September 21, 2022
[00:01:00] Gary Bisbee, P.h.D.: Good afternoon, Joanne and welcome.
[00:01:03] Joanne Conroy, M.D.: Thanks, Gary. It’s great to be here.
[00:01:04] Dr. Gary Bisbee: We’re pleased to have you at this microphone. And first thing I’d like to say congratulations on being chair elect of the American Hospital Association. Very cool.
[00:01:14] Dr. Joanne Conroy: Thank you. It’s really an honor to serve an organization that does so much for American healthcare and through my three years that I’ve been serving thus far, you really appreciate the complexity of the issues that they’re dealing with and how effective they’re.
[00:01:31] Dr. Gary Bisbee: What are the several key issues that the American Hospital Association is dealing with now?
[00:01:37] Dr. Joanne Conroy: We have had significant decreases in the number of nurses actually practicing in the workforce. And considering that we have an aging population across the us we need more nurses rather than fewer everything we wanna do requires people. And they’re just not enough people. And I live in a state where the unemployment rate is the lowest in the country. And we’ve just gotta be super creative now about how do we create a pipeline for our workforce? How do we retain them? And then if you can’t find people to do those jobs, how do you replace those jobs with technology?
[00:02:17] Dr. Gary Bisbee: Big job, for sure. And a longstanding job. I think it’s fair to say. Will you be promoting any personal issues during the time that your chair over and above what you’ll be doing for the AHA?
[00:02:31] Dr. Joanne Conroy: You know, Gary, that one of my personal passions is women in leadership and making sure that we advance women in healthcare leadership, considering the number of women that are in healthcare right now, it’s a little embarrassing that we don’t have enough in our pipeline in the upper ranks of leadership in hospitals and health systems across the country. But I’m also really interested in diversity and equity and social justice. And I think these are things that resonate with the AHA and the board, and they even have changed their mission statement to actually acknowledge the importance of justice in terms of health equity, but in terms of how we treat each.
[00:03:14] Dr. Gary Bisbee: Dartmouth health is the most rural of the medical centers. What specific issues for those that may not be aware? What specific issues does Dartmouth health need to address because it’s in a rural area?
[00:03:27] Dr. Joanne Conroy: So people who live in rural communities actually have poor health outcomes. Believe it or not, they have less access to care but a lot of that is because of transportation. We don’t have great transportation networks in rural America. The distances that they have to travel sometimes the geographies that they have to travel through. I would say at the same time the issues around broadband and internet and all the things you wanna deploy in order to deliver care in people’s homes, become a big struggle. Especially our home health teams often have to drive down a gravel road for four to six miles and they come upon a dwelling that they’re trying to care for. Somebody in that dwelling who may have iffy electricity and no internet and very little in terms of public services out in these incorporated rural areas of our community. It just creates those challenges to deliver care.
[00:04:28] Dr. Gary Bisbee: The pandemic obviously took a toll on health systems. You made reference earlier to the caregivers financially as well. What have you found that by way of new initiatives that you’re taking because of COVID.
[00:04:45] Dr. Joanne Conroy: So there are two great things about COVID. Number one, we realized that we could do telehealth. As I’ve said before, one small strand of RNA has actually done more for the telehealth industry than billions of dollars of venture capital. Until we had to do it, people were reluctant to change, but once they knew that they had to change, they changed. And the second thing is remote work. We are full in, on remote work. We look through all of our job descriptions and here at the academic medical center over a third of the people that work on this campus are working remotely, permanently remotely. That means we employ people in over 35 states across the country. And what it does for us though, is allow us to recruit nationally. So we can recruit you from any state in the country. And you can work from your home. That gives us huge kind of recruiting advantage versus having people have to come here to the upper valley because spouses have other jobs that may not be as movable. And it really allows us to access all that talent. And for two years running, we have determined that those people that are working remotely are our most engaged employees. They have just enough autonomy. They have enough responsibility and connection that they feel part of the team, but there is something about their ability to do their job in their own home that they appreciate. And it comes out on your engagement surveys.
[00:06:19] Dr. Gary Bisbee: well, Let’s turn to women’s leadership. You’ve been active in that for a number of years. You co-founded women of impact. Why did you do that, Joanne? And how has that worked out over the, I think last 10 years or so?
[00:06:34] Dr. Joanne Conroy: You know, I first was drawn into kind of gender equity in the workplace, believe it or not, in 1994, when I was at the medical university of South Carolina. And on their strategic plan they took six leaders and assigned them different aspects of this strategic plan. And what a surprise, what did they give me? Diversity? I said fine. And I went and got all the salary data over a period of five years and did a rank adjusted year of service adjusted analysis by gender and by race of everybody’s compensation across the university. And then I presented the report as part of our strategic plan. I don’t think they really expected it. And they were a little shocked by it. I have to say there were some women that were more than 20% outside the rank adjusted year adjusted average compensation. And they make good on that. They paid those women. Not only they increase their compensation, but they gave them some back pay. And I realized I did that all by hand. And I realized that’s something that we should be doing all the time. Not Five to 10 years when you have a strategic plan. So since then I’ve been pretty focused on at least gender equity around compensation and around access to opportunities that create leadership. So women of impact, I went to a leadership development session. I was like, Ugh, I don’t really know if I wanna go. And I went and I’m so glad I did. It was I was the only woman in healthcare there. There were women from Microsoft, Shell. And it was fascinating. They let us through this process, not giving us skills or just doing networking, but. Basically saying you’re at a point where you have incredible influence, what are you doing with it? What are you doing with it to actually make a difference in the world? That’s a very different construct than most leadership development programs. Like it throws it right back on you. And after I went through that, I said, you know, there’s a lot broken in healthcare that needs to be fixed and I can’t do it alone. And so I said well, I’m gonna grab a group of women and we’re gonna figure out what we can do about it. And I wrote a grant to the Robert Wood Johnson Foundation and they gave me like $95,000 and I convened the first group called Women of Impact. And I think we’re up to eight cohorts now. It’s invitation only. We don’t necessarily wanna be really big, but we wanna, number one, identify own personal impacts. And everybody has this kind of personal goal when they finish a two day session and everybody goes through a two day session when they come into the organization, but we also wanna do things together. So we’ve helped establish Carol Emmett Foundation, which actually has a leadership development program for women. We helped sponsor The Equity Collaborative, which is where HR and leaders from across the country look at our hiring practices and we send our data to McKinsey. That actually compares it with organizations that are not involved in the collaborative and does the collaborative actually make organizations move faster along that equity timeline. And it’s just frankly, it’s so energizing to be around women that are actually committed to a lot of the same things. And out of it I’ve got Karen Feinstein talking about creating a national patient safety board, like the NTSB. You have people that are actually championing diversity and equity causes within their own organizations and then taking them nationally. And a number of our members actually are serving in the current administration. It’s great. They are actually getting to the point where they are decision makers nationally. It’s just creating that pipeline. So number one, these women know each other and number two, they figure out how can we leverage each other’s strengths? And they’ve done that very effectively.
[00:10:50] Dr. Gary Bisbee: Well done on that. We’ve made pretty good progress in medical school admissions. Think it’s 50% women, 50% men. But as you mentioned earlier if you look at, for example, chief medical officers in the largest health systems, it’s not good. It’s substantially less than 20%. If you look at CEOs, your peers the last numbers I saw were around 20%. What can we do to try to move this along, Joanne?
[00:11:19] Dr. Joanne Conroy: There are a couple things. Number one It’s gonna take us a hundred years. If we go at the pace for moving right now. So we need to accelerate it. I think people understand that they’ve gotta invest in creating a pipeline for women leaders. People are very focused on having diverse pools with any leadership position. It’s not about merit. There are lots of people out there that are incredibly talented, but you have to work harder to find them and get them in your pools. And we also understand, for example, if you have a finalist pool and you only have one woman in the candidate pool, she runs a much lower chance of actually being offered the job than if you have two women. So they’re all of these behavioral dynamics that we’re beginning to understand about search committees, et cetera. I would say a lot of the leaders who are men appreciate the role of sponsorship. Like they need to sponsor women. They need to bring their names forward and say, we need to look at this really talented woman. Who may not really be in their unit or section and they need to sponsor them. We can’t do this without them. And we have an increasing number of men that actually appreciate the value of that. I would say, it’s also creating opportunities and also the awareness of a lot of young leaders about the risks and responsibilities of moving into leadership roles. And I tell every woman that asks about leadership trajectory, I say there are two things. I say, you need to have a appetite for personal and professional risk because you will be in a position where they may say, thank you for your service. Here’s your severance. And it feels crappy, but that comes with the job when, especially in healthcare, when you know, reorganizing a health system or a regional unit is not uncommon. I would say that second thing is that they have to be willing to move. And unfortunately, when you get two professional families that becomes a little bit more difficult. But that’s where the conversation begins within their family unit about whose career comes first at what time. And I know a number of couples that figure out how to balance that. It’s hard, but that’s one of the important transparent conversations that professional couples have to have early on.
[00:13:51] Dr. Gary Bisbee: Yeah, that’s pretty interesting. You’re talking about men personally, in terms of the family being supportive of a woman having to pay the price, so to speak, of becoming a leader, whether it’s moving or more time in a job or whatever. But in terms of the workplace or professional workplace, you talked about sponsoring men can sponsor. Seems to me there’s also a recruiting aspect of that where men can actually approach women and recruit them into leadership positions and then support the development. Are there other obvious things that men could be doing to be supportive here?
[00:14:28] Dr. Joanne Conroy: Yeah, it’s the equity of opportunity you’re talking about. And that’s something that we, at our institutions, we have to be very reflective. Do we have equity of opportunity? And that means looking at people that get scholarships for advanced training outside the institution, how are they selected? What’s the selection criteria? Making sure you have nurses that are representative. You have men and women. You have diverse candidates represented. You have to do that very intentionally in order to build your pipeline. I would say part of it is really developing the right leadership programs to identify people internally and externally. Also creating the opportunities for them to demonstrate their leadership in your organization. It doesn’t matter how much training you give somebody, they’ve gotta be able to apply it. So you need to be intentional about that within your institution. I get it that we have an affinity for people that are like us, but I know that my best leadership teams are teams that have all different backgrounds. Actually I’m in a minority, like I’m an extrovert. And most of my team is an introvert. They process very differently. And if I had a team just filled with people like me, I’m sure we would make a lot of really bad decisions. So so, diverse teams actually make better decisions. We know that we’ve known that for 15 years and this is a pathway to creating those diverse teams that can really steer a health system as an organiz.
[00:16:01] Dr. Gary Bisbee: Joanne. This has been a terrific interview. We really appreciate your time. I’d like to ask one last question if I could, and you’ve actually addressed this a bit, but let me ask it directly, which is, what advice would you have for young women who are thinking about leadership, not sure whether they want to actually go in that direction. What kind of advice do you have for them?
[00:16:25] Dr. Joanne Conroy: So number one, I do focus on personal and professional risk. I do focus on whether or not they’re willing to move. And then if they’re not saying, oh, I can’t be a leader. You just have to have a different set of tactics in order to be a leader within that organization. I also counsel women, if they can’t move to try to think about leading outside of their organization, let’s not ignore all the other important leadership opportunities that are in your community that are actually really great experiences for women to participate in. And I say, don’t think narrowly think really broadly about leadership opportunities. I would say that the most important thing I tell them though, is that they need to do things with, and for a purpose. They need to think about the roles and responsibilities that they take on and what impact do they wanna have in that role in the organization. Be purposeful about it. Achieve your goal. And don’t be shy about telling people about it. And make sure there is nothing wrong about tooting your own horn when you’ve done a good job. In fact, my first husband used to tell me, don’t break your arm patting yourself on the back but I learned to do that very quickly. Sometimes people are not running around, patting you on the back. You have to do a good job because you know that you wanna do that job. You do it well. And then you congratulate yourself for doing it. And you can tell everybody you want to, but you actually have to be centered around the reasons why you’re doing it. And don’t look to other people for approval or accolades. You should be able to give it to.
[00:18:12] Dr. Gary Bisbee: I’m gonna give you a great big pat on a back, Joanne. You’re just terrific and you have been throughout your career. Congratulations again on your post at the American Hospital Association. And please call enough if we can be at all helpful during your time there. Thank you again for being with us.
[00:18:29] Dr. Joanne Conroy: Well, thank you, Gary. It’s always a pleasure.