New CMO at DMC Prioritizes Integration With Community

Leonardo Lozada says health systems and hospitals generate benefits from connecting with the communities they serve.

Detroit Medical Center recently appointed a Kansas City–based physician executive as the organization's new chief medical officer.

Leonardo Lozada, MD, MBA, who officially began his CMO role at DMC in January, came from St. Luke's Health System, where he served as senior vice president and chief physician executive.

DMC, located in downtown Detroit, is an academic integrated health system with more than 2,000 licensed beds and 3,000 affiliated physicians.

Lozada says several duties at St. Luke's helped prepare him for the new position in Detroit, including building a primary care–focused multispecialty group from scratch, creating and operating the St. Luke's Care clinically integrated network, and managing a community-based approach to care.

"The hospitals were important, but we were embedded in the community with about 70 physician offices. We also had seven micro-hospitals that provided emergency and urgent care with eight to 10 inpatient beds to establish what we called neighborhood care," he says.

Lozada is a trained anesthesiologist. He completed his residency at Cleveland Clinic, and conducted a fellowship in neuro-anesthesiology at Mayo Clinic.

HealthLeaders recently spoke with Lozada to discuss his leadership goals at DMC. Following is a lightly edited transcript of that conversation.

HealthLeaders: There are many distressed neighborhoods in Detroit. How do you view social determinants of health?

Lozada: Good health is not something that you acquire from one day to the next. Health is something that individuals and communities work on constantly. Social determinants of health such as whether someone has electricity, running water, transportation or access to a grocery store or not—all of those elements factor in.

We focus more on health maintenance than health treatment and recuperation. That's why it is important for us to integrate into our communities, so we are a force within our communities.

HL: How do health systems and hospitals integrate with communities?

Lozada: At a high level, you participate in community boards at organizations that benefit large segments of the population. These boards include boards of education, grassroots boards related to security, and youth athletics boards. That's the easiest entrance into a community—through the leadership.

HL: Does DMC have a role to play in decreasing gun violence in Detroit?

Lozada: Health systems have to be embedded in the community to determine health, whether that health is psychological, educational, physical, or emotional. The role of health systems today is preventing any type of patient contact with healthcare providers, including gun violence. 

Gun violence has gone down in Detroit, and we think it is partly because we are embedded in our communities and we are asserting a sense of awareness about how gun violence can be curbed.

HL: What are your top priorities for clinical care at DMC?

Lozada: Care coordination is a priority at DMC, but I would like to see coordination of care hardwired through electronic records and through participation in clinical excellence groups across employed physicians as well as independent physicians. 

Another issue is access to care in the community. We want to have portals of entry for our patients, so they can achieve standards of health rather than receiving care for treatment of diseases.

I want to extend the information we give to the family members of our patients who are most vulnerable so they can have a better understanding of when to access our EDs and other care sites. Patients who are at the most vulnerable state require a transformation in the way they live so they can achieve and maintain health, rather than fall into a cycle of treatment-health-disease, treatment-health-disease.

We need to have a primary care strategy. We want our patients to go to their primary care offices more readily than they would go to our specialty care. We would like to have our specialty physicians more coordinated with our community physicians, so there is a mechanism to join care between the community and the hospital.

HL: In your role as CMO, how do you foster physician leadership?

Lozada: In the medical staff, leadership development is a continuous project. I see leadership in medicine as a series of areas that I work on with physician leaders who are already in place. I also work with the physicians who are coming up through the ranks, so they can become leaders in their own right.

[These leadership areas are]:

1. Relational leadership features physicians coordinating with other specialties. Particularly in primary care, relational leadership builds trust within the medical community.
2. Contextual leadership involves the role that the physician plays in the life of the patient, the life of the community, and the life of the health system. Contextual leadership is a byproduct of a sense of community.
3. In supportive leadership, physician leaders build a sense of initiative in the younger generation of clinicians. We want our younger physicians to constantly seek out best practices and implement those best practices day in and day out.
4. Inspirational leadership comes through example. As our physicians develop inspirational leadership, they provide a sense of "follow me" in the journey of healthcare. It is ever-changing like a great hike through the woods. In healthcare, there is new scenery every month. In inspirational leadership, physician leaders train other physicians to have a sense of excellence.
5. Responsible leadership allows us to develop a sense of stewardship within the organization. We're here for a limited amount of time; and in that time, we want to develop and create an organization that is better than when we took it over. That is the best way to pay homage to those who have preceded us.