AVIA expert spotlight: Sarah Carroll, Director, Center for Care Transformation
This year for Women’s History Month, we sat down with AVIA President and CEO Linda Finkel, and AVIA Executive in Residence Ninfa Saunders, former President and CEO of Navicent Health. The two healthcare veterans shared their experiences navigating the industry, offered perspectives on what makes them excited about healthcare today, and gave advice for women looking to advance in the field.
Ninfa Saunders: I grew up in the Philippines in a small town, and we lived close to the hospital. My family was mostly in the medical field. Every day I watched a nurse walk up the hill ready to embrace life as a nurse. In the afternoons, I’d watch her go home, looking just as she did in the morning. I was told that she was a great nurse and was well respected by her patients and colleagues. So I just knew this is what I wanted to be! I wanted to be a nurse. My heart still belongs to the nursing field in healthcare.
Linda Finkel: My father was an entrepreneur. As we lived that journey with him, I always knew I wanted to run a business. I just didn’t know what kind. At 29, I began to run and grow the first of several outsourcing businesses, public and private. While I loved the work, I did get to a point where I wanted “what we did,” not just “how well we did it,” to really matter. Then life happened and my family began a six month journey in our healthcare system that changed my career forever. I saw the best and the worst…and knew I wanted to engage.
Ninfa Saunders: Healthcare tends to be transactional. In the last 15-20 years it has moved from transactional to transformational. 15 years ago, healthcare wouldn’t look outside of the hospital industry to get lessons learned. Most recently, we look to Toyota for Kaizen, GE for Six Sigma. We are better learners and better adopters. We’re not laggards anymore. We may never be early adopters, but we’re working and embracing. What’s exciting is our outreach to learn more, to disrupt our current space, and to get to a new age in healthcare.
In the last 15-20 years [healthcare] has moved from transactional to transformational... What’s exciting is our outreach to learn more, to disrupt our current space, and to get to a new age in healthcare.
Linda Finkel: Impact and progress keep me excited. We had already seen an acceleration in the pace of change and adoption of new care models and digital innovation pre-COVID. The pandemic did what little else could—forced change in virtually every aspect of care delivery and showed patients, consumers, providers and others what was possible. Of course, there will be some slowing as reimbursement approaches harden and as health systems move toward a business model that supports keeping people healthy. For consumers and patients, however, there is no going back.
The pandemic also ripped off the cover about health equity. It is impossible to deny the need for change and it excites me to do my part to enable the critical and broadly acknowledged change required here.
Ninfa Saunders: For me, inspiration is bidirectional. My parents have always been my inspiration. My mom and dad would say “Yes, you can.” In one direction inspiration comes from them. I’m always trying to be what I hope they wanted me to be. Every now and then I still ask myself the question, “Mom and Dad, how am I doing?” They had great advice for us before we went to college. No matter what happens, you must leave people and places better than you found them. In the other direction, inspiration comes from my children. I want to be the mother that inspires them in their values and authenticity, and also in their work. To that end, I’m always looking at them as my mirror. How am I supporting them?
Linda Finkel: I took a great deal of inspiration from the leader my father was—not a perfect one, but one who learned, grew, led with passion, fought hard to win, and changed a lot of lives in a lot of different communities in the process of building a great company. He did it with a great deal of integrity—and had a helluva time along the way. If you really knew me, you’d know that’s my inspiration and North Star. Being the leader I feel like my children would be proud of is that much more inspiration to walk the talk.
Ninfa Saunders: In addition to my parents, I have always felt deeply for the housekeeping people in an organization. They help show me what matters. Before anyone knew I was the CEO at Navicent Health, I worked with housekeeping and followed them around. If you want to know about hard work, scrub the walls and scrub the toilet. You do all this work, yet people don’t even know you’re there. You’re this invisible person. So if they can go through that, I can do it, too.
Linda Finkel: Role models for me are leaders who have the courage of their convictions in the face of challenging situations. In business, in life, in politics. People who are willing to see it through, willing to walk rather than do something they don’t believe in. They take risks in their careers. They’re people who are willing to live their values when it’s really hard. I’ve watched leaders do that well and not so well. It’s easy when things are great. It’s when they aren’t that people are tested.
Role models for me are leaders who have the courage of their convictions in the face of challenging situations. In business, in life, in politics. People who are willing to see it through, willing to walk rather than do something they don’t believe in.
Ninfa Saunders: In the 1970s when I was starting to be in leadership, we were worried about the Queen Bee syndrome, the idea that when a woman gets to the top, they don’t want other women to follow them. I’ve seen that happen, it’s happened to me. Then in the ‘80s we were told you have a glass ceiling around you. And when you hit the glass ceiling you’re done. Fast forward to today, and there’s not a staircase or a glass ceiling anymore, but a labyrinth. So how do we navigate the labyrinth? Part of my job now is to look at those walls and shepherd other women through the labyrinth. More women today are happy to open opportunities for other women. They want to mentor.
In the past, I couldn’t push. Pushing was not an option. You were to be compliant. Today, young people are pushing the boundaries of the labyrinth and developing a new one that won’t be as circuitous but more straight forward. And we’re behind you, helping you.
Linda Finkel: In many ways, healthcare has long been an industry with unique opportunities for women and a particularly welcoming one—in health systems, digital health companies and payers. That said, as Ninfa could share, the path to the top can still be a challenging one. Often but not always, women have primary responsibility for raising their families, taking care of aging parents, and all that entails. That can force them off the path along the way, particularly when things go wrong. COVID has shown us the impact of that. At the board and executive level, women can still face issues of network and affinity. Are they known? Do they connect as quickly as a man might with a man? The issue is only greater for women of color. I do see a much deeper understanding of these issues today than even a year ago. I believe this heightened awareness and commitment to diversity at every level will be one of the gifts of 2020, particularly in healthcare where diverse perspectives can save lives.
Ninfa Saunders: Be directional. Be intentional. Don’t look at obstacles as “Okay, I’m done.” When somebody puts a cone to block you but you, you need to move it. Don’t wait for someone to move the cone for you. Get out of the car and move it yourself. Don’t have a conversation with the cone. Pick it up and move forward. Process it but don’t get stuck, just keep moving.
We’re a permission gender. Don’t feel helpless or hopeless. Charter forward and you will really find a path. You have as much right to get there as any other person, regardless of gender.
Linda Finkel: What Ninfa said! I couldn’t say it any better than she just did—in a healthcare career or any career. Be bold. Never let fear stand in the way of saying yes. Stop asking permission. Worry less about what others think. Move on from your mistakes. No one gets it right all the time. I don’t see men sweating their mistakes like women do. Most important, figure out what you want for you—and go get it.