HMP Connections - A New Way to Connect!
Interviews with HMP Alumni from the University of Michigan's School of Public Health.
A Conversation with Bo Snyder
I recently had the pleasure to interview Bo Snyder, the president of Bo Snyder Consulting and University of Michigan HMP Alumni Board Member. Bo received his MHSA from HMP in 1988.
With a foothold in both the provider and consulting world, it was great to get Bo's perspective on the value of an HMP education towards his career.
I hope you enjoy this interview as much as I did!
Anthony Parel, MHSA Candidate '18
Q: You began your career at a provider organization where you spent 18 years before starting your own consulting practice. Was switching careers scary for you?
I was 42 years old, and that was 11 years ago. I had a really great 18 year run with a wonderful organization...that had just won a Baldrige award, by the way. At that point in your life [40-something] you kind of assess things. After mulling it over, I decided that I would give starting my own company a shot. That was 11 years ago, so I would like to say that it worked. But yeah, as for your question "was it scary?" yeah, it was horrifying. I needed the complete support of my wife, and I had that so that was definitely helpful. But I was the sole breadwinner for our family. My wife didn't work and we had two kids in elementary school at the time so I kind of just jumped and hoped for the best. I figured it out as I went along which was both scary and exciting.
Q: What spurred your move?
I was at a good organization that became a great organization during the 18 years I was there. I felt that it was a blessing and a curse to being in a great place: the blessing is that it's a great place; the curse is you're there for so long that you get stale. Just because you're ready to do more, doesn't mean that the organization is ready to do more. This is my advice to young people: if you're on the provider side, go to a place that's big enough for you to move around and make sure that there are lots of opportunities within that organization. There will come a point in time where there are just fewer opportunities for you to move and you have to be patient. You have to either be patient, or you have to move...I felt like I needed to move but I didn't want to leave town; I had two kids in school. Since consultants can travel, I could set up shop in the town I lived in. So that's what I did.
Q: Do you have this same advice for people who start out in consulting, policy, or payer?
Well, that's the thing, I don't know because I didn't grow up in those worlds. But I will say this, take the time to think your career out, don't be rash, and make sure that you have trusted advisors. Also, consider how long you might want to stay at one job. Is the job you're looking for a means to an end or is it the end? I know people who make mistakes on both sides: people who stay at a job too long and people who jump too often. If you aren't sure what you want then find an organization that is big enough for you to move around in. But that's just my two cents and what I wanted to get out of my job. So I guess my key point here is that you should focus on what you're passionate about; just make sure to be flexible too. But definitely, try and find your niche and think about where you can succeed.
Q: You mentioned the importance of having mentors/advisors. How did you go about reaching out to alumni to be your mentors and did you feel as though they helped you grow as a student and professional?
To be honest, I didn't really take advantage of our alumni base early in my career. I've been on the alumni board for a long time now and I think that we've come to this point where there are better opportunities for students to connect with us. I don't know if the alumni network wasn't as active then as it is now or if I was too stubborn and myopic. But I never took advantage of that, in retrospect I wish I had. I kind of made up for that by building my own network and I try to be that mentor to any student that needs one. But that is honestly the best part of this program. Anyone and everyone will sit down with you and give you their time. High-level executives will gladly get coffee with you or any other student and that is invaluable.
Q: What do you think the future of healthcare looks like?
I have to be honest, I don't know. But as a healthcare leader, I'm prepared to deal with whatever happens and I look at the future with both interest and curiosity. There is work to be done whether or not the ACA is repealed. I'm a bit agnostic on the whole issue because I don't want the issue to detract from all of the other important work going on in the field. That being said, it is an important issue; I certainly hope more people have access to affordable healthcare but there are a lot areas in which we need to improve. We can't let this drama detract from the work that all of us healthcare leaders produce. Think about how much time you spend on productive things. If you spend too much time thinking about Washington drama, unless that's your day job, then you are not using your time well.
Q: What was your most beneficial experience as a student of our program?
There was learning at every turn. There was classroom learning, learning when meeting with Professors, and there was study group learning. We were a close class and I think that we learned a lot from each other. This wasn't solely a classroom construct, this also happened when we went out to bars and to get dinner. There was this real passion and desire to make a difference in healthcare and I think everyone grew from that engagement.
Q: What was your biggest regret from your two years in HMP?
I wish I had reached out to alumni more and taken more advantage of the network. I always felt inferior and awkward while talking to alumni. That was a part of coming into the program straight out of undergrad. When it comes to my career, I always wonder "Did I stay in provider for too long? Am I staying in consulting for too long?" I mean, I'm 53 years old; I'm at the last third of my career. What am I going to do for the rest of it? And I've been having this discussion with my wife: "Am I okay with what I'm doing now or do I need to change gears?" Luckily my kids are in college now so I no longer have roots that tether me to one place so I have the option to pivot.
Q: What is the best way to implement change within an organization?
Wow that's a big question. One answer is to get people to envision how things could or should be. Let me digress into my Baldrige world. Baldrige in three parts is: 1.) Is your organization performing as it should be? 2.) How do you know? 3.) What can you change or improve? Get people to articulate what better looks and feels like. Getting people to talk about it is the first step. Once people start talking about it, the gears start turning. People need to be able to identify with and buy into what point B is. Once people can identify point B, the job is easy because you have the wind at your back. A huge component of a leader's job is to think about articulating what point B is and then figuring out how you'll know you're there. Then finally deciding a cadence of accountability, "We are going to meet once a week for one hour to work on getting to point B." Keep chipping away and make sure that you meet every week. Be disciplined. Don't let your efforts become the flavor of the month.
Q: Last question! How do you become a change agent?
Looks for opportunities within organizations and just volunteer and take that opportunity over because no one else is doing it. Find a vacuum and jump in and take ownership and begin to move things. But make sure you do it respectfully because people may push back and challenge you. All in all, make sure that you have allies and people that both share your opinions and challenge them because that's how you really grow. A narrow view is limiting and you need to make sure that you listen to every side and angle as you make change.
Anthony Parel is a second-year MHSA candidate at the University of Michigan, Ann Arbor. When not studying for class, staying busy with class-rep affairs, or interviewing HMP Alumni, he enjoys discussing existentialism, debating the ideological divide between Sartre and Camus, all things outer-space related, and Brooklyn quality pizza.
A Conversation with Erin Shigekawa
A Conversation with Erin Shigekawa
Last month, I had the pleasure to interview Erin Shigekawa, a policy analyst at the California Health Benefits Review Program and University of Michigan HMP Alumni Board Member. Erin earned her MPH from HMP in 2013.
With so much attention on health policy in today's news, it was great to get Erin's perspective on the value of an HMP education, particularly the policy angles of that education, and how students can make the most of the opportunities here at the University of Michigan.
I hope you enjoy this interview as much as I did!
Ashley Hill, MPH, MBA '17
Q: What was the most beneficial experience you had during your time as an HMP student?
I'll give a few examples, because I can't pick just one thing.
First: the collegial environment of the department and the people there. I had great classmates and fantastic professors. I really liked that the coursework we had was interesting and demanding - we were challenged on our assumptions and to defend our logic, particularly in classes like Public Health Law or Health Law with Peter Jacobson. I learned a lot from the Data Management course with David Mendez, and appreciated opportunities to make connections between the classroom and the "real world"; the policy capstone and the managing people course that emphasized emotional intelligence and self-awareness are two examples. When I was at CHRT, I remember being nerdily excited to apply things I learned in health economics to a project on behavioral economics in health care.
I appreciated that SPH overall, the department and the Griffith Leadership Center made connections between what we were learning in the classroom and what was happening in practice through speakers and other events.
Second: I really tried to make my experience interdisciplinary. My summer internship was with Blue Cross Blue Shield of Michigan in the Policy Development & Reimbursement Strategies Department. I learned a lot about the process of setting medical policy as a major insurer, and had a substantive project to work through pretty autonomously. During the school year, I worked with Barbara Israel's team at the Detroit Community-Academic Urban Research Center within the Health Behavior & Health Education department. It was really valuable to get out into the community and learn more about this partnership approach to research. I helped out with community trainings for teens who were advocating to policymakers about the impacts of violence on their communities. We did trainings on community blight and discussed how different environmental factors impact health. It was a wonderful experience. I wanted to get a feel for industry, academic research, the community perspective and other areas; with experiences like these, I was able to do that.
Third: I enjoyed being a part of the Health Policy Student Association and other student activities. It was great to have applied experiences in the Michigan Capitol. I remember my first year speaking with legislators and staffers about the helmet law debate; getting perspectives from outside of academia was important. As a second-year student, fellow-HPSA members and I planned a case competition at SPH that required interdisciplinary teams to solve a community health issue through policy. The interdisciplinary aspect made my experience all the more enriching and created a lot of growth.
Lastly, this wasn't during my time as an HMP student, but when I was in college, I participated in Rich Lichtenstein's Summer Enrichment Program (SEP) which Ebbin Dotson now leads. Participating in SEP and completing my summer internship at Mercy Primary Care Center in Detroit were very beneficial experiences, where i learned a lot about domestic health care, health policy and health equity issues. During SEP, I first learned about the Detroit Urban Research Center (where Rich was a PI with Barbara) and began to consider Michigan as an option for grad school. Rich, Ebbin, and SEP's program staff should be commended for the program, which has served as a model for other similar programs across the country.
Q: Looking back, what would you have done differently?
There's really not a lot I would have done differently. Perhaps I would have tried to make my experience even more interdisciplinary. I could have pursued more classes at the Ford School, maybe a Social Work class - just trying to get a handle on perspectives related to health but outside of public health is beneficial. I love so many things about public health, but I think it's good to get other perspectives.
Related to my current work, it would have been good for me to take a regulatory policy class, because the work that I do at the California Health Benefits Review Program touches on many stakeholders: the legislators that are making the policy, health plans that are providing insurance coverage, providers, and regulators. Outside of the scope of a single state, focusing on how state regulation differs from federal regulation and having a class on that would have been really great.
Q: Since graduating, you've been a fellow at CHRT and now a policy analyst for the University of California system. What drove your decision to pursue roles in health policy?
When we talk about health policy, there's the traditional health care policy: access, quality and cost issues, health insurance coverage and health care delivery. That's already incredibly complex; it's a really important part of people's lives, and can have positive and negative consequences.
Then there's health policy in that health can be affected by every policy decision: a "health in all policies" framework. This, I think, is fascinating. So much outside the traditional scope of health care impacts health: the built environment, behavioral factors, existing systems and power structures. We only spend so much time in the doctor's office - if we even have access to a doctor. Understanding how these other factors impact health is crucial. It also causes a conundrum - if health impacts everything, where do you start?
Overall, I pursued a career in health policy because I think we can address existing issues to improve people's lives. Whether it's health care policy or the more-nebulous notion of health policy more broadly, there are opportunities to improve people's lives through better policy.
Q: What has been the most beneficial experience you've had since graduating?
I work now as a Principal Analyst at the California Health Benefits Review Program. We were established by the California legislature to give objective, unbiased information about the projected impacts of bills related to benefit mandates and health insurance coverage in the state. We provide evidence-based information that allows decision makers to make informed health policy choices.
What I really love about the work is that it's like piecing together a puzzle. For each bill that we analyze, we look at the background of the issue, the context, what other states are doing, and how it interacts with federal law. We also look at the medical effectiveness of whatever's being considered - whether or not it works according to the literature- and then at the benefit coverage, utilization, and cost effects: how much the bill would cost, would it change usage, how would coverage change? Then we look at public health: how would this impact Californians in a broader sense? Would it impact existing health disparities or health inequities? To answer these questions, we work collaboratively with a group of faculty and staff from across California and actuaries.
I find it really interesting to piece together this puzzle - to give a comprehensive report about the issue and the impacts we think it would have in a very short amount of time. We generally finish each report within 60 days. It's neat to hear the stakeholder perspectives: those of the bill authors or sponsors, the regulators, agencies, advocates, and then to attend hearings and see the whole process be debated or voted on. I also enjoy hearing about other bills that are being considered and debated at the hearings. Last week when I was at a hearing, there were bills related to opioid treatment, labeling of toxic products in commercial beauty salons, school-based health: all sorts of different things that impact health. Being a part of the hearings is a really interesting part of the process.
Q: What might students be surprised to learn about your work? Anything that you have done or do now that would have surprised you as a student?
People think of policy change as slow, and in some cases, it can be very slow. There has to be the political will, the timing has to be right, and the public needs to be interested in the topic. But in my job, it feels like policy can move pretty quickly and that can be really interesting to witness.
From January to April or May, we are analyzing bills that have been introduced to either Health Committee in the California Legislature. Throughout the year, bills are being debated in both the Assembly and the Senate. If a bill makes it through both houses, the governor decides whether or not to sign the bill into law around September. If a bill passes, it may go into effect relatively soon after; January 1 of the following year, for example.
In my first year at CHBRP, I worked with a team to analyze a bill, SB 999, to allow women in California in certain health insurance plans to receive up to a year-long supply of certain types of birth control at once. It was introduced and passed into law in September and as of this past January, women can receive up to a 12-month supply instead of having to receive one month or three months at a time.
Of course, we only see a bill if it's already coalesced into a bill, after it's been raised by a constituent or perhaps a similar bill has passed in another state. Still, in some cases, it's faster than what we think of when we typically think of policy change.
Q: What can students be doing now to best prepare themselves to enter the "real world" of health and health policy? Anything you feel we are not getting in the classroom that you think would have been great?
Try to wrap your head around what's happening in the current health policy environment. Thinking about the state's role is important right now. A lot of states are reacting to what's happening at the federal level; there's a lot of activity there to watch.
Something that stuck with me, that HMP really tried to drive home, is that you're not just on policy track, not just on management track. They're both important and they're both intertwined and nothing can be done in a vacuum. That is so true.
CHRT, the Center for Healthcare Research and Transformation, which HMP alum Marianne Udow-Phillips directs, is a good example of this. When I was at CHRT, half of board was from Blue Cross Blue Shield of Michigan, half was from the University of Michigan Health System [now Michigan Medicine]. Those two perspectives were both important; both sides also had to consider both the policy environment and how that would impact their organization and operations. At my current job, there's agencies, regulators, the insurance industry, providers, advocates and other stakeholders. Nothing is just policy or just management. You have to think about things not only on a broad policy level but also how the policy would be operationalized, how it would impact insurance - that point by the department was spot on.
It's also hard to overemphasize the importance of writing, especially writing about issues that are complex and technical. Being able to make those kinds of issues accessible to any audience is crucial.
Q: Any final advice to students?
I would encourage students to stay open. Be interdisciplinary and always consider perspectives from other fields outside of public health. Your ability to communicate the role and value of public health and health policy to non-public health audiences is important.
Challenge yourself. Make sure that in whatever job you take after graduation you're always trying to grow and learn. Be proactive about broadening your experience and making yourself an asset to your team.
It's an exciting time to be in public health and health policy. With uncertainty and the changing environment, there are certainly challenges, but there's also the opportunity to address problems and to innovate.
Ashley Hill (MPH, MBA 2017) is a recent graduate of HMP and the Ross School of Business at the University of Michigan. In her time at Michigan, she served as VP of advocacy and community partnerships for HPSA, VP of finance for WiHL, and as a research assistant for Professor Peter Jacobson. Ashley is always down for bike rides around town, visits to the library, and ice cream from Blank Slate.
A Conversation with Mira Spaulding
A Conversation with Mira Spaulding
This month, I had the opportunity to sit down with Mira Spaulding, MHSA 2013, who
is currently the manager of geriatrics and supportive care at Kaiser Permanente in
the San Francisco Bay Area.
She shared valuable insight into making the most out of a fellowship, the first years of an administrative career, and the amazing network at the University of Michigan.
I hope you enjoy the interview as much as I did!
John Crist, MHSA Candidate '18
Q: Can you start by talking about your fellowship experience?
Definitely. I was fortunate enough to participate in the Kaiser Permanente Northern California fellowship which was a rotation-based 18-month program. I started off working in Vallejo, a low-income and diverse community, which I was very excited about. I spent six months there with the medical group on a variety of projects: process improvement in the lab, managing teams in outreach call centers which was fascinating for the people management experience, and improving interpretive services for our Spanish-speaking members. The fellowship was a wonderful experience where I was able to see management from the top level. I was fortunate to have really strong mentorship and built a lot of great relationships. After six months, I uprooted and moved to Sacramento where I worked with our hospital & health plan side of the organization. I did some work on establishing a patient advisory council, hospital flow around discharges, partnering with local FQHCs and their promotoras [Hispanic/Latino community health workers] to build more links to our Spanish-speaking patients.
We partnered with the promotoras to learn about the experiences of Spanish-speaking patients navigating the KP system. They also led focus groups on perceptions of care, especially around colorectal cancer screening and diabetes care which we were prioritizing at the time.
Q: How did the connections that you made with leadership help you get where you are
During my first rotation, I had a great mentor who ended up offering me a position as an executive consultant when I was done. I wouldn't have had that opportunity without the fellowship. The relationships and the networks I was able to build during my three rotations were huge for opening doors in multiple areas and gave me options for where I ended up going in the end.
Q: What does it mean to you to maintain a relationship? What is the right amount of contact?
Some people are very good at this, sending articles or notes frequently and saying, "I thought of you when I read this." For me, I was lucky to work with my mentor as my boss for a year after my fellowship. For my other preceptors, I tried to stay in touch as it felt natural to me. For example, when I saw something about promotoras I reached out and asked how that project was going. Also, at Kaiser Permanente we often do site visits to our sister facilities, so I would say, "I'll be here on this day, would you be free to have coffee or lunch?", and everyone is very open to re-connecting. Also, if you're struggling with making a change or having an issue with a project, our fellowship alumni network is very tight knit and any of us are more than happy to jump on the phone and talk you through it.
Q: Was executive consulting something you were interested in from the start?
Generally, graduates of the fellowships take one of two paths when they are finished with the program; either transition to a management role, or consulting for an executive or with an internal consulting group. For me, executive consulting was a great opportunity to work on strategy and maintain connections with local leadership, while putting my roots down and exploring areas in which I might want to pursue a management role.
Q: So it sounds like you found your niche in geriatrics.
Yes, it was an exciting transition to my EC role. I helped develop a lot of the strategy and business plans for creating the service line, so it was a natural transition to managing those teams as well. Another reason I was excited about this role was that I had a great relationship with my physician partner, I knew we already worked well together and I was really excited about his vision. I also felt that we were truly thought partners, which can be rare. So much of management is about the people you work with every day, so it was a nice step for growth with friendly faces.
Q: I've heard from several alumni that "fit" is both key and difficult to determine from interviews.
Yes. As I interviewed with different fellowships, people discussed the notion of "fit" which can feel intangible. During the interviews, I started to realize more of what they meant by "fit" as I started to make stronger connections with certain organizations, but the interview process is not always the easiest place to figure out "fit"; being able to spend some time at the organization with your team is key if possible.
Q: What do you like most about your job?
It's a mix of strategy, business development, and managing people. We are still growing our programs, doing a lot of performance improvement work, and starting new initiatives. I like the mix of day-to-day operations with more forward thinking about where we are going with our geriatrics program overall.
Q: What is Kaiser Permanente or your department doing really well with geriatrics care?
I'm really excited about our home-based care programs. In our local service area, we've been piloting and testing new programs to see what might be sustainable and spreadable for the growing elderly population. We have a small group of physicians leading a home-based care program for the elderly – we are currently doing a formal evaluation the program. I'm very excited to see what the results are because we hear such great comments on a daily basis around patient satisfaction and appreciation it will be fascinating to see what the larger analysis shows us.
Q: What is the most challenging aspect of your current position?
We are currently in start-up phase for some of our clinics and programs. We have two new palliative care clinics that have opened this year, we are still hiring, building the teams, designing our space, and mapping the workflows. But mostly, it's exciting to be able to design the model and figure out what will work best for us and our patients.
Q: How does having a start-up culture within a giant organization present challenges?
Sometimes I have to take a step back and ask how I can influence change if it's not something I have complete control over. Where do I need to make alliances or bring someone else into the conversation so they can understand the processes and be an advocate for us? Strategizing about how I can move our programs forward or motivate others when I don't have direct control is a fun challenge to work through.
Q: I wanted to transition to professional development. When you transitioned from classroom to the career setting, what was the biggest roadblock for you?
I went straight from my undergraduate to graduate program, so I hadn't been in a full-time work position. The "newness" of the career was exciting but there were a lot of unknowns. The fellowship was a great way to push and test myself, wondering what my life would look like, and how I could contribute and add value. A lot of it is believing in yourself and your education. Graduates from the HMP program leave well-prepared, so have faith in your previous experience and allow it to carry you through the uncertainty. Having the network behind you is really powerful, too. My classmates are a great support system.
Q: As an early careerist, how do you deal with more senior employees who may be more resistant to change or less convinced of a young person's ideas?
Despite your age, your reputation ultimately comes down to the relationships you are able to make with people. When you are young and starting out, when you show your work and what you're able to accomplish, people begin to trust you and listen to you more. Additionally, having common goals and working towards them as a team, takes the focus off the individual, and has been a helpful approach in my management role.
Q: To your point on figuring out how to structure your career and what you are able to provide, what have you found is helpful for maintaining work-life balance?
A lot of it is setting boundaries. I know that I will be much more effective when I make time to exercise. When I make that a priority instead of working late, I know I do better work because I have taken the time to refresh. I also work at an organization that offers things like mindfulness and yoga sessions, walking meetings, and a general mentality of wellness. There are always times when deadlines require working late, but I try to be conscious of maintaining a balance.
Q: Have you had any pushback on your work-life balance routine?
I haven't seen much resistance, but there are days when I won't be able to stick to a normal routine, so I have to plan for how to recharge over the weekend. The organization is very supportive of taking time to refresh and do what's necessary to balance your workload. If you are overwhelmed with your work or your fellowship, it's important to let your supervisor know. The organization values balance and will help work with you to find it.
Q: You've had a great start to your career. What do you do differently than most early careerists?
I remember during our professional development course, we did an exercise in career planning. We thought about where we wanted to be, what's next, and what skills and experiences we needed to get there. It's not something I think about every day, but I certainly reflect on what areas I have not had as much exposure to, but feel the need to understand better. I will then ask my boss how I can get experience in that department in a way that would be mutually beneficial. The organization is very open to professional development. It's something to keep your eyes open for, but finding a mentor can be extremely valuable and rewarding. A lot of my growth and opportunities have come from the first mentor I had in my fellowship being an advocate for me, helping to push me and open doors.
Q: Do you have a formal way of self-reflecting?
I keep a document that I review from time to time, as well as a running list of projects I've worked on. For now, my subspecialty is geriatrics and palliative care, so I am thinking about how I can get broader experience and how to make links between geriatrics and other departments.
Q: Which courses did you find most valuable during your education?
I always loved 600. The case study of the young boy [Deamonte Driver] who had a dental infection and ended up passing away really stuck with me. Learning about disparities, because they are the reason I went into healthcare, was really valuable to me. I also did an IHI Open School project that was very applicable in terms of moving an organization forward with problem-solving tools from Lean. The professional/leadership development course on focusing on EQ, self-reflection, professional presence, coaching and building relationships has also been extremely valuable in my career.
Q: Last question of the day: What parting advice to you have for fellow alumni and current students?
What I got out of Michigan more than anything was the network of my classmates. I value the connections I made both on a personal and professional level. When I reach out to friends from the program, they offer support and professional perspectives. It's amazing to have this network. Related to your earlier question about maintaining contact - making those connections a priority is so powerful for keeping your network growing and going strong, which is one of the reasons I came to Michigan in the first place.
Q: Anything else you'd like to add?
I love working on the alumni board because it's a great experience to connect with and support current students with needs, general questions, case competitions, or anything else. One thing I am hoping we will do more of is create more pockets of interaction outside of Ann Arbor; for example, there is an event on the west coast at the end of May [editor note: HMP Connect! Bay Area Innovation Summit]. It's great to touch base with other early careerists and people more senior in their career and outside your organization who you can learn from. I highly recommend serving on the board!
John Crist is a second-year MHSA candidate at the University of Michigan, Ann Arbor. John is excited to serve as IHI speakers chair and MHESA philanthropy co-chair in the coming year. In his free time, John is outside as much as possible, climbing, camping, and biking with his friends and girlfriend.
A Conversation with Gerry Meklaus
A Conversation with Gerry Meklaus
A few weeks ago I had the pleasure of connecting with Gerry Meklaus, Managing Director at Accenture, University of Michigan HMP Board Member, and a 1992 MHSA graduate.
This is part of an ongoing series where students (like me) conduct in-depth interviews with alumni (like Gerry) and post the results. I hope you'll get as much enjoyment out of reading the following excerpts about the successes of our fellow HMP alum as I did hearing them.
Ruchi Aggarwal, MHSA Candidate '17
Q. What is your favorite memory from your time at Michigan?
There are so many. It was such a rich experience, but if I had a favorite it was anytime I had the opportunity to be taught by John Griffith. I have many "Griffith Moments" but having the opportunity to listen to his pearls of wisdom and unique style of delivery was a great experience. It was a lot of fun to learn from him and watch his unique approach to education.
Another one of my favorite memories was the Organizational Theory class taught by Jeff Alexander. Jeff is one of the preeminent organization theory academicians in health services. It was a real pleasure to take a course with him and I got the only A+ I've ever received so I have great memories of that class.
Q. You currently serve as a Managing Director at Accenture. How have the skills you learned inside and outside the classroom translated to your current role?
In my current role, I lead a couple of areas of our practice around value-based care and physician enterprise. The skills I've learned along the way are fully integrated in this role because I touch everything from information technology to strategy and organization change. I am asked to integrate all of these skills when crafting solutions for my clients. Thus, it's not individual skills but it's the ability to integrate them and create a holistic picture of where organizations should be going and assist them in making that transformation that is a key takeaway from my time at Michigan.
The traditional health administration program may have focused on certain skills that you would pick up in a business program. Yet, when you look at population health it encompasses epidemiology, health policy, and more. The strength of Michigan's program is that you're not just studying business skills. You're also learning in the context of public health, health policy, epidemiology, and health behavior and health education. The transformation of the healthcare industry is centered on taking a more holistic view of populations and consumer behavior, and creating a very different 360º view of healthcare. A view not only focused on the business of healthcare, but also very much focused on population health. I think that the program integrates that in a way that you can't get from a traditional business program.
Our industry has to move away from the traditional concept of treating people when they are sick to much more of a movement towards keeping people well and that's a very different skillset. I think that people who don't have the skillset that Michigan provides, in a holistic manner, will struggle with that concept. The program positions you well for the next generation of healthcare challenges which are much more based on population wellness and not as much on acute episodes. We will still have acute episodes but that's one piece of the continuum. Everywhere you go, even if you go to a health system, you will find that they are focused on making the transformation to a population health company, if you will. That has a lot of other elements that need to be brought together such as community interventions.
For instance, I had a conversation with executives of a leading insurer just yesterday and they were talking about their Medicaid program and how they are reaching out into the communities. They are identifying interventions for people who are homeless and working closely with local organizations that provide transitional housing. They recognize that we cannot be treating just an acute episode. The acute episode is a manifestation of the overall failure of the system. If we don't deal with those root causes, people will get sicker and will result in a higher cost episode. So we, as an industry, have come to realize that we must deal with those root causes—many of which are outside the traditional healthcare paradigm.
Q. What was the most valuable thing you took away from the program?
It's not the hard skills, but the transformation the program makes in who you are. Once you go through the program you have a maturity and confidence level that allows you to articulate positions to key executives in ways that you never had previously. It's intangible but I guess it's the exposure to the faculty combined with your externship experience, which for me was very formative. My externship was a great experience and I had the opportunity to work very closely with the CEO of a major health system. I got to see how decisions were made, how I could contribute, and think about the key elements of success.
Q. How have you utilized the alumni network both as a student and an alumnus?
The alumni network has been extremely valuable to me and I hope I've helped to pay it back. As a student, I went through an externship between the first and second year and I got offered a job out of school. I didn't do a fellowship, but I went back to work for the organization where I did my externship. Even before I graduated, I reached back out to Jerry Fitzgerald, CEO of Oakwood Healthcare which is now part of Beaumont Health in the Detroit Area. I said that I was going to be graduating and Jerry said "I've got the job for you...this is what I would like you to do. Are you interested?" He carved out a role and I walked right into it. So right out of the gate alumni have been part of my life.
After several years of working in the industry, an alum, who was a fellow classmate and had gone into consulting, asked if I was interested in consulting. She said that they had roles open at Ernst & Young, opened the door, and directed me to the right people. Twenty years later I'm still in consulting. With the exception of two additional jobs I've held, the majority of my career has been with organizations where alums have opened the doors. It's a very active alumni network.
Q. As students, we are frequently engaged in discussions about how healthcare will change under the new administration. What are your thoughts? What changes do you anticipate that we will see over the next few years?
At Accenture we are tracking this very carefully. We run healthcare.gov as well as Covered California, which is the largest state exchange. We do a lot of work with the federal government and multiple agencies including the U.S. Department of Veterans Affairs and Department of Defense.
So where do we think it's going? The administration is still settling into their roles and there has been some turmoil. Assuming that plans move forward, they will be consistent with what we have heard from Republicans as their platform. From a philosophical perspective, if you read Paul Ryan's plan called A Better Way you'll get a good perspective on these trends. With respect to the successor to the ACA, we are expecting more emphasis on consumer engagement and consumer decision making. This will likely take the form of health savings accounts (HSAs). They are currently in place with a few employers, but we expect to see more emphasis on HSAs. The emphasis on the consumer will grow and as a result, we will see the industry respond with lower cost options. We are already seeing this happen. If you look at the urgent care business, you will see the growth in that segment of the industry, due to convenience and cost. For example, United Healthcare, through their Optum business, has bought one of the largest chains of urgent care, MedExpress. Thus, we expect more and more consumer based and lower cost options.
There is also a focus on transparency of quality and cost. Up until now the traditional healthcare consumer couldn't figure out what healthcare may cost. We expect that transparency in the industry and the provision of data and information available to the consumer to increase. Consumers will have more access to digital tools that will enable them to make individual decisions about how they access care. Your generation has grown up with the cell phone and a lot of what you do is based on your phone. For example, you use Yelp when you need to make a restaurant reservation. It's all digital and integrated. Healthcare needs to move in this direction and will move in this direction. We aren't there yet, but we are in pockets. It's the old adage: the future is here, it's just unevenly distributed. This is very true in healthcare. If you look across the healthcare landscape there are organizations that have moved forward and new companies are coming up all the time. There is a huge focus on innovation and we will see more innovation coming forward.
However, everything I have described, the consumerism, the innovation, and movement towards digital is independent from what happens in Washington. What's very important to note is that there are certain secular trends that are going to happen regardless of what happens in Washington. We know virtually every major healthcare system has innovatriums (that's a cool new word!) where they are testing new solutions and investing in those solutions. That was not true even two-to-three years ago. So innovation is spreading, consumerism is spreading, and these are secular trends.
With respect to the new administration, we think that the nature of the Medicaid program will likely change significantly from an open-ended entitlement to a per-capita program that funded from the federal government.
Q. Any advice for current students and fellow wolverines?
Stay close to the program, it's a great asset. You will continue to learn by your exposure to the program and the time you put into being on the alumni board, or participating in another activity will be rewarded. You will also be paying it forward to the next generation of students. Our students value the alumni network and when I look back on my experience, the network was central to my life and career.
Ruchi Aggarwal is a second-year MHSA candidate at the University of Michigan, Ann Arbor. When not studying for class or organizing events for the MHESA Philanthropy Committee, she enjoys watching new movies, bonding with her classmates over coffee, and trying new restaurants in Ann Arbor.
A Conversation with Gonzalo Solís
A Conversation with Gonzalo Solís, FACHE
This week, I had the pleasure of connecting with Gonzalo Solís, Healthcare Executive at Yale-New Haven Hospital, Board Member of the University of Michigan HMP Alumni Association, and a 2009 MHSA graduate.
This is part of an ongoing series where students (like me) conduct in-depth interviews with alumni (like Gonzalo) and post the results. I hope you'll get as much enjoyment out of reading the following excerpts about the successes of our fellow HMP alum as I did hearing them.
Danny Gessel, MHSA Candidate '18
Q: What was the most beneficial experience you had during your time as an HMP student?
I completed my undergraduate degree at the University of Michigan and I was first inclined towards admission offers for master programs at other competitive universities. But Michigan has such a strong program that I couldn't leave Ann Arbor.
My most beneficial experience as a student was to be surrounded by the best and brightest. The quality of the student body and the faculty is one of a kind. It was great to have a very diverse class in every single aspect. My class had students who worked in hospitals and health systems, insurance companies, consulting firms, startups, and government agencies. Some of my classmates were entrepreneurs, physicians, engineers, and soldiers that brought diverse perspectives.
It was unique to find a faculty that were experts in various disciplines with a focus in healthcare -from corporate finance to technology, from health law to economics.- Michigan's faculty are authors of many books and articles used every day by executives in the field. Many programs don't have the resources that Michigan does, which reflects why it has been consistently ranked number 1.
Q: What from your Michigan education has served you best throughout your career?
In addition to learning about business principles and the healthcare industry as a whole, at Michigan, we truly learned how to problem-solve as leaders. We were given all the tools necessary to succeed in the workforce and to continuously improve as we gain more experience through our careers. The fact that you are learning how to critically think about different problems will help in the long-run as a leader.
Q: Looking back, what would you have done differently?
Great question. I wondered if pursuing a full-time before starting my master would have enhanced my academic experience. Luckily, I was very active during my undergraduate studies and surrounded by an outstanding faculty and experienced classmates that enriched class discussions.
Q: What do you think students can be doing now to prepare themselves best to enter the healthcare industry?
First, students should take advantage of all the resources at Michigan. Working on consulting projects during school is a great idea. There are many courses at Michigan that offer consulting services to companies seeking to meet their corporate objective.
Another idea is to get involved in professional societies like the America College of Healthcare Executives. It is a great way to develop professionally and to get in touch with the leaders in the industry. The more contact you have with these leaders the more you can bridge theory with practice.
Q: What has been the most beneficial experience you've had since graduating?
My most beneficial experience was starting from the bottom in an organization. After spending all summer of 2008 gaining experience in an internship at Yale-New Haven, I had plans to return for an administrative fellowship. I graduated in 2009 at the peak of the global financial crisis. Many fellowships and jobs throughout the country were canceled. When most students from the previous classes already had jobs before graduation, only about a third of my class had jobs that year. Consequently, I was challenged with figuring out my next career move.
Yale New Haven had to cancel their fellowship and instead offered me a job as a manager in support services amidst a lot of changes. Senior leadership wanted to improve patient flow and Press Ganey/HCAHPS satisfaction scores in the support services, which had been typically ignored. I saw the opportunity to supervise hospital operations in the frontline and a team of employees early in my career. Since then, I have been fortunate of increasing responsibilities and progressing in leadership roles all within the same world-renowned organization. This is a perfect example of how a challenging situation can be turned into one that positively impacts, not only my organization, but my career.
Q: Tell me a little more about your current role overseeing inpatient and outpatient operations
Hospitals around our nation offer services 24/7, but administration operates during regular business hours. Yale-New Haven Health is one of the largest and most innovative healthcare organizations in the country. Therefore, senior leadership identified the need for developing executives that could provide leadership during off hours. We used to rely on the common model of nursing supervisors that did a great work focusing on the clinical side of the operations, like bed management and staffing. Instead of relying on a senior leader on call for administrative issues, my role was created to have an executive on site during these hours
Currently, I oversee all of the inpatient and outpatient operations of our 1,541-bed academic medical center and its 1,400+ clinical and nonclinical personnel during nights, weeks and holidays. Our AMC includes the 168-bed Smilow Cancer Hospital, the 200+-bed Yale-New Haven Children's Hospital and the 76-bed Yale-New Haven Psychiatric Hospital and serves as the primary teaching hospital of Yale School of Medicine. I was trained by executives of every department operating in the hospital –from legal/risk management to supply chain to financial services- in order to supervise their areas. During regular business hours, I work with these teams on evaluating and coordinating project plans that support operational effectiveness, financial performance, patient experience, and safety and quality. Our major accomplishment was turning Yale-New Haven into a true destination hospital with 24/7 operations.
Q: What have you found is the best way to implement change in your organization?
To translate corporate objectives into culture you need to incorporate all parties involved at every level, including employees. This will lead to everyone sharing their interests and their own ideas to the table. When you listen to everyone with an open mind they will become champions of change.
Q: I see you have quite a bit of experience using Lean & Six Sigma Management how do you think learning lean has helped your career?
Lean and Six Sigma are very useful tools for every leader. As a Green Belt, these have helped remove waste and improve performance in my organization. Its principles are to define problems and goals, measure key variables, analyze the data, improve systems and processes, and control results.
Most importantly, these tools taught me to rely on data and to consider every decision's sustainability. You will hear professors say that culture trumps strategy, meaning that if everyone is not on board your strategy will not work. Since healthcare is constantly changing, then performance improvement tools like Lean and Six Sigma can help us adapt quickly.
Q: It's a very interesting time to be entering health care (or continue to serve in a healthcare role). What are your thoughts? Where do you see the future of healthcare?
There are many factors constantly changing the healthcare environment that makes it very interesting. In addition to our country's economic situation, healthcare is experiencing revenue/cost pressures, increased regulation, changes in clinical care models, modernization in technologies, and more focus on the patient experience. Organizations are trying to adapt to all of these; some are doing it better than others. It is exciting to be in healthcare because what we think of healthcare today will be different tomorrow.
I see a future where healthcare will move away from inpatient care and rely on technology more than ever. Of course, we will always have brick and mortar hospitals, but technology will serve as a resource to improve access and meet our patients' needs in the community.
Q: How do you stay connected with your cohort and other connections?
ACHE and as a member of Michigan's Alumni Board have been the best ways we've stayed
connected. And of course, through social media like LinkedIn.
(editor note: you can now follow HMP on twitter and Instagram at the handle @MichiganHMP)
Q: Any last advice for students? Alums?
Always remember why we chose this career. We are fortunate to be in the healthcare
The fact that we provide a service that impacts people in their best and worst times of their lives is very rewarding. Not only it helps me stay focused, but most importantly, helps me stay inspired.
Q: What has helped you have a good work-life balance?
First of all, work for an organization that values work-life balance.
What helps me is spending time with my family and being active in the community via volunteering work and boards. I also exercise and play sports, preferably soccer since I played competitively, to stay healthy.
It's very important to make time for yourself, for your family, and for your community.
Danny Gessel is a first-year MHSA candidate at the University of Michigan, Ann Arbor. When not studying for class or staying busy on MHESA and MCACHE committees, he enjoys spending time with his family, the HMP cohort and running.
A Conversation with Janet Pinkerton Dombrowski
A Conversation with Janet Pinkerton Dombrowski
This week, I had the pleasure of connecting with Janet Pinkerton Dombrowski, President of JCD Advisors, LLC, Board Member of the University of Michigan HMP Alumni Association, and a 1990 MHSA graduate.
This is part of an ongoing series where students (like me) conduct in-depth interviews with alumni (like Janet) and post the results. I hope you'll get as much enjoyment out of reading the following excerpts about the successes of our fellow HMP alum as I did hearing them.
Kim Pham, Global MHSA Candidate '17
Q. What do you cherish most from your experience as an HMP student? And now as an HMP alum?
As an HMP student, one of the things I cherish most has been all of the connections I have made, as well as the people that have comprised this program. It was great to observe so many different perspectives and walks of life, but all with the same interest in impacting health care in a different manner than my direct health care experience. Another thing was the exposure to all of these new ideas. It really broadened my perspective and helped me to understand what health care was outside of clinical care. I loved learning about urban health care, community health, and policy - really getting to understand the underlying themes in healthcare administration.
As an alum, I would say the same still rings true today: it's the connections and exposure that I still cherish. I've enjoyed staying in touch with my cohort, and other alums, and being connected with students as well. That's really special – the students always give me so much energy. I also love seeing how the HMP program has evolved – seeing new focus on subjects we didn't get to discuss as much, like mental health, international health, and population health.
Q. You currently serve as President of JCD Advisors here in Ann Arbor, which combines strategy and organizational development with executive coaching. Traditionally, HMP students are more exposed to hospital administration, consulting, or policy positions. What made you decide to pursue this venture?
[Chuckles] If you had asked me 20 years ago if this is where I would end up, I would've never guessed this. I only applied to fellowships after graduation and was set on hospital administration. I was fortunate to get a lot of experience in strategy development, and business development in both health systems and consulting. Understanding business operations - the value proposition, pitch, and delivery - I had the opportunity to get involved with mergers and acquisitions. At Trinity Health I led negotiations for the acquisition of St. Mary in Livonia, and was part of the leadership team to help integrate St. Mary's into Trinity Health. It was that endeavor where I realized that strategy and business development skills alone were not going to be enough for this organization's success; leadership, culture, and organizational structures were even more important. This was my aha! moment and my opportunity for growth and development.
Through the system's HR department, I was able to train in executive coaching, culture transformation, and other organizational development skills. With these skills, the strong professional relationships I'd built over my career, and a desire for flexibility for my family, I decided to start my own business upon leaving Trinity Health.
Q: How would you advise students interested in pursuing a track like this?
I believe that to do this type of work, you need to have lived the experience of a senior leader or have "sat in that seat". The necessary intuition and gravitas, or the ability to sit with power (to speak candidly with a physician or CEO), comes with experience. A big challenge is finding people who can have the credibility and authority to be able to do this effectively. That being said, anyone can always be a student of organizational behavior. When you and other students start out in your next job, observe how leaders lead, how work gets done, and how teams can be effective. Ask yourself questions, like what would you do differently? What do you think is really important? There are some tools out there that can help give structure to what you are seeing. A great book is The Five Dysfunctions of a Team, it provides a great framework.
Q. Additionally, your firm has emphasized key leadership competencies more widely discussed in positive organizational scholarship, like compassion and gratitude. Could you please speak on the importance of honing those, and potentially other aspects of emotional intelligence, as we all continue developing ourselves as leaders?
You can always build more technical competencies, but it's the behavioral competencies (or lack thereof) that tend to create problems for people. I work with professionals who are already "successful", so it's this idea of having them build self-awareness, getting them off autopilot, and intentionally choosing how to behave as a leader.
I am also learning a lot about the significance of neuro-leadership, the biology and physiology of leadership. For example, when you encounter a social threat (like an organizational or role change), functional MRIs show that your brain's response is similar to when it responds to a physical threat, like entering fight-or-flight mode. While you might not recognize this psychologically, understanding this innate response is important because it means you may have to fight against your self-protective mechanisms in times of change.
Q. As we enter an era of change for health care policy, how would you advise students and professionals in navigating change?
What leaders really need right now is to get the best out of themselves and the best out of other people. Build resilience. Keep people healthy and at their best - this is essential in tapping into their best thinking for innovation and creative problem solving. I like to use this analogy: when we are threatened during change, it's like an aperture in a camera that narrows and closes in (to protect ourselves). What we really need in the face of change or difficult times, is to open our apertures. We need to open up our minds and broaden our perspectives, engaging others' viewpoints.
Q. Any last words of wisdom to share with other fellow Wolverines?
Stay connected to the program and stay connected to each other. This helps to keep your aperture open. There are a lot of ways to stay connected and there's a lot of value in that. Also remember your network - it is there to give you a broader view of the world. Foster relationships, rather than "a network". For example, with LinkedIn invitations, include a personal note. Remember the reciprocity in relationships. Seek to provide value as you grow and maintain your relationships – that is when the value of your "network" will come back to you.
Many thanks to Janet Pinkerton Dombrowski for this lively discussion around leadership, networking, and change. Be sure to tune in next month for another alumni interview.
Kim Pham is a second-year Global MHSA candidate at the University of Michigan, Ann Arbor. When not studying for class or organizing events as an HMP Class Representative, she enjoys playing in the U-M Life Sciences Orchestra, bonding with her classmates, and discovering new restaurants in Ann Arbor.
A Conversation with Daniel Dimenstein
This week, I had the pleasure of connecting with Daniel Dimenstein, associate at Witt/Kieffer, Board Member of the University of Michigan HMP Alumni Association, and a 2013 MHSA graduate.
This is part of an ongoing series where students (like me) conduct in-depth interviews with alumni (like Dan) and post the results. I hope you'll get as much enjoyment out of reading the following excerpts about the successes of our fellow HMP alum as I did hearing them.
Marianthi N. Hatzigeorgiou, Global MHSA Candidate, '18
Q: What is your favorite Michigan memory from your time here as an HMP student?
This is probably the most difficult question to start with! Outside of the program, one of my favorite memories was beating Ohio State my first year here. Having done my undergrad at a small Division III school, I had never really watched or participated in big time college football, so it was exciting to see us beat Ohio State. Plus, it was at the Big House, which made it even more amazing.
My favorite academic memory will sound a bit like a cop-out but it's all the really great people I met: both classmates and professors. Again, I went to a small college of 2,200 students in Upstate New York where I had great relationships with students and professors. When I first came here, I thought that, because of size, and being a vast research organization, I would not be able to make those connections. However, I was still able to build these long-lasting relationships not only with my cohort but more impressively with my professors. During the silent auction, I won dinner with PDJ-- I highly recommend you and your classmates take advantage of the auction. That opportunity, and many others like it during my time, was a great moment to get to better know my professors and have discussions outside of the classroom.
Q: What from your Michigan education has served you the most in your career? Looking back, what would you have done differently?
Again, I would say it's really difficult to choose one thing. Overall, being able to understand healthcare trends and articulate them given the country's current status is invaluable: this is something that applies both from my past experience on the provider side and in my current role. Now as a professional, I attend many conferences and still hear a lot of "volume-to-value" and other trends being discussed. At first, I was almost shocked to hear these topics and would think, 'Wow, this is still a hot topic? I learned this within my first semester at Michigan.' At the time, I may have taken it for granted but it's true: we really did get the best education and that has positioned us as graduates to be leaders and the best in the field.
Also, I was pretty young when I entered the workforce (having gone right from undergrad to grad school), but I found that being able to speak articulately with those much older than me about high-impact issues has remained impressive to many I've worked with.
Q: So I wanted to shift the focus a bit: it's a very interesting time to be entering health care (or continue to serve in a healthcare role). What are your thoughts? Where do you see the future of healthcare?
Well, let's start with where I see it going: if I knew the answer to that I'd be wealthy and retired! It's really funny for me to reflect on this because while I was interning at NYU Medical Center in 2012, we were anxiously waiting to hear whether or not the Supreme Court would uphold the legality of the ACA. My classmates and I were in this text thread freaking out and wondering 'Well now what? This is such an important piece of legislation and so many people are going to suffer!' It feels like that again: there's a lot of uncertainty. While I'm not sure where it'll go, I know that, no matter what you feel about Donald Trump, he hasn't been the most forthcoming and there is no real idea of what his plan is to replace the ACA. To me, I cannot see a situation in which he would repeal the law without finding a way to ensure some of these people continue to maintain their insurance coverage. Once you give someone health insurance it'll be hard to take it away: that's why you haven't seen other countries do what we do.
Q: Any advice for us here as students? Is there something we could be doing to help prepare or educate? May something you feel we are not getting in classroom that you think would have been great?
Well, I'm not sure anything will prepare you for whatever Trump has in store! But, I am a bit biased in thinking that one of things the program lacked while I was there and perhaps still may, was the HR piece of the education. I took a class called Managing People (HMP 643) and HMP 603 that I felt were really beneficial to my education, but I would say you should make additional room in your curriculum for classes that address 'what it's like to work in the workplace'. When I worked in the provider setting, these types of classes became very helpful as they addressed what is unique about people and workflows, what doctors do, what nurses deal with, unionization, etc. Really even a survey course would be helpful. Again, I'm biased but I feel it's a really important and have made it a point to address these at Alumni Board meetings.
We're the best here in Michigan, we know that. We look and focus on the technical skill piece and we're so great at teaching and learning that. We get the hard skills, but the softer skills would be something I encourage students to continue to focus on because that's what is going to be the separator for you as you enter the workforce. Joe Horton's class is great too so you should be looking forward to that. It will get you thinking about how to apply what you learn in your other classes to specific cases that can and will happen to you during your career.
Q: You recently transitioned to Witt/Kieffer after having spent some time working in the provider side. Do you think that your roles with providers prepared you for the transition? What was motivating factor?
I initially had administrative fellowship with Hartford HealthCare and had a lot of exposure while there. By the end of my time there, I was working in the medical group, mostly with doctors. I found that I really enjoyed working with them: they are interesting stakeholders within healthcare when you stop to consider their priorities. As much as we administrators like to think of ourselves as the driving force behind the success of the health system, that engine is, and will always be the physicians. This only became more obvious after my fellowship when I took a job at Yale-New Haven Health System's employed physician enterprise, Northeast Medical Group – I started to watch this collaboration between administrators and physicians and felt that [providers] were the future; either when considering care, or the focus of health care, or even the leadership type. That being said, [administrators] need to learn how to work with physicians...so again, I'm tying in the softer skills. We don't have medical degrees but we still work together, and should effectively do so to produce results.
My time at Northeast Medical Group was spent working on projects that focused on development and acquisition for the [medical] group. The dynamic between the university's faculty practice and our health system's employed community physicians was particularly interesting: this relationship had a lot of overlap but also posed some interesting challenges to the work that I was doing. During this time, I was beginning to think about executive search but didn't know anyone who did this. I started chatting with some contacts of mine. I thought it could give me a chance to do the types of things that I loved about my role with Northeast Medical Group, but on a national level. So, after a few conversations and an offer, I made the transition. I was happy where I was but even more excited for this opportunity--and I think that's an important place to be at.
Q: So tell me a little more about your current role?
I currently work with an executive search firm. Our firm only works with healthcare, higher education and nonprofit organizations, and again, I work with physicians only. My job is primarily to identify physician leadership candidates and assess their potential fit with our client organizations. Much like with these physicians, I strongly believe finding your 'fit' is the key to happiness and success: I did with grad school, I'm guessing you did too, and I think professionally it should be the same: finding your fit. I think that's why I like this job so much – because of the importance of 'fit.'
Q: Any final advice to students and fellow wolverines?
So my final piece of advice to current students is this: don't let your classmates stress you out. I've said this a lot but you are at the number one program and are all extremely intelligent. You may study differently but you perform effectively on tests. If a classmate is worried about an exam or assignment, that does not mean you need to have the same mentality... that being said, it goes both ways: don't be that person who puts unnecessary and unwanted pressure on your classmates. Enjoy your time in school: learn the material but enjoy your classmates.
During my time in HMP, I noticed that the difference between us and other schools here is our collaboration and the cohesion among classmates. I've heard other schools where students were very competitive to the point of not helping. Be teammates, and help each other get through this. Keep telling yourself that these will be your future colleagues and the people you go to with questions. Support one another and make the most of it! The Michigan Difference and the Michigan Mafia is really a thing--use that to help you during the program, help you with internships, and help you grow. Being an HMP alum means a lot in the workforce and both your professors and the alumni want you to do well.
Thanks to Dan Dimenstein for taking time out of his day to discuss a wide array of topics. We will be back in 2017!
Marianthi N Hatzigeorgiou is a first-year global HMP MHSA candidate at University of Michigan, Ann Arbor. When not studying class materials or working at the Center for Value-Based Insurance Design, she enjoys spending time with her cohort and friends, drinking coffee, and planning future travels.
A Conversation with Steve Merz
This week, I had the pleasure of sitting down with Steve Merz, President and CEO of Maine Behavioral Healthcare, President of the University of Michigan HMP Alumni Association, and a 1995 MHSA graduate.
This is the start of an ongoing series where students (like me) conduct in-depth interviews with alumni (like Steve) and post the results. I hope you'll get as much enjoyment out of reading the following excerpts about the successes of our fellow HMP alum as I did hearing them.
There were a few things I expected from the conversation. I was not surprised that Steve is a hard-working, passionate advocate for behavioral health care. Neither was I surprised that he is no less an advocate for the Michigan difference. But there were more than a few things that did surprise me: the cyclical nature of the health system, the challenge of creating an integrated mental health network, and his advice for work/life balance that goes well beyond the credo of "be present" wherever you are.
J. David Fife, MHSA Candidate, '18
Q: What was the HMP program like when you were a student? What was your Michigan experience?
"I came to Michigan because I was convinced that a program grounded in a school of public health and focused on the general health of the community was the future. I came in at a moment in healthcare that was really interesting. President Clinton had recently been elected, and healthcare reform was a major initiative. In fact, it was controversial to have a first lady take on the type of leadership role that Hillary did.
Many HMOs were winding down, physicians were starting to take on more risk, capitation was increasingly accepted as a payment for total cost of care. Systems were purchasing physician practices and Medicare Advantage and Medicaid managed care options were changing public insurance programs.
So, really similar to today. And Professor Hirth, my faculty mentor [and current department chair], also taught his first course to my cohort."
Q: How did you begin to gravitate towards the mental health space?
"By chance, really. I began working at Yale New Haven Health as an administrative fellow after graduation. I worked for the COO of Yale at the time, Marna Borgstrom [currently the system's CEO], and she has mentored me throughout my career. I worked on a variety of projects as a fellow, and it often came down to tackling the challenge of the day and "making lemonade out of lemons".
One of those projects involved the psychiatric hospital. It had been losing money for years, and we were considering shutting it down. However, this would have left the community without a significant kind of care it needed. I wrote a plan, consolidated services with other hospitals, and ended up running a major consolidation effort as a 20-something administrator.
That began a career at Yale-New Haven that gave me a wide variety of experiences and eventually the opportunity to lead the Psychiatric Services service line."
Q: Why the move to Maine Behavioral Healthcare?
"It was an opportunity I couldn't turn down. In 2014, Spring Harbor Hospital, previously a freestanding hospital, had merged with 4 CMHCs [Community Mental Health Centers] with the aim to create an integrated mental health system, and I was recruited to lead that effort.
There are many challenges to merging 5 organizations, and that all happens while still dealing with the particular challenges that mental health care faces across the board. For example, a major challenge right now is that the evidence for what works in terms of clinical outcomes and lower costs is clear, but the reimbursement system lags behind that evidence. We have to determine how to build programs that support needs in our community when reimbursement models are still tied to fee-for-service and there aren't many incentives for improving mental health.
A comparison helps show the difference. If you have broken leg, the health system will pay for your treatment, therapy, crutches, and anything else to get you back on your feet. If you have cardiovascular disease, we'll pay for your pills, a variety of treatments, and even expensive rehab services just to keep you out of the hospital.
In behavioral health, it's the opposite. A family history of drinking or depression generally won't qualify you for insurance-covered preventive services, or you will have a limit on what you can receive until you actually hurt yourself or are in the hospital. You have to demonstrate that you have an active illness rather than having the system pay for services that can prevent you from falling into that risk in the first place.
Despite those obstacles and parity laws to stop this discrimination, we're proud to work on innovative ideas, like the Glickman Center for autism and working for early identification of psychosis with the PIER program.
There are huge and compelling needs in mental health, like the recent opioid epidemic. At the end of the day, organizations like ours are the ones who have to determine how to tackle these problems with a community mindset and new ideas that respect the bottom line and wrestle with these reimbursement and resource constraints.
That's the Michigan difference. With my training, I'm prepared to lead an organization that wants to do better than the people who came before. People are expecting us as leaders to, even if we don't have the answer, still come up with the right questions. Right now is a key time in healthcare. A huge opportunity. The economy is depending on us; the country is depending on us to figure this out."
Q: With that kind of professional pressure, how to manage to balance professional goals with personal ones?
"One thing they don't teach you is that healthcare is an industry that requires a large time commitment in order to lead. We truly are 24/7, 365 days a year industry. Some of that is also driven by the way healthcare works. If you want to meet with physicians, you either have to meet early in the morning before their rounds or late in evening after they close their offices. That can make for a long work day, and work-life balance can suffer as a result.
I didn't have great work-life balance early in my career. Later, I tried to separate work from non-work effectively. When I was at work, I worked liked a maniac. When I was home, I played like a maniac. I was putting in as much energy playing as I did working. And that's made a difference in my life and the lives of my family."
Q: Any last advice for fellow alumni? Students?
"For alumni: Mental health touches every cohort, every disease state, every community, and every organizational level. If you haven't looked for wins in your organization by managing mental health more effectively, look into it!
For students: Find a mentor wherever you can. Mine was very meaningful to my development. Tackle any hill that comes your way. Jump into any project. You never know which path will lead you where you want to go."
A huge thanks to Steve Merz for taking the time to share his thoughts. Check back next month for another fellow alumni interview.
Dave Fife is a first-year MHSA candidate at University of Michigan, Ann Arbor. When not using new knowledge from his first-year curriculum to prove all of his presuppositions about health care delivery wrong, he enjoys spending time with his family, his cohort, and his beloved Dallas Mavericks.