I had an amazing conversation with Mary Ellen Wells, hospital executive, who was a wealth of knowledge on a topic I knew very little about before speaking with her. Between growing up with my mother and now living with my wife (both surgeons), I have had many discussions about working as a physician in a hospital setting. I have not had the same opportunity to examine the administrative side of working in a hospital. Given this, Mary Ellen was a wonderful resource having decades of experience working in Minnesota in many roles: as a CEO, board member of a top-ranked Masters of Healthcare Administration program, administrator at a major healthcare system, and much more. Over the course of our conversation, Mary Ellen educated me on her perspective around many topics relating to healthcare administration, including how doctors can work more productively with administrators, and how young doctors can get more involved in hospital decision making.
We all know doctors are very smart, hardworking people. Many could probably do a lot of the work both Mary Ellen and I do for them if there was enough time in a week. Nevertheless, our jobs exist to help those who work so hard to heal others. As Mary Ellen said at the onset of the conversation, blood and guts may not be for us, but we value the work that medical professionals do day in and day out. It is our job to help medical professionals work efficiently, both in their careers and at home, to achieve their professional and personal goals.
I would encourage you to listen to full interview of this episode of ‘Planning on Call,’ the podcast, here:
Follow the links below to listen to The Atlas Advantage on Apple Podcasts, Spotify and Libsyn:
Mary Ellen’s path was somewhat relatable to me – as she knew she wanted to help people but also knew that being hands on in human biology and invasive procedures was not the route for her. Unlike me, as a woman plotting her career in the mid-1970s, she felt there were only a few clear paths laid out for her – being a teacher, social worker, or nurse. She spent the first part of her career being a teacher, but after some introspective analysis, she found that was not the path for her. This led to the first big piece of advice shared by Mary Ellen… that everyone should take an opportunity at some point in their career to evaluate if they are on the right path. In her words, take time to ask yourself, ‘what is my core purpose? Am I achieving my core purpose?’ This introspection brought her into the world of hospital administration, where she felt she could help healers through the process of healing organizations.
For Mary Ellen, her route into administration began with earning her Masters’ in Healthcare Administration (MHA) from the University of Minnesota. She is an advocate for pursuing an MHA if you are interested in the administration side of the field. She did note that if you already have a background in medicine, getting a Masters of Business Administration (MBA) is also a route that works. In her experience, these days a rise through the chain in the world of administration is difficult without one of these, but not unheard of.
Similar in some ways to my job as a financial planner, her job revolves around goal setting and planning. Ultimately, it has been her job to chart paths for hospitals and healthcare systems by creating efficient teams and processes to achieve the designed goals. Due to the ever-changing landscape that is life, she likes to think about all of her goals in 3 to 5-year increments and relies on the ‘dyad management model’ when constructing teams within a hospital or healthcare system.
The dyad management model teams a business-oriented individual with a doctor to create functional processes within a healthcare system. Under this model as Mary Ellen explained it, each individual focuses 80% of their time on what they do best, so for an administrator that would be on business and for doctors that would be clinical. The other 20% of the time is where this team connects. From an administrative standpoint, this means doctors will handle many of the delivery and best practices decisions, while administrators handle many of the systems like billing, scheduling, and advertising. Where they meet relates to the big picture issues within a hospital-like culture and strategy.
To me, this makes a lot of sense. Whether it be in a marriage, friendship, or hospital, disagreements on the little things are natural and omnipresent. You can overcome adversity, in most situations, when individuals agree on the big picture, on their core values. So even in a situation where neither administrators nor doctors have all the answers, together they can come closer. This is how a management model based on the output of two people (dyad), many times ends up producing more than their mere sum. I’ve linked a visualization Mary Ellen provided on this management model.
Seeing this play out in hospitals today, Mary Ellen is encouraged by the new generation of physicians that seem to a have broader and deeper array of knowledge when working in teams. She attributes this to perhaps more socialization, as well as earlier training on the importance of teams. This is even more important as private practice groups become less able to do it all on their own due to the increase of physician specialization and the interconnectedness of large systems.
Another piece of advice she shared for doctors working with administrators – stop calling administrators ‘them’, and start considering the organization as a whole ‘we’. Communication between doctors and administration is so important, so both listening and vocalizing ideas is extremely important for young doctors in dealing with administrators.
What are administrators doing that doctors need to inform themselves on? For Mary Ellen, the answer is found by dissecting the question itself with a series of her own. Her approach begins by asking… how does one get a hospital to work? There are many small details that need to be in place every day for a hospital to run, and to remain financially viable. Her example of one such detail is what goes into the determination of how to get enough PPE masks to run the surgical department of a hospital. The answer to that question relies on a number of variables. How many surgeries a hospital expects to have next week, next month, or even next year? What types of surgeries will these be, using what instruments? How much revenue will those surgeries generate? How many nurses does that require? Which ORs do they require? How much do we expect to pay for masks? Working all this out is some pretty complex logistics, all stemming from the simple question of ‘how many masks should a department purchase?’
Mary Ellen believes her core job as an administrator is to make sure doctors, nurses, occupational therapists, and other healers, within a hospital system can perform their jobs as efficiently as possible. Ultimately, the goal should be to take care of as many people as possible in the most economical and equitable way possible.
If you are a young physician and hospital administration or leadership interests you, Mary Ellen shared additional tips on navigating that path. Get good, really good, at your job as a physician…do that, and people will follow you. Once you have established yourself in this role, then reach out to try to take on more administratively. Start with trying to sit on committees and talking to the administration about getting involved in shaping things like best practices and quality controls – especially because doctors are the ones actually doing many of the things these policies affect. Mary Ellen is a big fan of the American Association for Physician Leadership and recommends looking into this organization for physicians interested in getting more involved in administration.
One last question that I wanted to gain additional perspective on was what she foresees for the future of healthcare and how the changing landscape might affect future physicians. Mary Ellen sees hospitals moving away from being the site of practice, and operationally, moving towards integrated delivery systems. Hospitals will still be important, but they will be one piece of a much larger system. She anticipates we will also see more technology, more robotics, and even more telemedicine. In her long, career she’s seen tremendous change. Her largest take-away over that time has been… that both successful physicians, and successful people, in general, have the capacity to change. So no matter where the future of healthcare goes, be ready for change.
To conclude our discussion, as I have in the past, I asked Mary Ellen for her best piece of advice for future physicians. She was nice enough to give me a two-part answer. The first piece of advice was reiterating the importance of being able to adapt and change. She paraphrased a quote that many times has been attributed to Darwin, indicating that it’s not the smartest of the species that survive, nor is it the strongest, but those that survive (and thrive) are the ones that can adapt and change. I thought this was very telling, and again says a lot about what she thinks of the healthcare industry moving forward.
Her last piece of advice is one I have heard before – learn how to establish a healthy work-life balance. If you are a young doctor deciding where to take your career next, be sure to do your due diligence when seeking an organization to work for. If an organization steers clear of identifying examples of work-life balance in their culture, know that you may be getting yourself into something unhealthy. In her career, Mary Ellen found it important to understand her personal flags or triggers, which indicated when work was taking up an unhealthy amount of her life. As an example, a personal red flag for her was gaining 10 pounds, highlighting the disproportionate amount of time spent at work versus the gym or other personal outlets. Understand your own, noting it can be different for everyone.
For additional leadership resources please check out these resources Mary Ellen suggested…
https://www.physicianleaders.org/
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