Leading Growth in a Niche Delivery System

The Future of Women and Medicine

INTRODUCTION:
You’re listening to Tiller-Hewitt’s Leadership Lens Podcast. If you’re a leader - or an aspiring leader - who wants to stay relevant and impactful… YOU’RE IN THE RIGHT PLACE.

At Tiller-Hewitt we believe it’s faster, smarter -- and less painful -- to learn from leaders who have walked before us. That’s why we invite top leaders to be our guests on the Leadership Lens.

Your host is Tammy Tiller-Hewitt – Founder of Tiller-Hewitt HealthCare Strategies. Let’s jump into the podcast.

TAMMY:
My guest today is Cameron McGregor the Chief Growth Officer for Ms. Medicine. This isn’t Cameron’s first executive role. In fact, she shares her experience leaving a senior system-level executive role in a large successful health system to be a part of this innovative women’s healthcare start-up. Cameron has some very thought-provoking answers to my leadership questions. Perhaps one of her best was the warning signs of when an organization is getting close to running off the track. As faculty at a local university, teaching future healthcare executives, Cameron shares a very thought-provoking exercise she has her students conduct their first day in her class; an exercise all leaders should use with their leadership teams.

TAMMY:
Cameron McGregor, welcome to the leadership lens podcast. I can't wait to share your insights and maybe even more of your sense of humor with our audience.

CAMERON:
Thanks for having me.

TAMMY:
You bet. Cameron and I've had the privilege of working together on strategic growth projects at a couple healthcare organizations. She, being the executive on the inside and she bringing Tiller-Hewitt in from the outside.

CAMERON:
Yeah, we've gotten to work together at Premier and Mercy and then we've gotten to take it on the road with a few pretty cool association meetings.

TAMMY:
Oh, yeah, I forgot about that and in pretty awesome destination locations.

CAMERON:
Yeah, I just, thinking this morning that we've been to SHSMD, and AHA and American Association of Physician Liaisons and how I always get run over at the end where nobody wants to talk to me. They're all rushing to ask you questions so that they can bring you into their organization. And I'm just sort of like a left, you know, holding your purse.

TAMMY:
Yeah, whatever, whatever. I love how, you know, we've talked so much about liaison to leader and people are just mesmerized with how you started your journey into healthcare and where you are today. So, it's always so funny I want to tell everyone. Okay everybody close your mouth. Close your mouth now. I know she's the triple threat, but please close your mouth.

So hey, before we jump in, do you mind if I tell our listeners a little bit about you? Because I know you're way too humble to share some of the good stuff.

CAMERON:
Be my guest.

TAMMY:
All right. Well, Cameron has a track record for innovation and alignment of physicians and operational teams toward strategic growth goals. So, Cameron is currently the Chief Growth Officer at Ms. Medicine, which is a national practice model of women's health trained providers, innovating the delivery of women's primary and specialty care. And prior to Ms. Medicine stealing you, Cameron was the system vice president for Premier Health, where she directed strategy and growth for multiple markets. She improved quality and expanded neurosciences, spine and oncology. You developed and directed multidisciplinary operational teams to implement the system strategic plan. And as then, you were the system director of operational innovation, which I love that title. And really where you started your Healthcare journey was in nursing, but you really cut your teeth and healthcare leadership as the regional director of physician integration then recruitment at Mercy Health.

So, Cameron has a master's degree in nursing and health systems management from the one and only Vanderbilt University. She's a national speaker and guest faculty on healthcare management at Boonshoft School of Medicine. And she's also a fellow of the American College of Healthcare Executives.

In addition, to all that stuff. she's also a wife and a mother of three children, ages 11 to 17.

Cameron I'm so excited seriously that you're here because you are just a different kind of leader in terms of… Just first of all you’re brilliant. Secondly, when I talked about being a triple threat, I was serious. You just have this commonsense approach that people think, okay yeah, it was that simple, why couldn't I have thought of that? And then you just have, like unhuman kind of energy and just really conquer any challenge that's put in front of you. So, my first question is, did you always know you wanted a leadership role?

CAMERON:
I did not actually. When I started I was a critical care OB nurse and it was only a month after I had done that for a couple of years and worked for someone who was a nurse manager. She did not have a college degree. She was a postpartum nurse and was managing a bunch of labor and delivery nurses, which are completely different breeds of animal. And had no idea how to do our job, much less lead us. At that point I decided, maybe if I did my homework and learned a little bit more and went back to school, I could actually lead. But frankly staying in the nursing leadership roles was not going to be my path.

TAMMY:
So, what was it? Was there a pivotal point in your career or a defining moment that felt like an epiphany or an affirmation of a chosen path or your chosen path?

CAMERON:
Actually, all of my pivot points centered around meeting specific people. I'd never know it at the time, but eventually those would be the people that would give me the opportunities that would change my trajectory. So, some people like you, would have an immediate impact and others would take a decade or more. The takeaway from that is to treat everyone as though your career depends on it because it might. And you might not realize that until it's too late. But I guess probably my biggest actual career pivot was my last one. When I went from a two-billion-dollar health system to a startup. That was an enormous change and probably one of the best decisions I ever made because from a skill-set perspective, it was night and day. And essentially, I started over in my early forties with an entirely new set of rules, regulations, and goals, which was a challenge I'd really didn't know I needed, but it's one I have absolutely loved.

TAMMY:
So that was a huge, huge step that you took leaving a huge organization. So, I get that it was a pivotal point. But wow, where did you get the chutzpah to do that. I mean that was risky.

CAMERON:
It was very risky. I think it was not so much chutzpah, I think it's burnout. I was really tired of doing the same thing every single day as I had done for years and years. And I had an amazing career with Premier. They were very, very, very good to me. There's no complaints there. But from a health system perspective, I'd kind of worn it out. Like, I just had kept seeing the same problems and it wasn't specific to that particular health system. I was seeing it across all health systems because we were encouraged to interact with other leaders. And certainly, in conversations, Tammy, you and I were having where you're interacting with so many other leaders. It was the same themes over and over and over again. So, the opportunity presented itself and in that moment, I think I was just I had reached a point that said this is what I need to do. And it was incredibly scary because as you know ninety-percent of startups fail.

TAMMY:
Well, I'm glad that you did because I love all the stories. I mean, their gain was definitely Premier’s loss. Talking about leadership challenges, what do you think the top leadership challenges are today, both professionally and organizationally?

CAMERON:
You know, it's funny. It's probably been the same answer that for decades right up until 2020 hit. And now I'd have to say it's labor in general across all industries. For the first time in a while, I can talk to leaders in any field, any industry, whether it's manufacturing or banking, and we're all saying the same things. We can't really find people. And the people we do find are not only very expensive, but they come with a big list of wills and won’ts. Like people don't want to get dressed for the office in suits anymore. They don't want to travel. They don't want to work 5 days a week in an office setting. They want flextime. And women specifically females, that's an entirely separate topic. We're starting to see something that's a good friend of mine actually, who I met in the field coined, the great she-session. Where women are leaving the workforce at an alarming rate and we're going to create an even bigger problem in our labor market if we don't figure that out quickly

She coined this term, she-session and it's true, you know the news media is all over it with labor. But specifically, people are looking at the female leader role and women are leaving the markets to stay home and to just be more around their families. I think if Covid taught us nothing was that life is fleeting and maybe your career isn't the end-all-be-all.

TAMMY:
So how are you facing those challenges and dealing with them?

CAMERON:
The great news for my organization, is that we are female-led and most of our teams are females. We do have a couple of guys that work with us who are great sports and our providers with the exception of one, are all females. So it was really developed around the central notion that women in healthcare are not small men. And that we have unique healthcare needs outside of our reproductive needs. And so, everything from how our bones break, to how our brains age, to how our hearts present with cardiomyopathies and other heart attacks, is all very different down to a molecular level in women and we need primary care and other specialists to address that instead of treating us with drugs that have been tested on, not only male cells, but male clinical trial subjects, and then pushed over to the female side of the market. Ambien is a great example of that. If people are familiar with that drug.

Ambien came on the market and the 10 mg dosage for all. Turns out that women don't metabolize it well and the max dose for a woman is really 5 mg. So, we were double-dosing women with a very powerful sedative. And these were women who were getting up in the morning and going to court cases and brain surgeries and driving their kids to school and doing all kinds of things, who are still under the influence of a scheduled drug. And they were unaware that they were still under the influence. They thought they had were sober when they woke up in the morning and they weren't. And that just goes to the research and how research is done on men for lots of reasons.

So, our challenges are a little different in the sense that we created a health system specifically for women. And our providers are female and so we haven't encountered quite the same She-session, but we certainly have our eye on it because it's affecting our patient population for sure.

TAMMY:
So, thinking back outside of now that you've created a health system for women when you worked with a health system that wasn't created just for women - so back to Premier or Mercy - I don't know if you're talking to any of your colleagues, but knowing that we have listeners on the line, the majority of them, the vast majority of them are not from a health system for women…. Any advice you would give to them?

CAMERON:
From a labor perspective, I would say that mental health for our healthcare workers is absolutely a challenge like never before. You know, for a lot of people healthcare is a calling. But even the most hardcore of us were knocked off balances by the challenges we faced with Covid. Healthcare workers and certainly first responders see things and hear about things all the time that the average person will never know. But we kind of go into our fields knowing that, however, to be at the center of a mass casualty event every day for almost two years is really almost unfathomable and it has taken a toll, to put it mildly.

So, we're going to need to change the way we approach the healthcare labor field entirely. We're going to need to start meeting employees where they are, in a way we've never had to before and we're going to have to put safeguards in place around the mental health and well-being of our employees that I'm not even sure we've dreamed up yet. But the first system that does do that will certainly win all the prizes. And more importantly, they will get all the talent.

TAMMY:
So, you're saying mental health programs for the employees themselves?

CAMERON:
Absolutely. So, between taking care of them and just acknowledging that this is a problem and proactively engaging to prevent it from becoming something that causes an employee to leave healthcare entirely. I mean, it's bad enough when they're leaving your system. But to have them abandon the industry that they love because they just can't do it anymore is a huge failure on all of our parts. We're actually the industry that's supposed to be responsible for getting everybody healthcare, mental health coverage, and mental health care and yet our own workers are leaving it at an insane rate. And largely citing the fact that they just can't do it anymore. It's too big of a risk. It's too big of a challenge. It's too big of a load to bear for them.

TAMMY:
That's very interesting. A really good perspective. We've heard a lot about burnout. We've heard a lot about just the crisis itself and at what everyone had to face and see and workaround, you know, well health care workers were spending hours and hours at work and maybe even contracting the disease while other industries were bragging that they're getting to spend so much time with their family. Well, that wasn't a luxury that healthcare workers, especially the clinical side were able to enjoy.

What do you think the warning signals are when the organization is getting close to running off the track?

CAMERON:
I think each organization has canaries in the coal mine and that looks different for everybody. Generally, what we see and my expertise is really physician relations, so I would use them as my frame of reference to say when our physicians stop talking, stop complaining, stop showing up to meetings, stop coming into the CEO's office and just sitting down and shooting the breeze. When that stops, you have a big problem on your hands. Because as long as people are talking, even if they're not saying things you want to necessarily hear, even if they're being what some might label negative, at least they're talking. When they stop talking, it's apathetic, right? So, the opposite of love is not hate, it's apathy. It's indifference. So, the opposite of engagement is not disengagement. It's just apathy. It's not caring anymore. It's actively sort of moving away from having an opinion.

So, if your medical staff or nursing staff or whomever your direct reports are, if they start getting quiet - in any way, you're running off the rails - in fact, probably already run off the rails. I mean, oftentimes, we don't notice until the loudest critics stop talking. Well, by the time they stop talking, it's done. It's over. It's time of death. But it's when the quieter people sort of just let go because they just can't care anymore. Then you have a huge problem.

TAMMY:
That's good. That's super good.

You know that Tiller-Hewitt works with organizations that want their leaders to consistently deliver strategic growth and measurable results - what are your secrets and success strategies around strategic growth or smart growth?

CAMERON:
Yes. I do remember having that hammered into me from a young age with you. I think our set, what we call North star about 20 or 22 months ago. And so, all decisions are run through the filter of does it increase providers and does it increase patients? And if the answer is either no or yes, but indirectly - then we don't do it. I get to teach a leadership class on high-performing teams twice a year for MBA and MHA students and we do a quick exercise that I have everybody stand up, cover their eyes and point North. And every single time when you uncover your eyes, people are pointing in all different directions.

So, we know that North is obviously an agreed-upon objective direction. It's the same no matter where you are in the world. But yet, if I just tell people to go that direction, everybody's going to go off in a different- what their version of or what they think is North. So if a leader says, hey our goal is company growth, that's entirely too ambiguous. Growth of what? Volume, revenue, net revenue, gross revenue, market share? What is it that you're asking them to grow? And I think that's a huge mistake that a lot of people make is these sort of large growth goals, but nobody actually knows what it is they're going to be judged on in the end and we leave it to be way too ambiguous. So defining the North star, making sure everybody is very clear on what that is, and running every single question of do we start this program? Do we end this program? Do we bring these individuals on? Run it through those filters, and if it doesn't come up as resoundingly YES, it's going to help us get to the North star, then the answer is, you don't do it.

TAMMY:
Yeah, that's good. That's, you know, not all business is good business.

Well, let me ask you can you describe a time which you're such a great storyteller, so I can't wait to hear your answer on this, but can you describe a time when you were terrified as a leader?

CAMERON:
My career path has been nothing close to traditional for a nurse, nor has it been linear in the sense that like one job hasn't built on the one before it. So, when I start as an imaging liaison where I worked with you, for the first time I had just graduated from my master's program, super green, and my entire working knowledge of radiology was a cross table C spine. Which I don't actually think is a test by the way. That was it. And then, I had to learn the entire thing like it was a foreign language and then fast forward several years, I had to do it again when I took over the neuroscience service line. I did not know there's a such thing as something called a functional neurosurgeon, which is basically a neurosurgeon who specializes in movement disorders, and then there's epilepsy and whatnot. I was like functional versus what, like non-functional like are we talking about? If you guys can get out of bed in the morning, I'm not exactly sure. So, my Google search history for those periods of time, I wish I had been able to keep because between all the research and actually going into the OR or IR suites with these physicians is how I learned. And I was really, really lucky because as scared as I was I had nurses and physicians around me all the time that were willing to teach and were so good to me. That was key in helping me kind of get over my fear. So, I did it and every time I did it, it gave me enough confidence to say yes to the next thing until finally I got to the point, whereas you mentioned, I took the biggest risk of my career a couple of years ago and just said, yes. And so far, it has not failed me but I'm trying to find wood in this room I'm sitting in to knock on because you know at some point that's going to run out.

TAMMY:
Well, it’s almost like being terrified was the fuel since I personally know you, I know how humble you are and appreciative you are when you tell the story. But now I've gotten kind of the front row seat along the way in a couple of times that it's just you were never afraid of the challenge or doing the hard work and I think people see the, you know, see the stage presence, and they don't know what all you did in the background to prepare yourself for that. So for some of the listeners here who are aspiring leaders, I never want anyone to walk away and feel like, well, you're just are a natural at this job or that job and it comes to you naturally. I mean, I really want you to emphasize the work that you had to do to earn your place and with each roll.

CAMERON:
Oh, I hustled. I mean I hustled. Even doing something like when you and I speak Tammy, I spend hours preparing because I'm a natural introvert. So to find words and put sentences together can sometimes be a challenge for me if I'm put on the spot. I do so much work in preparation for anything I do. There's nothing I feel like that comes naturally to me. I can make a joke, like nobody's business but that's not always a gift. But I have never made the mistake of walking around with the blazen words, like I'm a big deal. I am not a big deal. I work my tail off for the knowledge that I have and I am nothing if not incredibly grateful and humbled by the people who have given their time to me to teach me. I mean, these are really busy people and I think of some of the names that I've gotten to stand next to in an OR or as a nurse or whatever.

In fact, I just reached out, I didn't tell you this Tammy, that my mentor from when I first started in nursing, her name was Marlene Harris at University of Alabama at Birmingham, and I didn't know it at the time, but she had hand-picked me to come in based on just my resume from nursing school, which was awesome, and got to do all these amazing things and I just emailed her. I like hunted her down with my incredible stalker skills found her address. She's eighty-three years old, and I found her email address and wrote her an email, which she has not responded to yet by the way. But I'll write her a note too just to say thank you because I still use stuff she taught me about how to be a leader and that was like twenty-five years ago. And I just wanted to say thanks and at 83 she deserves to know there are still people out there like teaching, like bringing her legacy along with them. It's not my legacy, it's Marlene’s and she had done everything in that hospital. So, it's important to go back and say thank you.

TAMMY:
How do you pass on important lessons that you've learned that you can also leave a legacy that people are emailing you, searching and stalking you down when you're eighty years old?

CAMERON:
Well, I'm really lucky to be on the speaking circuit with you, and for healthcare leaders, but I also get the opportunity to teach those students that I talked about earlier and at the end of my lecture when it's an open conversation, then they can ask me anything about my career, my leadership path, etc., it's my favorite part because it gives me insight into what they're thinking about and what the next of generation of leaders wrestling with and, and that's really an opportunity for me to pass along all the lessons I've learned and certainly any time something reaches out to me and asks, for my time, the only thing I asked in return for that is that they're prepared when they come to me. That they don't just sit there and they're like, hey, tell me about yourself. Well, you can do a lot of research on me and figure out who I am. I'm not here to spend an hour like that. I want it to be an impactful hour. I mean people are asking you all the time like you, jeez I can barely get you to return a call for God's sake. People want more of your time than you have and so, but I'm happy to give it, I pay it forward because Lord knows people certainly pay it forward to me.

TAMMY:
Yeah, so if someone was listening again, if you have listeners who are aspiring leaders, is there a tip that you would give them if they're wanting to speak to a leader, what would you recommend that do?

CAMERON:
I would recommend they be prepared. Approach that leader with a very specific goal in mind. Hey, I'd love to sit down and talk to you specifically I want to know XYZ, tell me that you've done some research on me without, like, scaring me and making me feel like I need to have security present. But also let me know what you want from me so that I can have a chance to prepare I kind of like to know what I'm getting into a little bit.

TAMMY:
What factors influence your hiring decisions. What are the most important traits to look for when hiring a new member for your leadership team?

CAMERON:
Authenticity hands down. When I started my career in the nineties, health sciences was like a really male-dominated field. I mean it kind of still is but it was modeled for us that being soft was not an ideal trait if you wanted to move up the food chain. But you know, as it turned out that was a big fat lie. So, look I can teach just about anyone the textbook skills to be a leader. I mean, most of us can. It's not that hard. But what I can't teach you is how to show up and how you feel to others because people innately connect on levels that are different for everyone but the IT factor for all of them is are you real? I think the technical term is vulnerability or organizational agility or something fluffy like that. But essentially, what I want to know is, are you willing to be open and show me your flaws and your soft side which essentially signals to me that you trust me not to take advantage of you in the moment in which you're most vulnerable and that exchange of power is really key. And it's the thing, the least number of leaders I know really understand because the most powerful people in an organization are the ones that give it away. Those are the people that really hold the keys and the one I want on my team. Everything else is teachable.

Premier deserves a lot of credit on their leadership training with a company out of Columbus, Ohio called Gestalt, which was led by the late Norman Shub. And this group was brought in, I think it was a group of family therapists really and they became organizational leaders. But they taught us all how to communicate better with each other across multiple levels of the organization. And there are people who loved them and people who didn't love them and that's totally okay and understandable. But bottom line, end of the day, even the most fervent naysayers had to agree that we learned levels of communication and business partnerships that not many people had access to. And it was hugely impactful on just the leadership structure of the organization in general and really the stability of the leadership in the organization. It was imperfect. All organizations are imperfect. But certainly, just having that sort of investment in your leadership development, was a huge gift and one that I have taken outside of that organization as well. And it turns out that in multiple places I've run across his teachings since then. Even through my own husband who was taught inadvertently through a student of Norman's.

TAMMY:
If you would, I would love to have you back as a guest to really just talk about that leadership development because I love how you talk about when you're being identified for advancing within the organization, some of how the program works in terms of people who support you, that you don't even know are supporting you or not. So, if you would I would love to have you back for that

CAMERON:
Of course. For you, anything.

TAMMY:
Awesome. I can't believe that our times already up before we end, can I fire a few questions at you that we refer to as the rapid five wrap-up?

CAMERON:
Sure.

TAMMY:
What are you currently reading?

CAMERON:
When Breath Becomes Air. It's an autobiography about a neurosurgeon who was diagnosed with lung cancer.

TAMMY:
What words or mantra do you live by?

CAMERON:
Some women fear the fire, some women simply become it.

TAMMY:
That's powerful. How do you start your day?

CAMERON:
Oh, I wish I could say exercising, but it’s I log into my phone, check my email, texts, The Daily Skimm, which is world news in 60 seconds, and Instagram - not necessarily in that order.

TAMMY:
What's the most important characteristic of a leader?

CAMERON:
Be authentic.

TAMMY:
Okay. And one word or piece of advice, you would give to your younger self.

CAMERON:
If you think this is good, just wait until 44.

TAMMY:
Oh! That's good. That's there's a good story there.

Well Cameron, again, thank you so much for being a guest on the Leadership Lens and I look forward to you coming back and talking to us more about leadership development. Thank you so much.

Cameron:
Absolutely. Thanks for having me.

CLOSING:

Tiller-Hewitt works with leaders who want to consistently deliver strategic growth and measurable results.

The organization is recognized as the leading experts in strategic growth, network integrity, and physician engagement. Thanks for listening to this episode of the Leadership Lens. For more leadership resources and strategic growth solutions, visit tillerhewitt.com.