Board Member Interviews
What was your career journey, and how did you get to the place you are now?
If someone would have said that the last 22 years of my life would have been spent in the population health space, I would have said no way because the goal was to be a top hospital executive of a health system.
My journey started as a senior in my undergrad program and my initial desire was to go into public relations for general motors or broadcast journalism. The senior project was marketing the 50th anniversary for this hospital corporation. I made it a point to visit the corporate Vice President and he was looking for a part time person who could help write our hospital newsletter and take responsibility for our community liaison work. After calling him back I told him my afternoons were open since I was done with basketball season and on-the-spot he hired me as a part-time employee to write for the hospital newsletter and to become the employee and patient liason. When I graduated he offered me a job as an administrative assistant to run three hospital departments, which allowed me to learn about the business part of the hospital. I told him I would like to go to grad school and I applied to the department of Health Management and Policy at University of Michigan School of Public Health and was accepted. I shared this news with my then CEO and he told me that he would cover my salary and wages for the time that I was away because "you have done a great job here and someone sponsored me years ago. So all I ask is that you give it forward." So for 42 years that I was a hospital executive I had an intern, fellow, or executive in my time as an executive.
I went to Michigan, and I wanted to learn more about managed care and Henry Ford Health System had a large managed care department, so I spent the summer working for them. After I graduated, my former boss became the CEO of the Horizon Healthcare and so I went to work for him at the corporate office. At the corporate office, I worked on hospital governance, health system governance, union issues, medical staff issues, insurance, risk, and more. After working for him for one year, I got a call from one of my classmates who was the CEO for Hurley Medical Center. He asked me to interview for this opportunity, and I told my boss because I learned a long time ago if you’re honest and upfront with the people you work with, you can’t go wrong. I would encourage you and others to do the same because they want the best for you.
I eventually took this job with the approval of my former boss with the exception that I would be open to a call three years later. Working at Hurley was interesting because they had 11 unions, and I learned that if you work with leadership and treat people the right way you can achieve what you want to do. My father who worked for Chrysler for 33 years was also in a union so I knew what that experience was like and it helped me relate to the people I was working with. Three years later I got a call back from my former boss and he asked me to serve as the CEO of the hospital where I started my career.
I worked as the CEO for the tertiary hospital for five years. Five years later I got a call from David Campbell who was my mentor while I was at Henry Ford for the summer. He offered me a position as the Corporate Vice President of Corporate Services at the Detroit Medical Center. I did that from 89’-91’, and while I was there the CEO approached me and asked me to be the COO. I fulfilled this role from 91’-95’.
After that I had a visit from Terri Wright who was responsible for the Maternal and Child Health Division for the state of Michigan at the time and she asked me to address maternal and child health outcomes. As a result, we created a program called Family Road Care Centers, where new moms could go to access resources related to medicaid, employment, banking, fresh foods and vegetables, and more. Within three months, we won the Michigan Hospital Association Community Service Award, and in January of 96’ we won the American Hospital Association’s NOVA award.
From 1996-2005 I served as the CEO of Family Road, and I spent time working with communities all over the country to improve infant mortality for Black families. Eventually, I was hired by Gail Warden who was the CEO of Henry Ford at the time to solve the uninsured and underinsured problem among children and women in Detroit. I was able to build a $285,000 program with the help of the Detroit Wayne County Health Authority to a $15 million program that enrolled 60,000 people in less than two weeks after starting. We also created the Authority Health Graduate Medical Education Program with 71 Medical Residents in Pediatrics, Internal Medicine, Family Medicine and Psychiatry. This resident learning pediatric program paid hospitals to teach residents who would later go into underserved areas.
What are some key qualities that you think makes a good leader?
I was listening to church the other day, and I heard about a story of an almost tenured faculty member who decided to quit his job to pursue a career as a middle school teacher in an inner city school. The faculty member met an old colleague who asked him how he was doing, and he said he was doing great. Then he later went on to ask well what do you make? The former faculty member said I make a difference. That’s what it is really about is making a difference, so I say follow your passion and the money will follow.
Another observation is that in the 14 years I was CEO of Authority Health there were
6 different health department directors, and each one that came in did away with what
the others had learned. At the Center for Creative Studies, we hired 6 students from
across the world to study System and Structural Integration. They did an exhaustive
review using quantitative and qualitative analysis and they noticed how many silos
there were within the hospital system. They knew nothing about this before, but they
let their creativity and innovation support their strategy so I would encourage everyone
to think creatively about how to solve issues. What some valuable lessons you have
learned over the years?
What are some of the qualities you look for in an effective leader?
As young professionals like yourself it’s important to select a career where we can
make a difference and demonstrate by your actions and people will follow. We need
to empower, engage, and help motivate people to engage in their own actions to achieve
the desired outcome. People have said to me “You did that? They followed you?” When
I got a patent on Authority Health Orthotic Water Equipment someone asked me “Who
helped you do that?” What do you mean who helped me? We are very creative and Michigan
had a way of really honing me to show me that I can be better than I currently am.
I also think that having initiative is important as a leader. During my time in healthcare,
I am especially proud of the patent on Artho-Aquatic Fitness System that I created
because it was an idea that I brought to fruition from a personal experience. It’s
about learning how to turn your personal experiences into initiatives that you believe
will ultimately benefit others later down the line.
What was the most influential experience you had as an HMP student and how did it affect the work you are doing now?
The speakers who joined our courses enabled us to see people who were practicing in the profession. The program was so much more academically oriented back then, and I’m sure it’s a lot better now, but the most impactful experience was hearing about their careers and the professions that we could pursue.
What is some advice you have for early careerists who are pursuing fellowships or jobs?
Certainly for those starting now, it is a totally different world, but definitely avail yourself of all the opportunities that are available to you. So if it’s a fellowship, they are designed to give you exposure so I would just encourage people to explore the things that you think you are interested in, but also test out areas you’re unsure about. If you go into your fellowship thinking “Oh, I want to be in operator” well go and spend some time with the strategists in the system and understand their roles and the finance roles that are maybe not "responsible for operations" but are incredibly impactful. Sometimes you may figure out that you have that gift too or interest as well and/or you will be able to rule it out. If you don’t like managing people in those ways you can at least say you explored those areas. Likewise, if it’s a first job, I would suggest through your volunteerism you can expand your skill set. If you go into consulting, take on volunteer opportunities that are outside of your primary function. In the beginning, you really want to explore what all your gifts, talents, and possibilities are, and it doesn’t always have to be in your formal job, so really leveraging your opportunities when first starting out.
What are some ways you have seen Henry Ford Health System adjust or pivot to accommodate the surge of COVID-19?
In the first wave of COVID, we were like everyone else in Michigan. We had a very high number early on of COVID patients, and we were second to Beaumont Health System in terms of caring for those patients. So we of course like a lot of other health systems, changed our model of care and focused on delivering inpatient care. We stopped our outpatient services, we took away our elective surgical cases, and tried to do it in a safe way by turning on our telehealth portal. So that way we still gave patients a way to connect with the health system to prevent the patients with chronic health conditions from being unmanaged. We made sure people could get their prescriptions, and stay connected to behavioral health services. I think we pivoted well by using all the resources and tools we had; some of it we did by partnering with community resource groups to get into the community more aggressively than we could do.
Wave 2 was a little different because we didn’t have some of those same mandates coming from the state so we had to learn ourselves how to balance the volume. So how do we keep the elective activity and care going? If you think about someone who suffers with a bad knee or pain in their hip, it’s not elective for them to get their joints replaced. So people are still suffering and needing the care they want and so we thought, we will figure out how they want this.
As we’re now leaning into this next wave, as we see Michigan is again at the forefront, and near relatively open as a community, we don’t have the concept that we can slow things down. Our management this time around is focused on first and foremost the health of our employees because they have been doing this for a year. We have put a lot of additional resources out in terms of their mental health, their healing, their support, trying to create an environment where they know how intense it is to deliver this care to people who are extremely sick, have incredibly unique needs. It’s not care that staff would say they even did routinely, so first and foremost caring for our team is what we are doing.
At the same time we are very engaged in vaccination as a path toward better health. Literally today we are trying to figure out a way to partner creatively to keep our patients safe in the hospital at the same time we identify what we have to dial back on. We aren’t going to stop anything, but we are confirming hour on the hour what we can perform because not every hospital in our system has the same capacity. But if there are other hospitals in the community that can better serve someone we’re going to partner to get people where they need to be.
The patient is the center and focus of what we are here for. But we are also focused on keeping our staff safe and supported. We did things during the pandemic like raise our wages to promote a living wage of $15 an hour so we could give our staff that economic security because some of them are as vulnerable as the general population, so we are trying to take down some of those vulnerabilities for them as well.
What policies have been put in place that have affected the way you all serve the community? Do you foresee any future policy changes that would have an impact on the community?
Absolutely! So one of the wonderful service opportunities I had was participating on the Governor’s Racial Disparity Task Force. We know again unfortunately that nationally that Black people were affected disproportionately with bad outcomes from COVID. We saw really early that the mortality rate was extremely high and we also believe that is because of the health disparities and bias in the health systems and cultural incongruence. So how we communicate, how people are perceived in the healthcare system have risen to the forefront in terms of diversity, equity, and inclusion. There is discussion now about having anti-bias training for all licensed professionals in the state of Michigan. I think this will be a policy that is incredibly powerful. When people are coming into the health system, they are going to be seen for who they are as opposed to a lens of bias.
Another policy that we may see on the national front is around access to telehealth and how it will be on par to physical health. We already received parity for compensation during the pandemic, but there is a lot of discussion that would assume that the virtual environment is going to remain. It’s not a replacement for in-person person, but it is a very important compliment. It is about understanding how we spread our resources, especially for those in vulnerable communities.
The one last thing I would put with that is I think from an insurance perspective I’m not sure if there will be an accountable care update or if there will be something states do with Medicaid expansion to confirm that. Michigan will continue to look at medicaid eligibility and how to close the gap on the uninsured population. People who don’t have insurance and don’t have access to care tend to be sicker if they have chronic conditions that need to be managed. I think we are going to continue to see efforts to expand Medicaid from states that didn’t do that under ACA, and hopefully more protections around affordable care being offered to every citizen to ensure everyone has access to care.
What are some effective qualities of leaders that you saw exemplified in the pandemic?
You have to be a strong communicator. You have to be present. You need to come out your office to support front line leaders. You also have to be an assertive leader. I’m not a clinician, and there were times during wave one when I was in tears because I didn’t know what to do. I saw my colleagues suffering, and in the beginning we were the ones affected by COVID because we didn’t have the PPE for the non-clinical team, but we were the ones going into the hospitals every day to give food and give relief to the non-clinical persons. We had surgeons in some areas of the hospitals cleaning rooms because that’s what we needed at that time. Not to mention that the cleaning protocol was vastly different for someone who had COVID, so the disinfection process was very different than what we would do for a normal process. It was literally all hands on deck. That goes from Wright Lassiter our CEO down to our executive cabinet, market leaders, which I would be included in that group, and the market communications team. We met twice a day everyday, once in the morning and once in the evening. It wasn’t symbolic, but it was because we were changing policies daily. We would change the policy, send a bulletin at night, and see how it affected the next day. Fourty-eight hours would go by and we would say that’s not working so we would have to do something different.
Leaders also had to be flexible and if you were in healthcare at this time and hadn’t been connected to your servant leader skills you were reconnected. I was on a call with one of my teams today asking what we could do to support their COVID tent for testing, and part of being a leader is doing rounds to see how each team is doing. For our leadership team, we try to connect with people as individuals and try to be as supportive as we could of them. I think it’s the leadership challenge of the century, and truly it has been.
What keeps you up at night and how do you stay motivated?
The toll that COVID has taken on us as a community. I look at it in two phases: people working and people who have lost loved ones. In the beginning, people weren’t able to adequately mourn because they couldn’t have funerals as they traditionally would have. You've got all these pending memorial services for their loved ones and you would think they would be able to convene by now and say their goodbyes. There’s just so much hurt people have experienced under COVID, so it does make me restless sometimes to ask, "how will we be able to get back to the joyfulness of what we can do?" It’s like we feel like we’re fighting something we don’t understand, and we’re not helpless, I’m actually hopeful.
But there is a weariness felt. I own being a Black healthcare leader, and some of the things we talked about earlier around diversity, equity, and inclusion, and we’ve added justice here at Henry Ford Health System. I fantasize that one day we can have equality in healthcare and at some point we can have a true level playing field where your generation of leaders doesn’t need to have a mask on when going into organizations, and the ability for you to be authentically yourself, and you’re not immediately judged because of your beautiful brown skin. There’s all these other "isms" and other things and filters, so I say it’s a fantasy in the sense that we are a colorism country. I don’t know when that is going to evaporate, but I do hope that we were a little bit more awakened during this period, and I do think we were awakened as a country to how race and racism has played into a negative, toxic, and murderous environment that Black people have had to live in.
So definitely my prayer for the future is that we will sustain some of the equality conversations going on and that people can truly walk in who they are without feeling like that’s going to be a deficit.
Did you have a professor or class you that enjoyed the most? What was it and what
made the professor / class so enjoyable?
My favorite class was Program Evaluation with Paula Lantz. The skills I learned in that class were directly applicable to the programs and initiatives I have developed during my career.
What is some early career advice you have for an early careerist?
Don’t just think about what kind of career you want to have but think about what kind of problems you want to help solve.
What was your career journey, and how did you get to the place you are now?
I knew I wanted to practice medicine and integrate Public Health into my career to address health inequities but I wasn’t sure how that would be operationalized. I became an emergency physician and had the opportunity to influence medical education very soon after I finished residency. It began with teaching medical students about Emergency Medicine, then I began to teach medical students about health policy. From there I joined a research project studying U.S. medical schools that had a social medicine focus and intentionally sought to address unfair social conditions. This allowed me to have an opportunity to work for the Association of American Medical Colleges where I now lead the Equity and Social Accountability portfolio. We develop programs and initiatives to advance equity, racial justice, population health, and accountability in medical schools and teaching hospitals. I’ve enjoyed a diverse career that has allowed me to practice medicine, teach medical students, and influence medical education on a national level.
What are some health management changes within hospitals, consulting agencies, or
payers you are expecting to see?
I am excited to see payors join the efforts of academic organizations that have been committed to Diversity, Equity and Inclusion and are publicly making efforts to become anti-racist. An example is Blue Cross Blue Shield of Illinois that is partnering with medical schools and teaching hospitals in Illinois to advance DEI.
How do you imagine COVID-19 will transform the way we think of healthcare?
The COVID-19 pandemic gave our nation and the world an opportunity to face health inequities like we’ve never seen before. I hope that we can take this opportunity and decide that we can and must work with multi-disciplinary partners to dismantle structural racism and other systems of oppression to eliminate these unconscionable health inequities.
What are some of the qualities you look for in an effective leader?
A good leader listens, asks questions, is decisive and is committed to their own growth and development as well as the development of their team.
Amir Dan Rubin
Amir Dan Rubin is Chair & Chief Executive Officer of One Medical, a membership-based primary care organization on a mission to transform healthcare through a human-centered and technology-powered model delivering better health, better care, and better value. The mission of the organization he runs now aligns with Rubin’s personal mission—to make the health care system work better for more people. Rubin is a 1996 graduate of the University of Michigan, earning both a Master of Health Services Administration from the School of Public Health Department of Health Management and Policy (HMP) and a Master of Business Administration from the Ross School of Business. From here, he held leadership positions in multiple health systems, including as Chief Operating Officer at UCLA Health and President and CEO of Stanford Health Care, and later as Executive Vice President at Optum within UnitedHealth Group. We caught up with Rubin to reflect on his time in HMP and the importance of learning and leadership in the health care field.
Did you have a professor or class you enjoyed most?
Rubin shared he especially enjoyed any class that offered “a combination of lecture, discussion, and application,” such as case studies and outside speakers. Not just telling but showing how material would be applicable made it exciting and helped the content stick. In particular, Professor Griffith taught a health systems class that did a great job connecting theory to application.
What advice would you share with an early careerist?
Focusing on continuous learning is Rubin’s top advice. The HMP program teaches content, and it also teaches students how to learn. He noted that graduates will learn more specific content as their careers progress, but they should not forget to find ways to learn and understand more. He urges early careerists to explore and follow their interests and take advantage of their newfound knowledge and skills.
How do you imagine COVID-19 will transform the way we think of health care?
Many health care leaders have focused on the ways COVID-19 will transform health care, but Rubin was quick to emphasize the ways it is not transforming. The fee-for-service system remains in place. Care coordination has not been dramatically improved. Technology interoperability remains a challenge. He adds, “Health care is stubborn. Just because there’s lot of digital care reimbursed doesn’t mean care is revolutionized. It might, however, change how we look at the underlying problem statements in health care and solve them.” For example, infectious disease prevention was not thought about in recent times in the United States as much as chronic disease management and prevention. Now, all countries in various stages of commercial development have to think about infectious disease. While health care may not have been transformed because of COVID-19, it is changing what health problems we are addressing and how we think about these.
What are some of the qualities you look for in an effective leader?
Rubin looks for leaders with passion for what they are doing, and who demonstrate perseverance. Leaders with those qualities are lifelong learners because they love what they do, and they are internally driven to make impacts. Additionally, leaders need the ability to combine analytic and interpersonal capabilities, as they look to make change with and through other people. Additionally, they have to be able to make impacts in ways that support and advance people, rather than ways that might disregard or disengage people.
What keeps you up at night?
Rubin shared that he is constantly thinking about how to “simultaneously meet the needs of multiple key stakeholders” as that is what he believes is needed to transform health care.