Interview with Dr. Nwando Anyaoku
In today's inspirational interview, Dr. Nwando Anyaoku teaches what health equity is, and how to pursue a career as a chief health equity officer.
Dr. Nwando Anyaoku is Vice President and the inaugural Chief Health Equity Officer for a large health system in the Seattle area. She has been there since 2016 leading the pediatrics and Medicaid strategy. More recently, she served as the physician lead for health equity and community partnerships, which led to her current position. She is a board-certified pediatrician and professor of pediatrics.
Prior to her arrival at her current system, Dr. Anyaoku served as the Division Chief of General Pediatrics at the Children’s Hospital of New Jersey, then as the Medical Director of Pediatrics for CHI Alegent Creighton health system in Omaha, Nebraska.
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Education
Dr. Anyaoku received her medical degree from the University of Nigeria. She received residency training in pediatrics and served as chief resident at the Children’s Hospital of New Jersey.
She holds an MPH from the Johns Hopkins Bloomberg School of Public Health. And she completed an MBA from the University of Washington Foster School of Business.
Becoming Chief Health Equity Officer
Dr. Anyaoku has had an impressive career, with more to come. She is well-positioned to move into other leadership roles. And she had excellent advice about how to position yourself for positions with ever greater scope and responsibility.
She attributes her ability to move into progressive leadership roles to constantly learning and volunteering to lead new initiatives.
In addition to her work as Chief Health Equity Officer, she is a speaker, coach, and consultant. If you want to reach out to her, the best option is to go to her website at nwandanyaoku.com.
Summary
Bu constantly looking to pitch in and solve problems, Dr. Anyaoku learned new skills and demonstrated her competence for ever more challenging jobs. She is happy to come to your organization and speak about health equity and working as a Chief Health Equity Officer. She is also interested in coaching and mentoring young physicians who would like to follow her path to leadership.
NOTE: Look below for a transcript of today's episode.
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Transcription PNC Podcast Episode 235
How to Go from Population Health Strategist to Chief Health Equity Officer
John: I like talking about trailblazers, and today's guest is the first I've met with the title of Chief Health Equity Officer. So, I'm really excited to talk to her today. Hello, Dr. Nwando Anyaoku.
Dr. Nwando Anyaoku: Well done, John. Hello, Dr. Jurica. Hello to your audience. Thank you so much for having me. I am looking forward to this conversation.
John: That's my pleasure. The reason I like talking to people like you is number one, we want to learn how you got to where you are, but then we also are going to learn about the subject matter that you're an expert in at least a few minutes, because I think that'll be educational, and there might be people out there that want to follow in your footsteps. So that'll be great. As we usually do, let's just have you tell us about your background, your education, your clinical background, the work you were doing, and then you can jump to what you're doing now and then we'll fill in the gaps after we get that overview.
Dr. Nwando Anyaoku: Of course. I am a pediatrician by training. I went to medical school in Nigeria. I came to the US more years ago now than I care to numerate. I did a master's in public health. Really because out of the background that I came from, public health really made a big impact on people's lives in real-time. I think in the United States it's become par for the course, but it was much more proximate to my experience, growing up in Nigeria.
I came to the United States. I did a master's in public health at Johns Hopkins. I worked in the public health arena for a couple of years. Then I went and did a residency in pediatrics at the Children's Hospital of New Jersey at Newark Beth Israel Medical Center. I stayed there for a decade and change, working in the clinics as a general pediatrician.
I left as Division Chief of General Pediatrics and was recruited out to the Midwest, by a large health system in Omaha, where I was recruited to build their primary care pediatrics offering. I did that for a little bit of time and then was recruited even further west to where I am now in the Pacific Northwest working for another large health system, where I initially came as their associate medical director in charge of primary care pediatrics for the enterprise.
I shortly thereafter took over primary and specialty pediatrics and ran that for about four years. Along the way, there was a lot of conversation about population health and I kept waving my, "What about kids' flag?" Well, what about kids? Because people talk about population health and they talk about grown-ups with high blood pressure and diabetes and I'd be what about the kids?
I think I waved that flag one too many times. And so, I was invited to sit at the table of the larger system to which we belong, where I got to convene pediatrics specialty clinical and operational leads across seven states and 10 regions of our organization looking at population health from the lens of pediatrics.
And because I was at the population health table and because of my passion for speaking for the people who don't have a voice, I shortly thereafter got to be the clinical lead for our Medicaid strategy. And so, then I was looking at the impact of our work on children and adults.
And in the wake of the George Floyd murder and the pandemic that unfolded upon us two years ago, our organization made a commitment to health equity. And I became the lead for health equity too. At that point, I had three jobs. About a year ago, my organization made a decision to create the inaugural chief health equity officer position. And I was invited to take on that role and that's what brings me here today.
John: Awesome. We're going to learn about what that is in a minute and some other things, but that's pretty impressive, number one. I don't always ask my guests, but I see some people are a little more intentional than others. Were you thinking along the way, "Look, I want to take these opportunities, I want to expand my role, I want to be a leader?" Was that something you were searching for fairly early?
Dr. Nwando Anyaoku: I don't know that I was. I think that my passion, and it's the through-line that runs through everything I've done all my life, is really advocating for the voiceless. And so I was always in a position where I would look up and ask, "Well, how is what I'm doing landing for different groups of people?" As a pediatrician when you become a parent, as most parents know, nobody really cares about you. They just talk about the kid. But I would think about how I am helping the parents so that they can be better partners in the care of their children? How do the parents in the different spaces experience the care that I'm trying to deliver?
And because that's always been my lens, and then when I did the public health training, public health really teaches you to look at solutions for populations rather than one individual at a time. I've always had that overlap in the way that I looked at things. And when I was part of a residency program for many years, I would tell some of my residents, there are some of us who go to work and grind, we just do what we need to do and see one patient after the other. But there's some of us that look up and say, how are we doing this? Can we do it better? Can we do it differently?
And if you're one that looks up, then that's who you are and your responsibility is to step into that, own it, and see how you can make working better for your colleagues, better for you, better for your patients. Because everybody is not called to do that. And that was something that I recognized as a calling that I had very early on to look up and see how I can do things better, how we can run this clinic better, more on time. How can I make it work for my colleagues, my physicians, my patients, and the parents?
And because I was one of those who looked up, I always look up and I'm always trying to build that muscle and to get better skills in their ability to do that. And so, I don't know that I woke up one morning and said, "I want one day to be Chief Health Equity Officer" like you said, until about a year ago, it wasn't a thing that existed. But the through-line of my passion and my calling and commitment is what has brought me here. And it's really consistent with who I am and what I've always tried to do.
John: Those are very good observations. Instead of like a lot of physicians, they just put their heads down. They're seeing as many patients as they can. They just deal with EMR. They deal with the culture. They deal with whatever's going on. They don't necessarily pause and say "This could be better. I guess if no one else is going to do it, maybe I guess I need to figure out how to improve it." That sounds like what you're really describing to me.
Dr. Nwando Anyaoku: That's how I've always described it. And honestly, it's not bad. Everybody doesn't have the same skills. Some people are designed to grind and they are the ones who identify the molecular differences in things, and the new variants and whatever new thing that is happening to us, but some of us are systems thinkers. And so, if we're systems thinkers, then we need to step into that and try to improve systems, especially as physicians. We talk about burnout, moral injury, how physicians feel disempowered. And part of it is that we just haven't historically stepped into leadership.
And so now as we get our voice, we can actually advocate among the people who are actually doing their best to make the right decisions, but don't have the right input. Having physicians at the table makes a difference for all of us as physicians and for our patients. So that's how I think about it, is that that's my calling and I step into it and own it.
John: All right. I'm going to tease it out a little bit more now because you mentioned systems. That was going to be my next word, we work in a system. From a practical standpoint, does that mean going to your media supervisor and expressing an interest, expressing a willingness to take on new things? Is it to talk, to matrix, to go out and network? How do you actually get that word up so they can look at you and go "Well and come on up?"
Dr. Nwando Anyaoku: Well, I will say that the journey is different for different people. And as a woman of color, physician leader of color, your strategy might vary a little bit, but the strategy for everyone really is to raise your hand and say, I will. They're always looking for somebody who's going to do something, serve on some committee or the other, and you can say, "Okay, I can do that." It's not always the first thought that comes to your mind because you're trying to make it through the day and get your RVU quota and all of that sort of thing. But if you think about it, there are ways that you can make it work for yourself. The first step is to say, "I will. I will be part of the change." And healthcare, thankfully, I would say over the last decade has really become more intentional about trying to elicit the physician's voice.
Now, I will say, as a physician leader, sometimes I feel as if they call us as doctors to manage other doctors, just keep them quiet. That's the vision that sometimes leadership has of physician leadership, but that's not what we are trying to do. And if you are not at the table, then that message continues to perpetrate itself. So, raise your hand and say, "I'll do that. We want to do better in this quality improvement process. I'll be the champion. I'll do it." But to go back to my point about being a woman of color, the other thing that sometimes minority physicians need, not sometimes, is that I think every one of us needs a mentor, a coach, and a sponsor. And the sponsor is that person who will say your name in rooms where you are not. Sometimes when a decision is being made about big opportunities, people can get someone who knows them and who'll say, "Hey, this doc is really doing a good job. Why don't we trust them with that?"
But it's not always easy. We have to actually be intentional about cultivating those relationships. And sometimes you think, "Well, who can be my sponsor? I'm the first woman of color in this organization. There is no one ahead of me." But your sponsor doesn't have to be one that looks like you. It just has to be one who knows your work. I tell people to share your thoughts, share the things that you're thinking about, making things better. Identify somebody that you build that relationship with so that someone knows what your interest is and what your passion is. So that when those opportunities come up in rooms where you are not present, there's someone who can say, "I had a conversation with so and so the other day, and I think it'll be great to give them an opportunity to do this." So that's a muscle that I have built over the years, in my leadership journey.
John: Well, that's a really good point. We don't actually talk about that very much. In the 200 plus episodes, I don't think we spend a lot of time on sponsors, but an informal person in the organization who will vouch for you because they know you, you're conversing with them on a regular basis. They understand maybe what you're looking for and what you're willing to do. And maybe other people might not know that and what your capabilities are. That is a very important thing. It's probably overlooked quite a bit.
Dr. Nwando Anyaoku: Yeah. Oh, it is. It is by everyone because we don't think about it. You just figure that these things just happen, but they don't. They happen when you have those connections. If you are not part of the majority, sometimes you have to be really intentional about building those connections.
John: I guess it segues a little bit into the health equity or equity and then health equity, these concepts. So why don't you give us a real, good look at what a Chief Health Equity Officer does? At least where you are. I'm not sure they all do exactly the same. I mean, it's a new title, but you would think, well, there's certain things that would be common to that. Explain what health equity is addressing and what a person who's working in that field is spending their time doing?
Dr. Nwando Anyaoku: I'm happy to talk about this all day. Health equity is often described as a negative, sort of in a reverse. It's the absence of systemic disparities in health outcomes and experience for different groups of people. The absence, where there is no difference between how different groups of people experience our healthcare, how their outcomes show up. And why is that the case? People sometimes use the term inequity and disparities as synonyms, but they're not synonyms. They mean something a little bit different. You can have disparities in healthcare between different groups, for reasons that are explainable, that makes sense. And so the example I use often is a difference in rates of breast cancer between men and women, biological men and women.
There's going to be a difference because there's hormones. So it's a disparity, but it's not an inequity. An inequity tends to be differences that arise due to systemic disparities in education, income, transportation, social determinants of health. And as such, those differences are not biological and therefore are considered more unjust. And that's what we talk about, when we talk about inequity.
Health, we've known for many, many years that different populations experience healthcare and have health outcomes in different ways. We know that your zip code impacts your life expectancy. We've known this for a long time. Why has it suddenly risen to the top? Well, I would say that it was the twin pandemics of coronavirus and following the murder of George Floyd, what we also as a societal uprising in response to. What people have talked about for years, but was now shown in living color for us to see the different experiences of different people in our system.
And those two things came into together caused us to pause as a nation and say, "What is going on here? And how can we make this better?" The pandemic, I think is the biggest lesson that hit, because we've known that diabetes, these things show up, we know that. But this time it turns out that all those things that we've known, the comorbid conditions, the poor access to health, poor access to transportation, all the things that made it worse for minority populations also made it worse for the rest of us. Because what we've learned from this pandemic is that everybody's health depends on everybody else's. And so we are now motivated to try to find a solution to these problems that we have been aware of, but have now come to sit right in our face.
As Chief Health Equity Officer, what we try to do is first share education about what these differences are, because a lot of people don't actually know because they don't have to, they haven't had to look at it. Help people to look at data and disaggregate the data, filter your clinical outcomes, quality metrics, or whatever performance indicators you look at in your space filtered by race, ethnicity, and language. Filtered by sexual orientation and gender identity. And see whether the work you're doing is landing the same way for everyone. Because as physicians, most people when I have a conversation with them will say, "Well, I treat everybody the same." And my answer is everybody doesn't need to be treated the same. Everybody's coming to this table with different baggage, with different challenges. So you need it to understand what those variables are.
And you're thinking in a 15-minute visit, "How much can I do?" And so what I try to teach you is first, you need to know, because nothing can be solved that is not faced. Once you know, then you can identify partners who can come alongside you to mitigate those challenges. You can put strategies in place to mitigate those challenges so that it's not impacting your time. But if you don't look at it, if you don't understand it, it's never going to change. So that's the work that we are trying to do.
And the amazing thing in 2022 is the influence of data. Data is now, and I live in Seattle, so data is in the land of Amazon or Microsoft. This is what we do, but how do we understand how data can actually worsen health inequities? Because of the way that the system is structured, how can we use the power of that data and all of that to change the way that people see things and understand and make a difference for our population? I could talk about this all day, John. So, I'll just warn you, I'll take a deep breath and pause. But this is what we're trying to do to try to close those gaps.
John: Okay. What comes to my mind is when you're in a role like that, you are part of a system, you are part of an organization. To identify and then address certain disparities or differences, you have to be able to measure them. Is that one of the things you're working on? Do you have good measurement tools? You're not going to necessarily just take public health data from the entire state, although you could, because it's probably across the board, but you have a certain population you're trying to serve. So, how do you address all that?
Dr. Nwando Anyaoku: It's literally taking the data that exists. When I have conversations with people, I'm like, I'm not asking you to invent anything new. I want you to look at the data that you currently gather for two reasons. One is that you've already gathered it. Two is that you've already ascribed value to those things that you're measuring. For all of us, we're looking at our rating, our Medicare star ratings, and all of those things. We have to have metrics, heated measures that show how we are performing with our patients. We've already ascribed values to those metrics.
What I then say is put a filter on it. Because if you look at the majority, you're not going to see the impact, because if you are looking in a space, I live in Seattle and the African American population is 6%. Well, if the rest of the 94% is doing great, nobody's ever going to see what's happening in 6%. The indigenous population is barely 2%. So, you have to then put a filter on and then see, what do those numbers look like for this subgroup? What do they look like for that subgroup? And now you can see where the opportunities lie.
I tell people, apply the filter of race, ethnicity, and language and see what rises to the top. And you will find that in all those things that you've already ascribed value to, control of high blood pressure, cancer screening, all those sorts of things. Patient experience. Press Ganey Scores. In all of those things that we have already ascribed value to you are finding a difference in the way different subpopulations experience the healthcare that we deliver.
And as physicians, we come to our job and to our careers with one goal, to help people. Nobody leaves home planning to harm anybody. And yet when this data comes to the top, you see that there is opportunity for us to do better. So that's the first thing we do. I'm like, just filter it. And then as we start this conversation, maybe, are there other things we can measure? Are there other ways that we can iterate this so that we can be more refined in our efforts? That continues to evolve as we do the work. But the first thing I do is just go with what you already have and see what it looks like for everybody.
John: One of the things I found was sometimes difficult, as Chief Medical Officer, I was in a relatively small town and we were trying to improve the healthcare and we weren't focused on equity at that time. We are talking a long time ago. But the thing that sometimes was difficult was I had my measurement tools inside my organization. And there were other organizations and I couldn't necessarily measure changes in the public health, or what was reported by the county and state and so forth. So it just was a challenge. It just made it tough. Do you feel like you can see the changes, or expect to see them eventually locally? Are you able to measure them internally with your own population, your own patients?
Dr. Nwando Anyaoku: Yeah. What I tell people is that everything we're dealing with today did not come into existence in the last year. As such, it's not going to reverse in a year. But what we want to see is an incremental change. And you can see it once you start to build the muscle of measuring and responding to what you find in the measurement.
An example I'll give you is when we rolled out the COVID vaccine at the end of last year or the beginning. COVID time has completely collapsed, at this point. I don't even know where we are, but at the end of 2020, we got the vaccine and we were now trying to roll it out to our society.The first big mass resource was this website where you could go and click and pick. Okay, well, that sounds great if you have a computer, if you are able to get to the place and all these things. We were as an organization, quite intentional about saying, "No, that's not going to work for everybody. We need to go to the community and find the people that we need to serve." And with our data, we could identify which population was at higher risk. And then we identified which community-based organizations served those populations. And then we partnered with them so that we could come alongside them, and in a local way, in language access the people that they were serving and be more targeted in our delivery of vaccines to those people.
We were able to see early on there was a significant gap. Like I said, the percentage of African Americans in our greatest Seattle area is about 6%. And the first wave of vaccine delivery, we barely got 3% of the African American population. But as we started these targeted efforts, we could see in real-time that gap closing, because we were able to be intentional about the way we deliver with care.
And so, it's a small thing. It's like one and done, you get it or you don't. It's not the same as long-term control of hypertension or diabetes, but it tells you that if you are looking at it and if you are intentionally targeting it, you can make that impact and you can measure it. That's something that we're extremely proud of in our organization. And that's the muscle that we want to get people building in different spaces all across the country.
John: I remember back a long time ago when I was starting out in hospital administration. One of the things people would just say, "Well, I know the care is good, because I give good care", like you mentioned earlier. It's like, no, we have to measure it. We have to find something we can measure and track and create a process or come up with a solution, change something and then see if it gets better. But I think most people are pretty much on board with that. It's just a matter of finding that tool sometimes.
Dr. Nwando Anyaoku: Yeah. The Institute for Healthcare Improvement, PDSA model, it's the same everywhere. And so, what do you want to do? Plan it, do it, study, raise and repeat, always doing that and asking, "Am I measuring the right thing? Am I making it worse by this change?" And that's some of the things that we have to think about, especially in this space, because like I said, a lot of this stuff is structural and sometimes you shift this gender piece and the whole thing moves a whole different way. So you have to be intentional about building in benchmarks and ways to assess whether you're actually making an improvement, whether this change is an improvement or whether it's actually a worsening of what you are trying to address. Physicians, literally always are like, "Well, I'm giving good care. I do this." I'm like, "I know you do. I know your intention, but how is it showing up? And you're not going to know unless you look at it." So let's look at it.
John: Yeah. And a lot of the things that impact the outcomes really don't have to do with whether they pick the right medicine or has to do, like you were mentioning earlier, transportation, income, language barriers, all these other things that once a person walks into your office, if you don't have a way to deal with that, it's just not going to happen. Or even before they often leave the office, obviously, how do they get to the office? Or do you go out with them? Like you said.
Dr. Nwando Anyaoku: And sometimes the answer is all of the above. Different organizations across the country are solving for this in different ways because the impact is different. The reasons are different. Some organizations partner with the apps that drive people and they have a contract by which they bring people to the hospital. Some organizations partner with community-based organizations. It's really looking in your local space and identifying what are the particular issues that your community is facing and how can you make it better? The other thing that I'd like to talk about, because it's something that doesn't show up a lot, is thinking about how you increase the diversity of your workforce. Because one thing we know from all kinds of organizations is that having diversity of thought, diversity of lived experience makes your product better.
And so, if you are in an organization that doesn't have a diverse physician body, nursing body, then your lens of how you treat patients is going to be somewhat narrow. One of the best ways that you can improve health equity is to diversify your provider, your physician, APC, and clinical staff body and just the rest of the hospital. Because what it does is that as people get to know people who are not like them, they start to be comfortable with different perspectives, with different ways of looking at things, and different partnerships. And so, we're never going to get to the point where you will have every minority patient will have a minority physician to match, but if you have the pool mixed up, you will start to see that impact on the patient population.
But as a physician of color trying to navigate the healthcare system, it can be particularly challenging. And I'm sure that as you've done these interviews, you've met some people who would tell you just how difficult it was for them going through residency, through practice. Last week, there was a young lady on Twitter that talked about being the first black fellow at her institution. That story is so common and so repeated. And what it does is that you first struggle to create that pipeline. And then the pipeline gets shut off because people are not able to survive.
So, what I've done for many years is try to be a coaching resource for physicians, especially physicians of color who are trying to navigate the healthcare system. How do you survive? How do you thrive? How do you bring your gift of service to your population in a way that makes an impact without you being burnt out or being crushed by the system? So, it's work that, I think is really important and key. And I always want to call it out because it's a big burden that we face, but it's one way that we can be intentional about impacting our patients' lives.
John: That's such good advice and people need to keep their eyes open and encourage those things. I have a couple more questions I want to ask you quickly. One is, you're in that position and you mentioned what other organizations may be doing so you have a feel. What do you see in terms of this position or one like it, do you see a lot of growth? Do you see most large organizations doing this when you go to the meetings or Zoom calls or whatever you're looking for and talking to your peers?
Dr. Nwando Anyaoku: I went to a CME conference in Boston in the fall, and I was absolutely blown away by the absolute number of Chief Health Equity Officers.
John: Really?
Dr. Nwando Anyaoku: I will say that there were not a lot of us from health systems. There were a lot of Chief Health Equity Officers from payers, they're from tech companies. Then large health systems like mine are beginning to create that. A lot of organizations recognized the value of a DEI officer. So they've had a DEI officer, and my organization has one too. But the way that we look at our work is a two-sided coin. And my chief health equity work is focused on more clinical and patient facing. It's talking about culturally competent care, looking at health outcomes metrics.
My DEI partner looks at the workforce. How diverse is the workforce? How are we creating an inclusive culture? And when we're talking about diversity and equity, we're not just talking about race. We're talking about language, ageism, ability, sexual orientation, all of those things that make people find themselves othered in an organization is what we look at. And so, we work very close hand in hand, because like I said, if you have a clinician who comes in and finds themselves the only one. Initially they're hired, everybody's like, "Yay, we got a diverse candidate." And then very shortly thereafter, their very diversity begins to be weaponized against them. Because you're not conforming, you're different, which is the reason why you got me in here by the way. But now, because I'm different, I'm experiencing microaggressions and all those challenges.
And so, what we try to do, we try to create that culture that is welcoming, that allows people to bring their whole selves to work so that they can be available for their patients in the way that the patients need. Because that patient sees, I walk through my clinic and I would have patients who are seeing other doctors come out of the room and be like, "Is she a doctor? Can I switch to her?" Because they have never seen a doctor that looks like them. They want that comfort.
Like I said, we're not going to get to the point where everybody has that congruency in the match, but as we build a workforce that is more diverse, we make it more welcoming for everybody. That's the way that we look at the work right now in my space. The American Medical Association has a similar structure. They have a Chief Health Equity Officers and a Chief Diversity Equity and Inclusion Officer. And that's the model that is beginning to grow. There's so much work to be done in this space that I think we will be around for a while.
John: Yeah. I think it's going to be quite a while before there's anything near saturation of that. A couple more things. I've got to get going here, but I do want to first say, where do we track you down? I know listeners are going to want to follow you. They're going to want to possibly contact you. So I know we could probably find you on LinkedIn.
Dr. Nwando Anyaoku: Yes. You can find me on LinkedIn and you can find me on my website, which is my first name and last name dot-com, nwandoanyaoku.com. Really easy. You can send me an email through either of those two channels. I would love to talk to you and see how I can help.
John: Awesome too, and I'll put that in the show notes. They'll definitely be able to contact you if they want to do that. And so, the last thing is, you've told us how you've come up and what you've done and the masters and so on and so forth. My listeners are looking for different things to do. Maybe they transition out of clinical to something like you're doing. Anything else you would do differently or recommend to them if they are looking to move into something like you described?
Dr. Nwando Anyaoku: Well, the first thing I'll say is I have an MD, I have an MPH, and an MBA. They all showed up at different times. You don't need all of those to do this work I'm doing. You don't need any of, well, you need the MD, but you don't need to have an MPH or an MBA. There are many ways that you can build muscle. And I've done that for many, many years. I did my MPH before I did my residency, as I told you, because that's the lens that I came to healthcare with. And it helped me to refine my skillset in that arena. And what I've always done is I always tried to see "What toolbox do I need for this task?"
Nobody taught us how to be leaders. You're the busiest doctor, you have the biggest panel of patients, ergo, you're the medical director. Well, the skillset you need to build the biggest panel is not the skill set you need to manage physicians and host meetings and things like that. They're two different skill sets. And yet that's the criteria historically that people have used to get promotions.
When you find yourself there, either because you raised your hand, you were nominated or you got dropped into it and you feel you can do it, then there are lots of resources out that you can start to find, to just build the muscle that you need to learn to be a leader. I advocate that every physician leader gets a coach, gets somebody who is going to help you on your journey, who can stand outside and be a safe space to help you navigate, to do the best work that you want to do.
But the other thing that helps is having a mentor. If you look around your organization and see somebody who's doing work that you like. And these days LinkedIn has made it easy. When I started, there wasn't LinkedIn, but now you can basically scroll through LinkedIn pages, follow the tracks of people that you already follow and see other people who are doing exciting things, and look at what their journey looks like. And I send them an email, "Hey, can I have a conversation, a 20-minute call? How did you get to what you're doing? What do you do every day? What are the things that keep you?" I just have those conversations. And have a conversation, not an interrogation, or quizzing somebody to make them give you a job, but just so that you understand what the possibilities are.
I imagine that in your podcast, you've seen so many possibilities of what physicians can do. I tell people, we've learned so much that our skills can be deployed in so many ways because health is life. From pharma to payer, to community, to advocacy, to government, to everywhere, the skillset that we've built becoming physicians is extremely valuable.
But as a person, how do you figure out which path to take? First, figure out what's there, but also figure out what's important to you. What is your passion? What is your unique gift and what do you feel that you are brought here to leave? And as you put those two together, the path becomes clear over time. I hate to sound cocky, but it really does. And as you get to understand how you serve and how your service makes an impact, it really becomes clearer and clearer. And then you're like, wow.
When my CEO called me and offered me this position, I was like, I have done this out of my passion for years. In every position I've found myself, I'll find who I can advocate for? How are you dealing with these people? How can I make it? And all of a sudden this thing that I've done after hours on weekends and in my lunch break becomes my job. And it's just absolutely amazing. Being able to understand what you bring to the table, what is your unique gift. All of us are doctors, but not in the same way. And we are not all called to be doctors the same way. So, figure out what you want to do and what else is out there and marry the two and have lots of conversations.
John: That sounds like great advice. We've heard bits and pieces of that in the past. So those are really core things. And the mentors. Yeah, I tell people, don't make your mentor own your career. That's not what your mentor is for. You just ask a few questions, get a little push, get a little advice, avoid the landmines and just keep moving forward. That's great advice.Well, I want to thank you for being here today. It's been a lot that we've learned, so I really appreciate it. Yeah, I want to see how things go over the next year or two. Maybe we'll follow up in the future. Dr. Anyaoku, thank you so much for being here today. And with that, I'll have to say goodbye.
Dr. Nwando Anyaoku: Thank you for having me.
John: You're welcome. It's my pleasure. Bye-bye.
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Transcription PNC Podcast Episode 235
How to Go from Population Health Strategist to Chief Health Equity Officer
John: I like talking about trailblazers, and today's guest is the first I've met with the title of Chief Health Equity Officer. So, I'm really excited to talk to her today. Hello, Dr. Nwando Anyaoku.
Dr. Nwando Anyaoku: Well done, John. Hello, Dr. Jurica. Hello to your audience. Thank you so much for having me. I am looking forward to this conversation.
John: That's my pleasure. The reason I like talking to people like you is number one, we want to learn how you got to where you are, but then we also are going to learn about the subject matter that you're an expert in at least a few minutes, because I think that'll be educational, and there might be people out there that want to follow in your footsteps. So that'll be great. As we usually do, let's just have you tell us about your background, your education, your clinical background, the work you were doing, and then you can jump to what you're doing now and then we'll fill in the gaps after we get that overview.
Dr. Nwando Anyaoku: Of course. I am a pediatrician by training. I went to medical school in Nigeria. I came to the US more years ago now than I care to numerate. I did a master's in public health. Really because out of the background that I came from, public health really made a big impact on people's lives in real-time. I think in the United States it's become par for the course, but it was much more proximate to my experience, growing up in Nigeria.
I came to the United States. I did a master's in public health at Johns Hopkins. I worked in the public health arena for a couple of years. Then I went and did a residency in pediatrics at the Children's Hospital of New Jersey at Newark Beth Israel Medical Center. I stayed there for a decade and change, working in the clinics as a general pediatrician.
I left as Division Chief of General Pediatrics and was recruited out to the Midwest, by a large health system in Omaha, where I was recruited to build their primary care pediatrics offering. I did that for a little bit of time and then was recruited even further west to where I am now in the Pacific Northwest working for another large health system, where I initially came as their associate medical director in charge of primary care pediatrics for the enterprise.
I shortly thereafter took over primary and specialty pediatrics and ran that for about four years. Along the way, there was a lot of conversation about population health and I kept waving my, "What about kids' flag?" Well, what about kids? Because people talk about population health and they talk about grown-ups with high blood pressure and diabetes and I'd be what about the kids?
I think I waved that flag one too many times. And so, I was invited to sit at the table of the larger system to which we belong, where I got to convene pediatrics specialty clinical and operational leads across seven states and 10 regions of our organization looking at population health from the lens of pediatrics.
And because I was at the population health table and because of my passion for speaking for the people who don't have a voice, I shortly thereafter got to be the clinical lead for our Medicaid strategy. And so, then I was looking at the impact of our work on children and adults.
And in the wake of the George Floyd murder and the pandemic that unfolded upon us two years ago, our organization made a commitment to health equity. And I became the lead for health equity too. At that point, I had three jobs. About a year ago, my organization made a decision to create the inaugural chief health equity officer position. And I was invited to take on that role and that's what brings me here today.
John: Awesome. We're going to learn about what that is in a minute and some other things, but that's pretty impressive, number one. I don't always ask my guests, but I see some people are a little more intentional than others. Were you thinking along the way, "Look, I want to take these opportunities, I want to expand my role, I want to be a leader?" Was that something you were searching for fairly early?
Dr. Nwando Anyaoku: I don't know that I was. I think that my passion, and it's the through-line that runs through everything I've done all my life, is really advocating for the voiceless. And so I was always in a position where I would look up and ask, "Well, how is what I'm doing landing for different groups of people?" As a pediatrician when you become a parent, as most parents know, nobody really cares about you. They just talk about the kid. But I would think about how I am helping the parents so that they can be better partners in the care of their children? How do the parents in the different spaces experience the care that I'm trying to deliver?
And because that's always been my lens, and then when I did the public health training, public health really teaches you to look at solutions for populations rather than one individual at a time. I've always had that overlap in the way that I looked at things. And when I was part of a residency program for many years, I would tell some of my residents, there are some of us who go to work and grind, we just do what we need to do and see one patient after the other. But there's some of us that look up and say, how are we doing this? Can we do it better? Can we do it differently?
And if you're one that looks up, then that's who you are and your responsibility is to step into that, own it, and see how you can make working better for your colleagues, better for you, better for your patients. Because everybody is not called to do that. And that was something that I recognized as a calling that I had very early on to look up and see how I can do things better, how we can run this clinic better, more on time. How can I make it work for my colleagues, my physicians, my patients, and the parents?
And because I was one of those who looked up, I always look up and I'm always trying to build that muscle and to get better skills in their ability to do that. And so, I don't know that I woke up one morning and said, "I want one day to be Chief Health Equity Officer" like you said, until about a year ago, it wasn't a thing that existed. But the through-line of my passion and my calling and commitment is what has brought me here. And it's really consistent with who I am and what I've always tried to do.
John: Those are very good observations. Instead of like a lot of physicians, they just put their heads down. They're seeing as many patients as they can. They just deal with EMR. They deal with the culture. They deal with whatever's going on. They don't necessarily pause and say "This could be better. I guess if no one else is going to do it, maybe I guess I need to figure out how to improve it." That sounds like what you're really describing to me.
Dr. Nwando Anyaoku: That's how I've always described it. And honestly, it's not bad. Everybody doesn't have the same skills. Some people are designed to grind and they are the ones who identify the molecular differences in things, and the new variants and whatever new thing that is happening to us, but some of us are systems thinkers. And so, if we're systems thinkers, then we need to step into that and try to improve systems, especially as physicians. We talk about burnout, moral injury, how physicians feel disempowered. And part of it is that we just haven't historically stepped into leadership.
And so now as we get our voice, we can actually advocate among the people who are actually doing their best to make the right decisions, but don't have the right input. Having physicians at the table makes a difference for all of us as physicians and for our patients. So that's how I think about it, is that that's my calling and I step into it and own it.
John: All right. I'm going to tease it out a little bit more now because you mentioned systems. That was going to be my next word, we work in a system. From a practical standpoint, does that mean going to your media supervisor and expressing an interest, expressing a willingness to take on new things? Is it to talk, to matrix, to go out and network? How do you actually get that word up so they can look at you and go "Well and come on up?"
Dr. Nwando Anyaoku: Well, I will say that the journey is different for different people. And as a woman of color, physician leader of color, your strategy might vary a little bit, but the strategy for everyone really is to raise your hand and say, I will. They're always looking for somebody who's going to do something, serve on some committee or the other, and you can say, "Okay, I can do that." It's not always the first thought that comes to your mind because you're trying to make it through the day and get your RVU quota and all of that sort of thing. But if you think about it, there are ways that you can make it work for yourself. The first step is to say, "I will. I will be part of the change." And healthcare, thankfully, I would say over the last decade has really become more intentional about trying to elicit the physician's voice.
Now, I will say, as a physician leader, sometimes I feel as if they call us as doctors to manage other doctors, just keep them quiet. That's the vision that sometimes leadership has of physician leadership, but that's not what we are trying to do. And if you are not at the table, then that message continues to perpetrate itself. So, raise your hand and say, "I'll do that. We want to do better in this quality improvement process. I'll be the champion. I'll do it." But to go back to my point about being a woman of color, the other thing that sometimes minority physicians need, not sometimes, is that I think every one of us needs a mentor, a coach, and a sponsor. And the sponsor is that person who will say your name in rooms where you are not. Sometimes when a decision is being made about big opportunities, people can get someone who knows them and who'll say, "Hey, this doc is really doing a good job. Why don't we trust them with that?"
But it's not always easy. We have to actually be intentional about cultivating those relationships. And sometimes you think, "Well, who can be my sponsor? I'm the first woman of color in this organization. There is no one ahead of me." But your sponsor doesn't have to be one that looks like you. It just has to be one who knows your work. I tell people to share your thoughts, share the things that you're thinking about, making things better. Identify somebody that you build that relationship with so that someone knows what your interest is and what your passion is. So that when those opportunities come up in rooms where you are not present, there's someone who can say, "I had a conversation with so and so the other day, and I think it'll be great to give them an opportunity to do this." So that's a muscle that I have built over the years, in my leadership journey.
John: Well, that's a really good point. We don't actually talk about that very much. In the 200 plus episodes, I don't think we spend a lot of time on sponsors, but an informal person in the organization who will vouch for you because they know you, you're conversing with them on a regular basis. They understand maybe what you're looking for and what you're willing to do. And maybe other people might not know that and what your capabilities are. That is a very important thing. It's probably overlooked quite a bit.
Dr. Nwando Anyaoku: Yeah. Oh, it is. It is by everyone because we don't think about it. You just figure that these things just happen, but they don't. They happen when you have those connections. If you are not part of the majority, sometimes you have to be really intentional about building those connections.
John: I guess it segues a little bit into the health equity or equity and then health equity, these concepts. So why don't you give us a real, good look at what a Chief Health Equity Officer does? At least where you are. I'm not sure they all do exactly the same. I mean, it's a new title, but you would think, well, there's certain things that would be common to that. Explain what health equity is addressing and what a person who's working in that field is spending their time doing?
Dr. Nwando Anyaoku: I'm happy to talk about this all day. Health equity is often described as a negative, sort of in a reverse. It's the absence of systemic disparities in health outcomes and experience for different groups of people. The absence, where there is no difference between how different groups of people experience our healthcare, how their outcomes show up. And why is that the case? People sometimes use the term inequity and disparities as synonyms, but they're not synonyms. They mean something a little bit different. You can have disparities in healthcare between different groups, for reasons that are explainable, that makes sense. And so the example I use often is a difference in rates of breast cancer between men and women, biological men and women.
There's going to be a difference because there's hormones. So it's a disparity, but it's not an inequity. An inequity tends to be differences that arise due to systemic disparities in education, income, transportation, social determinants of health. And as such, those differences are not biological and therefore are considered more unjust. And that's what we talk about, when we talk about inequity.
Health, we've known for many, many years that different populations experience healthcare and have health outcomes in different ways. We know that your zip code impacts your life expectancy. We've known this for a long time. Why has it suddenly risen to the top? Well, I would say that it was the twin pandemics of coronavirus and following the murder of George Floyd, what we also as a societal uprising in response to. What people have talked about for years, but was now shown in living color for us to see the different experiences of different people in our system.
And those two things came into together caused us to pause as a nation and say, "What is going on here? And how can we make this better?" The pandemic, I think is the biggest lesson that hit, because we've known that diabetes, these things show up, we know that. But this time it turns out that all those things that we've known, the comorbid conditions, the poor access to health, poor access to transportation, all the things that made it worse for minority populations also made it worse for the rest of us. Because what we've learned from this pandemic is that everybody's health depends on everybody else's. And so we are now motivated to try to find a solution to these problems that we have been aware of, but have now come to sit right in our face.
As Chief Health Equity Officer, what we try to do is first share education about what these differences are, because a lot of people don't actually know because they don't have to, they haven't had to look at it. Help people to look at data and disaggregate the data, filter your clinical outcomes, quality metrics, or whatever performance indicators you look at in your space filtered by race, ethnicity, and language. Filtered by sexual orientation and gender identity. And see whether the work you're doing is landing the same way for everyone. Because as physicians, most people when I have a conversation with them will say, "Well, I treat everybody the same." And my answer is everybody doesn't need to be treated the same. Everybody's coming to this table with different baggage, with different challenges. So you need it to understand what those variables are.
And you're thinking in a 15-minute visit, "How much can I do?" And so what I try to teach you is first, you need to know, because nothing can be solved that is not faced. Once you know, then you can identify partners who can come alongside you to mitigate those challenges. You can put strategies in place to mitigate those challenges so that it's not impacting your time. But if you don't look at it, if you don't understand it, it's never going to change. So that's the work that we are trying to do.
And the amazing thing in 2022 is the influence of data. Data is now, and I live in Seattle, so data is in the land of Amazon or Microsoft. This is what we do, but how do we understand how data can actually worsen health inequities? Because of the way that the system is structured, how can we use the power of that data and all of that to change the way that people see things and understand and make a difference for our population? I could talk about this all day, John. So, I'll just warn you, I'll take a deep breath and pause. But this is what we're trying to do to try to close those gaps.
John: Okay. What comes to my mind is when you're in a role like that, you are part of a system, you are part of an organization. To identify and then address certain disparities or differences, you have to be able to measure them. Is that one of the things you're working on? Do you have good measurement tools? You're not going to necessarily just take public health data from the entire state, although you could, because it's probably across the board, but you have a certain population you're trying to serve. So, how do you address all that?
Dr. Nwando Anyaoku: It's literally taking the data that exists. When I have conversations with people, I'm like, I'm not asking you to invent anything new. I want you to look at the data that you currently gather for two reasons. One is that you've already gathered it. Two is that you've already ascribed value to those things that you're measuring. For all of us, we're looking at our rating, our Medicare star ratings, and all of those things. We have to have metrics, heated measures that show how we are performing with our patients. We've already ascribed values to those metrics.
What I then say is put a filter on it. Because if you look at the majority, you're not going to see the impact, because if you are looking in a space, I live in Seattle and the African American population is 6%. Well, if the rest of the 94% is doing great, nobody's ever going to see what's happening in 6%. The indigenous population is barely 2%. So, you have to then put a filter on and then see, what do those numbers look like for this subgroup? What do they look like for that subgroup? And now you can see where the opportunities lie.
I tell people, apply the filter of race, ethnicity, and language and see what rises to the top. And you will find that in all those things that you've already ascribed value to, control of high blood pressure, cancer screening, all those sorts of things. Patient experience. Press Ganey Scores. In all of those things that we have already ascribed value to you are finding a difference in the way different subpopulations experience the healthcare that we deliver.
And as physicians, we come to our job and to our careers with one goal, to help people. Nobody leaves home planning to harm anybody. And yet when this data comes to the top, you see that there is opportunity for us to do better. So that's the first thing we do. I'm like, just filter it. And then as we start this conversation, maybe, are there other things we can measure? Are there other ways that we can iterate this so that we can be more refined in our efforts? That continues to evolve as we do the work. But the first thing I do is just go with what you already have and see what it looks like for everybody.
John: One of the things I found was sometimes difficult, as Chief Medical Officer, I was in a relatively small town and we were trying to improve the healthcare and we weren't focused on equity at that time. We are talking a long time ago. But the thing that sometimes was difficult was I had my measurement tools inside my organization. And there were other organizations and I couldn't necessarily measure changes in the public health, or what was reported by the county and state and so forth. So it just was a challenge. It just made it tough. Do you feel like you can see the changes, or expect to see them eventually locally? Are you able to measure them internally with your own population, your own patients?
Dr. Nwando Anyaoku: Yeah. What I tell people is that everything we're dealing with today did not come into existence in the last year. As such, it's not going to reverse in a year. But what we want to see is an incremental change. And you can see it once you start to build the muscle of measuring and responding to what you find in the measurement.
An example I'll give you is when we rolled out the COVID vaccine at the end of last year or the beginning. COVID time has completely collapsed, at this point. I don't even know where we are, but at the end of 2020, we got the vaccine and we were now trying to roll it out to our society.The first big mass resource was this website where you could go and click and pick. Okay, well, that sounds great if you have a computer, if you are able to get to the place and all these things. We were as an organization, quite intentional about saying, "No, that's not going to work for everybody. We need to go to the community and find the people that we need to serve." And with our data, we could identify which population was at higher risk. And then we identified which community-based organizations served those populations. And then we partnered with them so that we could come alongside them, and in a local way, in language access the people that they were serving and be more targeted in our delivery of vaccines to those people.
We were able to see early on there was a significant gap. Like I said, the percentage of African Americans in our greatest Seattle area is about 6%. And the first wave of vaccine delivery, we barely got 3% of the African American population. But as we started these targeted efforts, we could see in real-time that gap closing, because we were able to be intentional about the way we deliver with care.
And so, it's a small thing. It's like one and done, you get it or you don't. It's not the same as long-term control of hypertension or diabetes, but it tells you that if you are looking at it and if you are intentionally targeting it, you can make that impact and you can measure it. That's something that we're extremely proud of in our organization. And that's the muscle that we want to get people building in different spaces all across the country.
John: I remember back a long time ago when I was starting out in hospital administration. One of the things people would just say, "Well, I know the care is good, because I give good care", like you mentioned earlier. It's like, no, we have to measure it. We have to find something we can measure and track and create a process or come up with a solution, change something and then see if it gets better. But I think most people are pretty much on board with that. It's just a matter of finding that tool sometimes.
Dr. Nwando Anyaoku: Yeah. The Institute for Healthcare Improvement, PDSA model, it's the same everywhere. And so, what do you want to do? Plan it, do it, study, raise and repeat, always doing that and asking, "Am I measuring the right thing? Am I making it worse by this change?" And that's some of the things that we have to think about, especially in this space, because like I said, a lot of this stuff is structural and sometimes you shift this gender piece and the whole thing moves a whole different way. So you have to be intentional about building in benchmarks and ways to assess whether you're actually making an improvement, whether this change is an improvement or whether it's actually a worsening of what you are trying to address. Physicians, literally always are like, "Well, I'm giving good care. I do this." I'm like, "I know you do. I know your intention, but how is it showing up? And you're not going to know unless you look at it." So let's look at it.
John: Yeah. And a lot of the things that impact the outcomes really don't have to do with whether they pick the right medicine or has to do, like you were mentioning earlier, transportation, income, language barriers, all these other things that once a person walks into your office, if you don't have a way to deal with that, it's just not going to happen. Or even before they often leave the office, obviously, how do they get to the office? Or do you go out with them? Like you said.
Dr. Nwando Anyaoku: And sometimes the answer is all of the above. Different organizations across the country are solving for this in different ways because the impact is different. The reasons are different. Some organizations partner with the apps that drive people and they have a contract by which they bring people to the hospital. Some organizations partner with community-based organizations. It's really looking in your local space and identifying what are the particular issues that your community is facing and how can you make it better? The other thing that I'd like to talk about, because it's something that doesn't show up a lot, is thinking about how you increase the diversity of your workforce. Because one thing we know from all kinds of organizations is that having diversity of thought, diversity of lived experience makes your product better.
And so, if you are in an organization that doesn't have a diverse physician body, nursing body, then your lens of how you treat patients is going to be somewhat narrow. One of the best ways that you can improve health equity is to diversify your provider, your physician, APC, and clinical staff body and just the rest of the hospital. Because what it does is that as people get to know people who are not like them, they start to be comfortable with different perspectives, with different ways of looking at things, and different partnerships. And so, we're never going to get to the point where you will have every minority patient will have a minority physician to match, but if you have the pool mixed up, you will start to see that impact on the patient population.
But as a physician of color trying to navigate the healthcare system, it can be particularly challenging. And I'm sure that as you've done these interviews, you've met some people who would tell you just how difficult it was for them going through residency, through practice. Last week, there was a young lady on Twitter that talked about being the first black fellow at her institution. That story is so common and so repeated. And what it does is that you first struggle to create that pipeline. And then the pipeline gets shut off because people are not able to survive.
So, what I've done for many years is try to be a coaching resource for physicians, especially physicians of color who are trying to navigate the healthcare system. How do you survive? How do you thrive? How do you bring your gift of service to your population in a way that makes an impact without you being burnt out or being crushed by the system? So, it's work that, I think is really important and key. And I always want to call it out because it's a big burden that we face, but it's one way that we can be intentional about impacting our patients' lives.
John: That's such good advice and people need to keep their eyes open and encourage those things. I have a couple more questions I want to ask you quickly. One is, you're in that position and you mentioned what other organizations may be doing so you have a feel. What do you see in terms of this position or one like it, do you see a lot of growth? Do you see most large organizations doing this when you go to the meetings or Zoom calls or whatever you're looking for and talking to your peers?
Dr. Nwando Anyaoku: I went to a CME conference in Boston in the fall, and I was absolutely blown away by the absolute number of Chief Health Equity Officers.
John: Really?
Dr. Nwando Anyaoku: I will say that there were not a lot of us from health systems. There were a lot of Chief Health Equity Officers from payers, they're from tech companies. Then large health systems like mine are beginning to create that. A lot of organizations recognized the value of a DEI officer. So they've had a DEI officer, and my organization has one too. But the way that we look at our work is a two-sided coin. And my chief health equity work is focused on more clinical and patient facing. It's talking about culturally competent care, looking at health outcomes metrics.
My DEI partner looks at the workforce. How diverse is the workforce? How are we creating an inclusive culture? And when we're talking about diversity and equity, we're not just talking about race. We're talking about language, ageism, ability, sexual orientation, all of those things that make people find themselves othered in an organization is what we look at. And so, we work very close hand in hand, because like I said, if you have a clinician who comes in and finds themselves the only one. Initially they're hired, everybody's like, "Yay, we got a diverse candidate." And then very shortly thereafter, their very diversity begins to be weaponized against them. Because you're not conforming, you're different, which is the reason why you got me in here by the way. But now, because I'm different, I'm experiencing microaggressions and all those challenges.
And so, what we try to do, we try to create that culture that is welcoming, that allows people to bring their whole selves to work so that they can be available for their patients in the way that the patients need. Because that patient sees, I walk through my clinic and I would have patients who are seeing other doctors come out of the room and be like, "Is she a doctor? Can I switch to her?" Because they have never seen a doctor that looks like them. They want that comfort.
Like I said, we're not going to get to the point where everybody has that congruency in the match, but as we build a workforce that is more diverse, we make it more welcoming for everybody. That's the way that we look at the work right now in my space. The American Medical Association has a similar structure. They have a Chief Health Equity Officers and a Chief Diversity Equity and Inclusion Officer. And that's the model that is beginning to grow. There's so much work to be done in this space that I think we will be around for a while.
John: Yeah. I think it's going to be quite a while before there's anything near saturation of that. A couple more things. I've got to get going here, but I do want to first say, where do we track you down? I know listeners are going to want to follow you. They're going to want to possibly contact you. So I know we could probably find you on LinkedIn.
Dr. Nwando Anyaoku: Yes. You can find me on LinkedIn and you can find me on my website, which is my first name and last name dot-com, nwandoanyaoku.com. Really easy. You can send me an email through either of those two channels. I would love to talk to you and see how I can help.
John: Awesome too, and I'll put that in the show notes. They'll definitely be able to contact you if they want to do that. And so, the last thing is, you've told us how you've come up and what you've done and the masters and so on and so forth. My listeners are looking for different things to do. Maybe they transition out of clinical to something like you're doing. Anything else you would do differently or recommend to them if they are looking to move into something like you described?
Dr. Nwando Anyaoku: Well, the first thing I'll say is I have an MD, I have an MPH, and an MBA. They all showed up at different times. You don't need all of those to do this work I'm doing. You don't need any of, well, you need the MD, but you don't need to have an MPH or an MBA. There are many ways that you can build muscle. And I've done that for many, many years. I did my MPH before I did my residency, as I told you, because that's the lens that I came to healthcare with. And it helped me to refine my skillset in that arena. And what I've always done is I always tried to see "What toolbox do I need for this task?"
Nobody taught us how to be leaders. You're the busiest doctor, you have the biggest panel of patients, ergo, you're the medical director. Well, the skillset you need to build the biggest panel is not the skill set you need to manage physicians and host meetings and things like that. They're two different skill sets. And yet that's the criteria historically that people have used to get promotions.
When you find yourself there, either because you raised your hand, you were nominated or you got dropped into it and you feel you can do it, then there are lots of resources out that you can start to find, to just build the muscle that you need to learn to be a leader. I advocate that every physician leader gets a coach, gets somebody who is going to help you on your journey, who can stand outside and be a safe space to help you navigate, to do the best work that you want to do.
But the other thing that helps is having a mentor. If you look around your organization and see somebody who's doing work that you like. And these days LinkedIn has made it easy. When I started, there wasn't LinkedIn, but now you can basically scroll through LinkedIn pages, follow the tracks of people that you already follow and see other people who are doing exciting things, and look at what their journey looks like. And I send them an email, "Hey, can I have a conversation, a 20-minute call? How did you get to what you're doing? What do you do every day? What are the things that keep you?" I just have those conversations. And have a conversation, not an interrogation, or quizzing somebody to make them give you a job, but just so that you understand what the possibilities are.
I imagine that in your podcast, you've seen so many possibilities of what physicians can do. I tell people, we've learned so much that our skills can be deployed in so many ways because health is life. From pharma to payer, to community, to advocacy, to government, to everywhere, the skillset that we've built becoming physicians is extremely valuable.
But as a person, how do you figure out which path to take? First, figure out what's there, but also figure out what's important to you. What is your passion? What is your unique gift and what do you feel that you are brought here to leave? And as you put those two together, the path becomes clear over time. I hate to sound cocky, but it really does. And as you get to understand how you serve and how your service makes an impact, it really becomes clearer and clearer. And then you're like, wow.
When my CEO called me and offered me this position, I was like, I have done this out of my passion for years. In every position I've found myself, I'll find who I can advocate for? How are you dealing with these people? How can I make it? And all of a sudden this thing that I've done after hours on weekends and in my lunch break becomes my job. And it's just absolutely amazing. Being able to understand what you bring to the table, what is your unique gift. All of us are doctors, but not in the same way. And we are not all called to be doctors the same way. So, figure out what you want to do and what else is out there and marry the two and have lots of conversations.
John: That sounds like great advice. We've heard bits and pieces of that in the past. So those are really core things. And the mentors. Yeah, I tell people, don't make your mentor own your career. That's not what your mentor is for. You just ask a few questions, get a little push, get a little advice, avoid the landmines and just keep moving forward. That's great advice.Well, I want to thank you for being here today. It's been a lot that we've learned, so I really appreciate it. Yeah, I want to see how things go over the next year or two. Maybe we'll follow up in the future. Dr. Anyaoku, thank you so much for being here today. And with that, I'll have to say goodbye.
Dr. Nwando Anyaoku: Thank you for having me.
John: You're welcome. It's my pleasure. Bye-bye.
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