Chapter 03: Learning the Complexities of Institutions; Balancing the Goals of Administrators and Physician-Leaders at MD Anderson

Chapter 03: Learning the Complexities of Institutions; Balancing the Goals of Administrators and Physician-Leaders at MD Anderson

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Description

In this chapter, Ms. Hay first reflects on how her role as a Patient Services Coordinator benefited her career. She developed a commitment to fixing the complexities and difficulties of institutions, prompting her to earn a Masters of Science in Healthcare Administration at Houston Baptist University (conferred 1999). She explains that she was awarded an Administrative Fellowship in 1999 and talks about the opportunities this afforded.

Ms. Hay characterizes MD Anderson as a physician-led organization. She compares administrators to physician leaders, noting the need for true partnership between the two groups/perspectives to make an institution work. Business goals must be adapted to the goals of clinicians and basic researchers, she explains, rather than overlaying business goals over their activities. She notes that MD Anderson can advance and grow because the institution has figured out the right balance in this leadership.

Identifier

HayAC_01_20150204_C03

Publication Date

2-4-2015

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Overview; Professional Path; The Administrator; MD Anderson Culture; Understanding the Institution; On the Nature of Institutions; Leadership

Transcript

Amy Carpenter Hay:

So, during that timeframe, really, it’s—I think a lot of my early negotiation skills came from being a patient advocate. Having to interface, basically, not only with the patient and their family, but also with the clinicians back at MD Anderson. So, I was—I was in the middle, and it was my job to come to a resolution in a way that was palatable to both sides. So, excellent experience, but it was during that time that I realized that that was not what I wanted to do forever. Great experience. Incredible opportunities. Allowed me to meet people—specifically, the physicians across this organization. I networked. Met every doctor that I could. Tried to continue to kind of be the go-to for them. That led me into thinking through my right position, which, as I worked through administrative issues and issues of bureaucracy and, you know, how tough sometimes it is for patients and families to work through this place, it became very clear that I wanted to help fix that. And while my role was important at the time, I felt like I could do more if I went back and got a great educational background specific in healthcare—healthcare administration and healthcare business finance. So, during that time, I applied to Houston Baptist University, just here in town. They have a Master of Healthcare Administration program. I picked HBU because they had an after-hours program, so I could keep my job and I could go to school every night from 6:00 to 10:00, Monday through Thursday. [laughs] and we did—I did that, and was able to finish the program in two years. And when I completed the program, I had a master’s in healthcare administration with an emphasis in finance. And it really pushed me to the next step, which was applying for the administrative fellowship at MD Anderson. And I applied for that and was awarded the administrative fellowship in 1999. And it was really another big growth for me. I was the first administrative fellow that was ever an internal candidate at MD Anderson. They’d never had that. They’d always recruited big, big names. You know, UAB [University of Alabama at Birmingham] has a strong program; Wash U [Washington University in St. Louis]; others. And Sherry Martin was in charge of this program at the time, so she knew me from early on. And I think she believed in me. And so, she gave me this unbelievable opportunity, and I took it, and I used it every single day. It was a really interesting opportunity in that they usually hire two to three administrative fellows. That year they hired two of us, myself and a young woman who is still at MD Anderson as well, which is interesting. Because in that timeframe, a lot of people were coming and going, especially at that age group. And she came from Wash U. Excellent background, excellent credentials. Really was, administratively, over nursing, and a lot of Wash U, just excellent, you know? But we had very, very different skill sets. I came from internally, so I knew this place, and she came from externally, so had a lot of experience. So, fantastic opportunity that year, really grew, and this organization worked.

Tacey Ann Rosolowski, PhD:

What do you feel was—what were some of the big lessons you got from that year, in that role?

Amy Carpenter Hay:

Mm-hmm. You know, big lessons were the complexity of MD Anderson, appreciating that because this is a physician-led organization, the complexity that is required in order to push forward our research agenda and our clinical agenda, I think is not always understood. I also had the opportunity, at that time, to work with a couple strong leaders. At the time, I was in between Kevin Wardell as the CEO [chief executive officer] and also Dr. David Callendar, who’s back in the system at UTMB [University of Texas Medical Branch, Galveston] now. So, really getting to see the dynamic between physician leadership and administrative leadership. And I think that was the first clear sign to me that, in order for MD Anderson to run as efficiently as it can, and to meet its goals, that it’s a combination of a physician leader and an administrative leader. And it’s not only a combination, it’s a partnership, and it’s working together in order to accomplish those goals. That’s not necessarily normal out there.

Tacey Ann Rosolowski, PhD:

How would you describe the differences in, you know, values and focus for physician leaders and then more traditional administrative leadership?

Amy Carpenter Hay:

I think, you know, quite frankly, on the physician-leadership side, they are physicians first and administrative leaders second. In this environment, that is the right approach—absolutely the right approach. And I think we had a great example of that between Kevin Wardell and Dr. Callendar. Kevin was a fantastic leader. He was business savvy. He’s gone on to do—and done fantastic things across the US [United States]. But he wasn’t a physician. And Dr. Callendar had a very different approach. He was a physician first, so he could understand the role and, quite frankly, the desires of the doctors and the basic researchers, and then adapt the business to it instead of coming something from a pure business perspective and attempting to overlay the clinical. That’s a huge lesson learned, and it’s one that I th—hopefully I’ve matured over time. Because one of the most important things here at Anderson is that, from a business perspective, we always—we have to make sure that we’re never ahead of the clinical perspective. We have to be working in tandem. And it’s easy to get that out of balance if you’re not very careful.

Tacey Ann Rosolowski, PhD:

Mm-hmm. But it seems like a real subtle dance.

Amy Carpenter Hay:

I think it is. It’s something that, I think, MD Anderson has matured over time, and really evolved. And it works so well, and it’s so important for the doctors and for the patients. Because without that balance, something is going to get disjointed. And so, that approach, I think, has been really part of why we’ve been able to grow and evolve as much as we can.

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Chapter 03: Learning the Complexities of Institutions; Balancing the Goals of Administrators and Physician-Leaders at MD Anderson

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