alone, you actually have to work with your communities. I do remember when Maine health focused on childhood obesity. And worked with the communities and actually decreased the BMI average BMI for, I think it was grammar school students significantly across a Portland area. And that’s a great example of doing it through partnership.

[00:13:18] Dr. Dora Mills: Exactly. No, that’s a, that is a great example. And that, that occurred before my coming here. So I can’t take any credit for it at all, but we’ve got some great physician leaders and other leaders, Tory Rogers, and others who’ve led that effort for a number of years. And I’m very proud to help oversee it now. But yeah, we say Maine’s not really a state is one big small town. And I think part of the lesson there is just that we do get things done through our relationships with each other. And that’s true anywhere, but I think just, recognizing that and getting involved early in your career and anywhere along your career for that matter with your community and, getting to know if you’re in medicine, getting to know the editors of your local newspapers or getting to know the large employers in your area, their leadership and others. Sometimes , you sit down for coffee and you realize, wow, you have a lot more in common than you thought. And then if crisis hits, you can pick up the phone and it’s a lot easier to, to forge ahead together.

[00:14:09] Dr. Joanne Conroy: Yeah. Now I know that innovation was in your portfolio at the university of new England, and I have to believe that being head of improvement. At Maine health is probably in your portfolio as well. Talk about the role of innovation at Maine health or healthcare at large, however you wanna kind of address it.

[00:14:31] Dr. Dora Mills: It starts, as I mentioned, I think a lot with developing relationships because sometimes I feel like I’m not the most innovative thinker, but if I develop relationships with people who are in different fields than I am in, or develop relationships with people who are thinking differently. I learned from them and maybe I teach them something as well and together we can exchange ideas and really forge ahead in a much different way, a more innovative way. But also I find sometimes just talking to young people, they think differently. I mean, I learned so much now from my two young adult kids, who were in their early twenties. They’re both in college. They think so differently than I do in many ways about the world. And so sometimes I’ll just toss an idea their way and they’ll come up with things I never would’ve thought of. So sometimes being innovative, you don’t have to necessarily have it in your DNA if you feel like you’re not the most creative person. But you can become more innovative simply by developing relationships and listening to people and asking questions of people and particularly people who aren’t necessarily the people who look and sound like you do and do the same things that you do.

[00:15:35] Dr. Joanne Conroy: Yeah. That’s a good point. It’s about not being so rigid about what the one way to do something is understanding there many ways to do things. I was actually talking to a friend who’s bringing an 18 year old daughter to college and the way young people connect and get things done using social media and using technology is. Is fascinating. And I wonder a little bit about how we can translate some of that to healthcare, because I don’t think, we both live in states that have some of the oldest demographics in the United States. I don’t think we’re gonna have enough people. To provide care the way that we currently are providing care and we have to replace what will be vacancies with technology. How are you guys thinking about that at Maine Health?

[00:16:28] Dr. Dora Mills: Oh, we are thinking about it all the time, as I’m sure you’re doing at Dartmouth health as well. There are so many new tools and I think it’s a balance. So part of it is, Looking at all these wilded new tools that can do things that we never dreamt of a few years ago, but also balancing that with, okay, are they really gonna replace people? Or what people could do and you and I have been around long enough to know that there have been technologies that had held great promise that then fell flat. So I think it’s a both ends, we have to be look at everything with a great deal of enthusiasm and openness, but also some caution too. Cause there was plenty of cautionary tales along the path of technology in the last few years. But we are looking at things like, how can we do so much more home monitoring and not just monitoring pulse and, blood pressures and things like that, but really empowering people to look at constant monitoring. I mean, we know these watches, I’ve got this, one of these, what is an apple watch, but I understand now you can get an EKG on one of these. So there’s a lot more. In fact, I think Steve jobs, when he was asked with the what was gonna be long, long lasting legacy of the iPhone, and he said it was going to be health. So I think we’re starting to be in that. I’m not trying to promote Apple products, but I think that it’s a But I think we’re in that realm where actually they’re starting to come become true and that there are a lot we can list. There’s a lot we can learn from our partners in technology. So we are very much trying to figure out how can we better monitor people, patients at home, where they prefer to be and where they’re safest, frankly, most of the time. And how can we do that better using technologies. So yeah, we are, in fact, we just got a $4 million grant from HERSA from maternal child health around the state. And part of it is to connect the state obstetric providers and patients through telehealth. So the first year we know is gonna be taught traditional telehealth, but then the years two through four, we’re looking at really some innovative ways so that pregnant women who are in rural Maine, can be more connected to providers who can monitor their health. So it’s not just older people, but also sometimes younger people too, who need that connection.

[00:18:36] Dr. Joanne Conroy: That’s really important. We’ve been concerned about, we call them maternity deserts here, where people actually have to drive almost two hours to deliver a baby because rural critical access hospitals have closed their obstetrics units often because of volume issues. And it becomes more difficult to maintain the quality, but that means for that woman who’s in labor. In like where my family’s from, Piscataquis county. If she’s up north in Piscataquis county, she’s got quite a drive to actually find a place that will deliver her baby.

[00:19:11] Dr. Dora Mills: And as we think about the delivery time period, but actually the months leading up to that, where you have to go in every month and sometimes especially a high risk pregnancy every week and drive that two hours every week. That’s a lot, but a lot of those things that we monitor women with high risk pregnancies, we can do some of that monitoring remotely. So we’re excited about, working on some of those tools and implementing them in Maine.

[00:19:35] Dr. Joanne Conroy: So let’s talk about your Family. It sounds like you have incredible women leaders in your family though, with your aunt, the master science librarian. So you have the enviable maybe sometimes unenviable position of being a sister to the current governor of Maine. That is like going from being in the spotlight as the Chief Health Officer in Maine to being in the total fishbowl because of your relationship with your sister, but you were watching how difficult the job of any public leader is. What advice would you give to young women? And I think there are a lot of them who may be considering public office because they really wanna make a difference?

[00:20:23] Dr. Dora Mills: Oh, yeah. I mean, it’s I’m a big believer in public service. I mean, my grandparents were all in public service and. And my parents too to one degree or another, my mother was high school English teacher for many years. And so a form of public service in many ways. So it’s been in our DNA to at least give back to our communities in one way or another. And so I, with my sister, she had been she was attorney general for Maine for a number of years and and had been district attorney. She was the first woman I think he’s in the Mississippi or something was district attorney. And the first US attorney in Maine. So I watched her for many years and really admired her to line and we’re very close sisters as well. But she, it was shortly after the 2016 presidential election. When she shared with me that she thought she might run for governor in 2018. And at first I thought, oh my goodness, did you not just see the headlines that this very, you know, qualified woman, and I’m not trying to get too political on this, but very qualified woman lost the presidential election and made us all wonder if the country was ready to elect a woman. And and Hillary Clinton had not done so well in parts of Maine. So I thought gee is is Janet reading the same TVs I’m reading? But I didn’t wanna be discouraging cuz I just thought, wow, this is quite a brave thing to talk about. I was still kind of reeling from the election and then she’s talking about running for governor in two years. But she had the fire in her belly, and she knew what she was doing. And she had a, I think there were seven or so candidates in the primary in 2018. And she got through that. And then, there were four in the general election and she won that. And it’s hard for me to talk about that tearing up. I couldn’t have been more proud of her. I think when I observing her and advice for other women thinking and running for office, I mean, do think about it. If you thought about it, keep thinking about it and act on it. I’d also the same advice I gave earlier, which is to reach out to people for advice, women who’ve run for elected office. And seek their advice. There are programs also for women candidates to help train them on how to run. There are certain things that we know help work for women candidates. We are in a position where in this day and age, it’s still, there are some tough things we have to go through. People generally like a very tough man leader, but they don’t want women to be too tough or too soft. I’m not an expert on this part of it, cause I haven’t run for office but I do know from hearing I know a number of women who run for office, not just my sister, but they always talk about that kind of the balance of coming off as personable but also knowledgeable showing what you know but also confident, but not too confident, firm, but not too firm. And so it is a balance that we have to strike and there are different programs that help women learn how to run for office and strike those balances. Then be who you are. I know that the time that makes me most proud of Janet it was when, I drove her a lot in 2018 on the campaign trail. She now has a state trooper with her all the time that drives her. But 2018, I wasn’t working Maine health yet. And I was able to take a lot of time off and drive her around and what I saw. In the fall around after labor day in September. I mean, she’d had all kinds of advice. Everybody wants to give you advice when you’re running for office. So I am telling you seek advice, soak in that advice, but filter it too and make sure that you find your own voice. And I know about after labor day when I was driving around and I heard her speak day after day, I could sense she was really finding her voice. I mean, she’d been having everybody coming up to her and throwing advice at her. And she was absorbing it. You could tell, but then there’s sometime around after labor day, I think she thought, okay I am running for office. I have beliefs. I have a plan. I need to start really communicating me and my own voice. And that was, it was a subtle change, but it was also palpable. And to see her on the campaign trail in September and October of 2018 it just makes me so proud. I mean, she really found her voice and people could sense it ,

[00:24:12] Dr. Joanne Conroy: She’s very

[00:24:13] Dr. Dora Mills: She was very authentic and that term gets overused, but I could tell, she just had found that fire in her belly and was out there. So yes, the advice is helpful but in the end you have to find that gem inside of you, that’s your own voice, your own heart. And to communicate that.

[00:24:30] Dr. Joanne Conroy: I just love it because she actually answers the questions. Sometimes you listen to politicians and you’re like, did they really answer a question? Or did they just Dodge it completely? And. Of the fact that she answers questions and I love the ads that she has

[00:24:47] Dr. Dora Mills: thank you.

[00:24:47] Dr. Joanne Conroy: actually highlight her four daughters.

[00:24:50] Dr. Dora Mills: Yeah. Yeah. There’re five, five steps. She married the winner with five kids, five daughters. One of them has been pretty ill, so she’s not able to be in the ad, but there are five stepdaughters. She helped to raise. And people oftentimes don’t realize that about her. Yeah, so she’s and she said that. Helped her maybe run. They were age six to about 17 when she married, her husband has now passed away. So she said raising five daughters through adolescence and pre-teen years probably had something to do with her being equipped to, to run state government during some of the most chaotic and worse times in the last hundred years or so.

[00:25:29] Dr. Joanne Conroy: It was great training. So I bet when you get together for your family reunions, it’s amazing. You sound like you have an incredible number of women leaders in your family. And are in really tremendous role models for a lot of women across the state of Maine and in new England. We do have a few questions that we like to ask all of our speakers. The first is, do you think you’re an accidental or an intentional leader?

[00:25:55] Dr. Dora Mills: Oh, my goodness. That’s a great question. I, it is gotta be both. I mean, I really, I, there was a lot. A lot of coincidences and in some ways I don’t really believe in coincidences, but there were certainly a lot of coincidences, including Dr. Moultons, the head of the biology department back in 1980 ish or so who tapped me on the shoulder and said you should be considering medical school. So I think there are a number of coincidences like that, that I was just so fortunate to fall into. But I also think that there were also intentions along the way, too, in that, I had been quietly thinking about medicine. I didn’t dare to mention it, and I had taken some science classes, so there was a combination, even in that one story of both incidents and coincidence, I mean, coincidence and intention. So if I hadn’t taken some science classes, he wouldn’t have known me.

[00:26:43] Dr. Joanne Conroy: Yeah. Yeah. Yeah. And it also I think assuming a path for leadership actually takes a little bit of grit too, because it’s not always easy. And you’re right. Not only does your sister have to in politics walk a fine line, but I think women in leadership often have to figure out what that fine line is for them as well. And finally, what do you think is a personal characteristic that has made you successful?

[00:27:10] Dr. Dora Mills: Oh I think I’ve always when I was growing up, I had I’ve been told my friends of mine I grew up with. I grew up in Western Maine and went to the same school system, nursery school through 12th grade. So the people I grew up with, know me. And they’ve often said, you were always, not necessarily all that outgoing as a kid, I wasn’t so much, I was kinda shy. But they said, you’re always friendly with everybody. You always made friends with everybody. And I think that growing up in a, it made a pretty diverse community. It wasn’t diverse racially and ethically so much, but we had a lot of kids from different socioeconomic backgrounds and the like in rural Maine. Were all one small town and I think I was good friends with a number of different types of kids. I wasn’t really a click kind of person. And I think that’s continued. And I think that I didn’t view it as anything unusual, but they will say to me, now we go to reunions. You just kind of knew everybody, you were friends with everybody. And I think that’s helped me. I think that I’ve been able to just, as I said, talk to somebody, as I said earlier, talk to somebody at LLBeans or somebody who was an electrician or a plumber or farmer and connect with them and listen and learn from them because we all have stories. That we can all learn from. And so I think that’s something that I think in recent years, I just went to a class for you in this class above me in high school. And they were telling me that, oh, I guess that’s kinda come in handy. I hadn’t really thought of it as a skill, but I think that’s that, that kind of making friends with everybody been skill that, but I’ve also known, when you can’t do that to some people too, so not too naive as well.

[00:28:43] Dr. Joanne Conroy: You know what, it’s probably a perfect example that diversity and yours was kind of a diversity of experiences of friends of thoughts, actually helps you make better decisions. And it’s, too many of us like to live in our little narrow echo chamber. And that is actually quite dangerous. When you’re living in a world like we’re living in now and you just have to be open to every single different way of thinking so well. My family is from rural Maine and I yay. I love. I love Maine

[00:29:18] Dr. Dora Mills: oh,

[00:29:18] Dr. Joanne Conroy: It is one of the most beautiful places on the earth, I think. And it’s just been a pleasure to talk to you. You’re really a prince and princess of Maine. You belong into that very rarefied club and you’ve just made a huge impact on many more people than you appreciate. So thank you Dora for spending the time with us.

[00:29:39] Dr. Dora Mills: Thank you so much. It’s been a real honor to be here as part of your podcast. So thank you. And for everything you do your leadership for many years, not just in New Hampshire and other states as well has great appreciated. And I’m so glad you think of yourself as a daughter of Maine.

[00:29:54] Dr. Joanne Conroy: Yeah. Yeah.