HeartBeats Episode 9: Women in Leadership

Host

Welcome. I'm Cathy Murtagh-Schaffer. And I'm your host for this episode of heartbeats. This podcast is brought to you by Shipley Cardiothoracic Center, an educational series dedicated to providing our patients and the community with information and education about our cardiothoracic surgery program, Lee Health, and matters affecting your health. Today, I have the great honor and pleasure of talking with Kristine Fay, Chief Officer for Population Health and Physician Services, to talk to us today about women in leadership. Thank you so much for joining us, Kris, I've been looking forward to this discussion. Perhaps we can begin, if I ask you to talk a little bit about your new title over behavioral health and what your new responsibilities are. Can you kind of give us a little bit about your background and the trajectory of your career?

Kris Fay

Sure. So my career in healthcare actually started when I was 16 years old and I got a job after high school in an outpatient dialysis unit and I was the ward clerk. So I was responsible for filing and answering phones and typing, and I loved it. I loved the physicians, I love the patients, I love the nurses, I love the energy and I knew I wanted to do something in healthcare. So I was very fortunate that relatively early on, I knew exactly what I wanted to do, not exactly what role I wanted to play, but that I knew I wanted to be in healthcare. And so went on to college thought I would be a physician, but I'm not good at science. Love the art of medicine, perhaps not the science and so decided to get an MHA. So I have a Master's in Health Administration, worked for years in New Hampshire, where I was born and raised. And then more recently I've worked at Providence Health Systems in Spokane, Washington, Bon Secour Health System in Richmond, Virginia. And then I was recruited here almost nine years ago to Lee Health as their Chief Administrative Officer at the time. So when I was first hired, I was responsible for Lee Physician Group, which was approximately 250 providers, It's now over 765. So tremendous growth in the last few years. And I was delighted to be here, love living in paradise, loved the system, the not-for-profit nature, the safety net mission, and focus on our patients, the ability to treat all. And I think we have very talented physicians and staff and leaders. So I've really enjoyed my time here. More recently, I was promoted to Chief Officer of Population Health and Physician Services. So in addition to LPG, which I still continue to oversee, my dyad partner, Dr. Prasad and myself oversee the population health department, which is really comprised of three business lines, which is a Medicaid managed product that we own Lee health owns, best care collaborative, which is our next gen ACO, which is a CMS Medicare program, and then we also have Innovatives, which is our clinically integrated network. So it's been great because I've had more exposure to physicians, independent, employed in different models where we can really drive improvement in care, through the reimbursement mechanism, which is, which is helpful. I've also been very involved in behavioral health, which I love. You and I worked closely on that Substance Use Disorder Council have to put a plug in for that, also Heart and Vascular Institute working with that service line oncology, neurosciences and case management system-wide. So how do we organize our case managers to be sure that we're getting patients to the right place and safely.

Host

And as I spoke with, uh, Dr. Kole, a couple of weeks ago, we know that case management, nurse navigation are critical components to a lot of these programs.

Kris Fay

Absolutely.

Host

In your position, I'm sure you've been presented with challenges of navigating between exceptional geniuses and sometimes maddening personalities, but you seem to do it with tremendous grace and diplomacy. Is that quality of grace under fire, something you learned or is it a personality trait?

Kris Fay

So it's probably a combination. Frankly, I enjoy what I do and who I work with and I enjoy the tension and the conversations and sometimes conflict that can result, because I think through working and listening to individuals who are struggling you can get to a better spot. So I really take it as a challenge if I'm in a difficult situation really trying to understand what is this person trying to tell me, what is the real underlying issue and how can we move forward together? I have found in my decades long experience, there is virtually nothing you can't solve, right? You just have to be open to the thinking and to the listening piece. So because I enjoy what I do so much and I respect the physicians and the leaders and the staff I work with so much, I have found that it's actually can be can move us all to a better place when you tackle those issues. And I also think age has a lot to do with kind of mellowing out, I could tell you, I probably couldn't say this 20 years ago, right? So I think age as well is helpful, right? That wisdom that comes with age

Host

In your position. I imagine you have to navigate through a quagmire of complexities daily. How do you keep everything straight? Do you have a special way of dealing with issues that creep up unexpectedly?

Kris Fay

I wish I had a magic answer for that. The way I manage my kind of day to day work is, I have a wonderful assistant, Sue Murray, who I do whatever she tells me, because she's so terrific, and she really keeps me moving. I have a book, I don't go anywhere without my book because I don't have the memory I used to. So I really, I'm not shy about everything is written down and crossed off. I get great pleasure from being able to cross off the to-do list. I've realized over time that whatever you intend to do that day, if you can get maybe a quarter or half of it done, you should be delighted. And so I don't have set expectations. I would say that I've just would leave at the end of the day, feeling like I didn't accomplish what I needed to, and, you know. Dr. Scott Nygaard always says this, sometimes the dialogue is the work, right? And so as you move into senior leadership, a lot of what you're doing is strategy, talking with individuals, listening, kind of organizing the next initiative. And so it's less doing checking the box and more engagement and discussion and presence, which I enjoy.

Host

Yeah. That's a excellent thought. I hadn't thought about senior leadership in that way, but you're right. Without being able to engage in and listen, you probably are going to miss a lot of opportunities.

Kris Fay

Yeah, exactly.

Host

I know when I talked to you about doing this interview, you suggested that we talk about women in leadership, and I love that idea. I feel like there's so much opportunity in the world right now for women to share their voices and lead, hopefully to a much better place than we are in currently. What characteristics or personality traits do you think women need in order to pursue leadership positions and how do you suggest women prepare for leadership?

Kris Fay

Hmm. So that's a great question. Um, in part that's why we don't have as many female leaders at that C suite or senior leadership level, because we've not done a good job of really identifying leadership in women and supporting it. So I think the first thing is if someone's interested in leadership as a, as a woman, you have to have a passion for what you do, right. Something's got to drive you because it's a lot of work, frankly. And so you really have to love what you do. You also have to have courage, right? Because you may be in meetings and in locations where you could be the only they call it the only right, the only woman in the room with a bunch of, of men. And I found myself there many times, it's like anything else, you get more comfortable with it. Right. But ideally that would not be the case. Um, so you, you really have to have a passion. I think you have to have the courage to just go in there, take a deep breath and just say what you have to say and put it out on the table. And the other thing I would say is perseverance, right? You don't get to these positions overnight and you've just got to in your mind's eye, have your goal. And then really very methodically set out how you're going to get there. I will share that women many times, much more so than men think if they put their head down and do a good job, the work will speak for itself and good things will happen. i.e promotions and raises. And that is not always the case. Women are not typically as good self-advocates as men and you make your own luck. Right. And so, as being a woman leader, you've really got to understand that dynamic and not only do a good job and develop a following, right, but you've also got to make sure you are front and center when opportunities come up and ask, right. And ask for things, which again, women are not known for asking for things. So I think those are some, some trends it's that I would suggest are helpful for women in leadership and moving up in leadership.

Host

For our younger listeners, what type of schooling do you recommend if you want to pursue this type of leadership position?

Kris Fay

So, obviously based on your industry, you'll have to get the associate, you know, the associated degree and you'll probably need a graduate degree if you want to get to that senior leadership level in whatever you're trying to do minimally. Um, so certainly there's the formal education piece equally. Let me say equally as important is the leadership development, right? And you can do that through some schooling, you can do that through some networking and support groups. So we have a lean in circle here, and we do a lot of that education with the women who are part of that circle. So I think there's opportunity there reading books, finding, you know, an author or to of leadership that you like and read voraciously to get a different perspective. And then the other thing for me that has been helpful is observing, right? So I've worked for many people, many good, some not, and you learn, you just, you're very intentional about looking at them and saying, you know, I would do that or no, you know, I wouldn't handle it that way. And so that can be very powerful and a wonderful opportunity to learn and grow.

Host

Those are great suggestions, Kris, I think though, that we have to acknowledge that the forces that we continue to bump up against as we pursue these opportunities, for instance, women continue to earn 80 cents to every dollar a man makes. Gender stereotyping continues, the fact that the power differential in most companies swings towards male dominance, and of course the disparities are even worse if you're a woman of color. I can safely assume that you've somewhere in your career faced some of these realities. What has been your experience as a female sitting around the table with a predominance of male leaders, what skills been most influential in your success in navigating these issues?

Kris Fay

So again, this doesn't happen overnight, right? So there's years and decades worth of exposure and getting comfortable in different situations wrong and doing it wrong. Exactly. There's a lot to be learned, right? I'll give you an example of something that happened just recently in the last few years that I was like, really, you know, I've come this far and I didn't realize this. So I had a group of senior leaders to my home to do some strategic planning. And I was the only female at the table, and my husband came home early and we have a open concept house. So he was in the kitchen doing something. And later he said to me, Kris, do you know that those men kept interrupting you when you were speaking? And I said, they did? Didn't even notice it. And then he said, yes. And then you apologized. So I would be interrupted then I would say, Oh, I'm so sorry. Yeah. And I was like, women say, sorry too often. I remember nothing else women say, sorry too often. And so I had no idea and he said, you, you need to stop that because they're, just kind of minimizing your influence. Right. And so the very next day I had a meeting and it happened. And again, I had an awareness that I did not have before. So I think the key, one of the keys is you have to be self-aware and you have to take feedback when people are very fortunate to give it to you. And so that happened again, and instead of apologizing and stopping, I said, excuse me, and I kept talking and I had to do that probably two or three more times around the table, and all of a sudden it stopped. So it's just one of those things that it doesn't matter how long you've been in this business and how long you've been a leader. There's some, there's some things that you do that you're not aware of. So somebody you can trust to give you feedback, I think is helpful, but that's just a small example of what happens to women typically right. In a room full of men is that they, their voice is not heard. And so that's why it's so helpful to have multiple women in the room. Right. So it kind of evens out that dynamic, so that's one of the key things that I've learned, recently in my leadership career is make sure your voice is heard.

Host

Didn't we see a prime example of that demonstrated on a national level when Camila Harris said, I'm not done talking exact, but this exactly to your point exactly to your point. One of the things that I'm acutely aware of is that working with a predominantly masculine energy, it becomes really easy to assume that energy and lose the benefit of the feminine voice. How does one protect that valuable energy and stay true to the female voice?

Kris Fay

So i think the best advice, this was one of the tougher questions. I think the best advice I could offer is be true to yourself, really, you know, and I think the value that you bring in the uniqueness that you bring and the view that you share of the world is valuable. And by virtue of being a woman, right, it's a different perspective. So I think one of the keys really is to make sure that you're true to yourself, right? That you're genuine, and that you continue to work through some of the confidence issues that many women have, right. To really speak up and be heard. But I think the key is to not follow the crowd, right? You need to build good relationships. You need to build the respect of your colleagues. So when you do speak, they want to listen. But outside of that, it's just being who you are, right. It got you here, as far as it's gotten you. Right. So you're doing something right. And then how do you just stay true to that and true to your heart and stay focused on the work at hand, if we're all talking about patient care, then there is an issue we can't solve, right. If we're all galvanized on the topic. So I think that's important not getting distracted.

Speaker 1 (16:03):

And I think what I hear you saying is this notion of being confident about who you are, confident in your level of skills, and as you say, what you're bringing to the table, exactly. In health care, there appears to be this dichotomy that exists. Women make up 65 to 75% of the healthcare workforce. And they typically make 85% of healthcare, consumer decisions, but only 30% of senior leadership positions are female, and only 13% are CEOs of healthcare organizations. Yet, research strongly shows that companies with a higher percentage of female leaders deliver better returns to the shareholders. I'm curious to know what gaps in leadership do women feel that makes, that makes their leadership different. And why do you think that influences the bottom line?

Speaker 2 (16:59):

That's a great question. There's lots of literature that suggests that if you have a more diverse group of senior leaders from a gender ethnicity, racial perspective, you perform better up to 50% better financially. And in part there's some thinking that women see things differently, they tend to listen more, they tend to try and build consensus, right? So perhaps less of the command and control or direct leadership style amd more of a consensus building seeking to understand. And I think that that's very valuable. They are typically more likely to embrace employee friendly processes and benefits and more likely to champion gender and racial diversity. So I think by getting again, a diverse group of leaders, and I would argue, it's not just males and females, it's all of, all of the different ethnicities and racial diversity, you just get a better product because you have a better sampling of what the real world looks like. And you can bring that voice to the table, you know, especially in women, excuse me, in healthcare, where women are the majority of the worker environment, the caregivers, and they make virtually not virtually most healthcare decisions. There's a lot of data that suggests that the woman makes a lot of the healthcare decisions for the entire family. Correct. Um, it only makes good business sense, right? And so, um, I think that's what in the data consistently show that a more diverse group produces better results.

Speaker 1 (18:44):

Jerome Powell, the Federal Reserve Chairman said the pandemics economic fallout has disproportionately hurt women and suggested that improved childcare policies could help the economy. And I remember when my children were little, childcare was a bigger expense than a mortgage at some times, and certainly more volatile and its dependability, Lee Health has certainly done some good things in this area for working moms with a new childcare center going up at Gulf Coast. Do you feel this is an example of why having women in leadership positions is so critical to all working women? Is this one of those gaps that women in leadership are more sensitive to?

Speaker 2 (19:26):

So I would absolutely agree. Um, I think by having women at the senior leadership table, they can bring forward ideas that benefit, not all, not just women, but all employees. So an example of this and certainly the childcare centers is terrific and is going to be very well received. And that obviously is a major concern, right, for parents if they don't have good childcare. One of the other issues I think that has potential coming out of the COVID pandemic is workplace flexibility, right? It used to be three shifts a week or, you know, Monday through Friday eight to five. And I think we've learned that we can be more flexible and still produce great results, if not be more productive. Um, sometimes with folks working from home. So one of my goals is coming out of this pandemic, we create a model for folks who can at least have a little more flexibility than they've had in the past, which really speaks to women because women typically are the ones who know rearing the children and maintaining the home and so forth. So again, I think there's lots of potential there as well. So I think having a woman who has experienced these issues is definitely helpful at the table when companies are trying to think about what could we do right. To improve the work-life balance.

Host

What are some of the obstacles that you're going to encounter in this particular cohort and how do we address them? Exactly. I think your comment about flexibility is well taken in that. One of the things that I've been working a lot with is stress and burnout of our healthcare providers. And I think having that flexibility would relieve some stress, just for some of the reasons you've just stated. Yeah.

Kris Fay

And it will keep people in the workforce longer. Yes, absolute most people enjoy their work. And if given even greater flexibility to better balance their personal and professional life it's a win-win

Host

I'm wondering if with all this COVID, once it's over with that, we won't see some overhaul of some of our labor laws and rules that keep us confined in these types of situations that are really are workable anymore in the 21st century.

Kris Fay

Exactly. Now that people have had a taste for flexibility, it's going to be very difficult to go back to the old way of doing things. And it is

Host

Lee has a workforce of some 14,000 employees, I believe. How does Lee identify and develop potential leaders within the system? I know you mentioned something earlier in our discussion, what qualities strike you when you're working with someone that says leadership potential and what do you do when you find that someone?

Kris Fay

So, um, we do have a program within Lee Health and we've actually piloted a talent mobility program within Lee Physician Group, or we've identified at the manager director level high talent, high potential, and we've given them stretch assignments for instance, which has been really great. What do you mean by a stretch assignment? They participate in a committee that they ordinarily wouldn't have access to, they get more exposure there, they can speak at a meeting or they participate in a meeting or can listen in on a meeting that they wouldn't ordinarily attend. So it's a wonderful opportunity to get them used to, you know, kind of what that next level of leadership looks like and what they do and see if they like it, frankly. Right. So I think there's a couple of things. Um, when I see leadership potential, it's typically because somebody is technically proficient, right?

They're an expert at what they do. They know their job really well. That's just one piece of it. They have demonstrated that they can create a culture of teamwork. And so when you talk to their staff or to their physicians or whomever colleagues, you get the same story, they're the same person, right? Yeah. And they really, their success depends on the success of their team and they are vested in their team's success and have a personal interest in the folks who work with them. So I think that's really important. That's a, that's the only way you can drive results. Long-term right. It's to get right. Make owners of everyone. Right. So I think that's key and you know, what do you do when you find that person? So the first thing, and it sounds so simple, but it's so powerful is to tell them yeah.You know? Yeah. If there's a female leader listening, they'll remember when somebody took them aside right. Early on, probably in their career and said, listen, I see something and you you're good. You know, and you kind of walk through what those qualities look like and what do you want to do? Because you've got a lot of potential. So I think even sharing with them that you see it, offering to assist, right. If you're in a position to either mentors or sponsor is really important. But I think the key is to say to somebody, I see it in you.

Host

Yeah. I think that particularly for our younger folks who are still struggling to kind of find their place in the world, having somebody such as yourself say that to them, it could be absolutely the trick that turns them in to the direction they want to.

Kris Fay

You have to see it in yourself. And many times people don't, unless somebody tells them first puts up all those possibilities, right. Especially women, particularly with, especially women

Host

In article, after article, I've read. One of the ways that people develop into leadership positions is to have mentors and sponsors. Was there someone in your life that played that crucial role and what did you take away from that relationship?

Kris Fay

So I was very fortunate that once I got out of grad school, I worked for an organization and I worked for a female Vice President of Physician Services. And back then, there were even fewer, if you can imagine. So, um, she was terrific. She was strong. She had a lot of the qualities that we've talked about. Very good listener would tackle the tough issues, manage conflict very well. She was extraordinarily supportive of me and all of her other direct reports. And I had the opportunity to work with her for 12 years. So she left a lasting impression imprint on me and the way I think. So again, I was very fortunate, to have that, and I think everybody needs somebody, right? Yeah. Everyone needs someone in their corner. If they want to move into, you know, move up in leadership who is going to support you. Right? So whether it's your boss, whether it's a colleague, whether it's a spouse or a partner, everyone needs somebody who you can talk to and dream with and help you get to that next level. Right. The person behind you saying, of course you can do it. You should apply for that job, go for it. You know? Uh, so again, I think that's more unique to women that the feeling like you have to know 80% of the job before you apply for it, where most men, they say, well, no, 20% and still abroad. Right. And feel like they, you know, it's not going to be a problem. So I think having somebody in your corner, and for me, it was this, this woman.

Host

Do you feel that women should have female mentors or can it be male mentors as well ?

Kris Fay

i would say both, but I've had a lot of opportunity to work with some excellent leaders, male leaders and physicians who I respect very much who have been very supportive of me and my role. And frankly, there just aren't enough women at a senior leadership, true level to provide the sponsorship and mentorship that many young females need coming up. So I think it's a combination and I, I'm a firm believer that you observe everyone, you find out who you like as a leader, you watch what they do, watch what they do and you know, things that you wouldn't do, right. Because you can learn from that as well, and you just absorb all you can from leaders that you respect in the organization, regardless of their gender.

Host

How do you recommend finding a mentor or a sponsor, particularly in this new world of virtual communication?

Kris Fay

So that can always be tricky. I think finding a group, even such as the lean in circle, finding a group of like-minded individuals who want to move forward and want to learn together, I think is key. I think, again, identifying someone in, oftentimes your mentor, your official mentor perhaps is not your boss, right? Because you can't always be as open if you're talking to your boss offline, as you'd like to be, it can work, but it depends on the relationship. So I think finding another leader that you respect, um, and then really there's a lot of literature on how to be a good mentee, right? So if you ask somebody to do and give up their time, you've got to make sure that you're in the producing, you're in it. Right. So there's lots of good literature on how to develop a good mentor, mentee relationship that I would encourage folks to look at. But again, I think it's just finding someone that you connect with that you think you can learn from and really sticking your neck out, so to speak right. And asking, you know, and I can assure you, um, women leaders, um, are just happy to help. Right? I would help anybody because I know what that felt like. So, I think there's a lot of, um, openness to mentorship by females. In fact, they tend to mentor more than males. If you look at the literature. So I think it's just a matter of finding the right person and asking the question

Host

And my final question, looking from a 30,000 foot view at our 2020 elections, 126 women now hold seats in the United States, Congress, which is about 24% of its membership, 25 women in the Senate and 101 women in the house of representatives. And I'm very proud to say, we now have our first ethnic female vice president of the United States. How do you see the future being influenced by these women leaders?

Kris Fay

Oh, I think this is a terrific time. It really is cool. It's groundbreaking. The diversity that we're seeing in the government and politics I think is refreshing, frankly, I think their presence and their input at those levels will, my hope is catapult forward. Many of these issues and struggles that women are dealing with, especially single moms and black and Latinas who really struggled with having opportunity, and access to the right leaders to move forward. So I'm very excited about it. I think it'll bring a new thinking, perhaps new policy that will allow women to be more successful. And frankly, I think, I think we're ready for it. I think the country is ready for it. There's been a lot of discussion, there's been a lot of movement in the right direction. And if you think about it, every, every male has a wife or a sister or a daughter who he wants to do well, right. He wants to see them maximize their talent and skillset. So I think fundamentally we're all on the same page, whether we realize it or not. And so I see a very bright future and I am very impressed with the progress that we've made, especially in the last few years.

Host

I'm hoping that with the diversity of females in, in our new Congress, that our diplomacy efforts take a little different track. And I guess we'll see, we'll have to wait and see, I guess we'll see. Yeah.

Kris Fay

I wouldn't bet that you're correct. I certainly hope so.

Host

I just love doing these podcasts because it gives me the opportunity to have these great conversations with people before we close. Kris, is there anything else you want to add?

Kris Fay

First I'd like to thank you for inviting me, Cathy. I always want to talk about women in leadership wherever I can. So I always welcome the chance. And for me it's really important that women who are listening and who are either mid-career or early career, understand the potential they have ahead of them and really make sure that they are maximizing their talents and putting their time into something they really enjoy. So I'm always delighted to talk about women in leadership and some of the real challenges we face as we move forward. But I think it's a, it's a great topic. It's great discussion. And I think it's going to move us all in the right direction.

Host

We've certainly come a long ways from when I first started at long ways to sure. Thank you so much, Kris, for taking time to do this. I know how busy you are until next time. I'm Cathy Murtagh-Schaffer, and this has been heartbeats Shipley, cardiothoracic center podcast, dedicated to bringing research innovation and education to our patients and the community.