City of Hope Orange County President on Community Cancer Needs

Annette Walker, president of City of Hope Orange County, shares expansion plans, innovations, and advice for future healthcare leaders.

Editor's note: This conversation is a transcript from an episode of the HealthLeaders Women in Healthcare Leadership Podcast. Audio of the full interview can be found here.

Annette Walker has more than 40 years of experience working in the healthcare sector and has held senior leadership positions at some of the nation's largest healthcare systems in the country.

In July 2018, Walker joined City of Hope Orange County as president and has led the effort to build the organization’s comprehensive cancer campus in Irvine, California.

She currently leads the expansion of City of Hope into Orange County by working with physicians, community leaders, and healthcare experts to bring innovative cancer care and research closer to the patient populations served by the system.

In January 2020, City of Hope opened its first Orange County location in Newport Beach and there have been plans to further expand the cancer care footprint in the county. In this podcast interview, Walker provides background on the expansion, how City of Hope strives to meet the community's cancer needs and advice for future healthcare leaders.

This transcript has been edited for clarity and brevity.

HealthLeaders: City of Hope announced a $1 billion investment to build a new comprehensive cancer campus at FivePoint Gateway in Irvine, which is slated to open in 2022. How will this new campus assist in City of Hope's goal to cure cancer?

Walker: One of the most important things for leaders in healthcare is trying to understand what a community needs and tailoring our services to fit the needs of the community.

Orange County, California has 3.2 million residents and [it's] the sixth-largest county in the United States. When our team got on the ground, we evaluated how people were receiving cancer care in the community and we came to understand that nearly 20% of [residents] need to leave Orange County to get specialty cancer care and access to clinical trials.

What we are specifically addressing is that 20% [of patients] and that is our niche. City of Hope is a specialty cancer and research hospital. We have [more than] 400 physicians who are specialized in a specific area of cancer, and in addition to that, we have 800 scientists and researchers are dedicated to finding the cure for cancer.

Irvine is going to be the centerpiece; that's where a comprehensive cancer center is going to be. We're on schedule, and on budget, to open next August. We are also on schedule to break ground on Orange County's only specialized cancer hospital in 2022.

But in addition to that, we understand how people live and how they travel. There will need to be some more convenient access positions at different parts of the county because we understand and know how far someone will travel for a particular service. For example, with radiation oncology, one of the other services we provide, how far from Irvine can that be for our patients to still feel like it's convenient? We're mapping out the problem patterns of Orange County, the populations of Orange County, and their predicted diagnosis of cancer.

In some areas of the country, traffic patterns are not as important, but they're a big deal here. It's one of the additional reasons why we decided to come to Orange County. We're 55 miles away from Doherty, California. That doesn't sound like a terribly long distance in certain parts of this country, but in Orange County, that can be a two-hour drive each way. So, if you add a four-hour commute on top of a cancer treatment, then your day [turns into a] 12-hour day. It's burdensome. There are people who do it; 3,000 people do it when we were originally doing this study, but it's just not what's right for the patient.

We are answering a call to come to Orange County to specifically meet that need to put specialized cancer experts on the ground and [provide] clinical trials to people who have the most difficult and challenging cancers to make sure they have access to the latest and the best that science has to provide.

HL: Can you talk a little bit more about the other locations that are slated to open in Orange County, including the Lennar Foundation Cancer Center, and Orange County's only hospital exclusively for treating and curing cancer?

Walker: The cancer center, which is going to open in August 2022, is the Lennar Foundation Cancer Center. Lennar was generous to City of Hope and the community of Orange County in making a significant landmark donation of $50 million to ensure that we could have the center on the ground for the people of Orange County. Lennar has been a citizen of Orange County for many years and has built many homes in our communities. [The company] has always given back and this is one of the most significant ways that they're giving back.

The Cancer Center is going to be a fully comprehensive specialty cancer center, [where] we'll be doing surgery, all types of cancer treatments, [and conducting] clinical trials; it will be a gamechanger for access to the Orange County community.

[Additionally,] the hospital, which we are going to break ground on next year, will be Orange County's only specialty cancer hospital. You might ask why that matters. Cancer is complex, is often chronic, and doesn't just affect the patient, it also affects the family. Imagine a place where 100% of the people who work on that campus understand cancer. They understand the patient's journey, they are highly specialized, so we have the benefit, or the luxury of [being] solely focused on cancer. It's going to be the most leading edge with the most highly expert types of personnel that you can find.

HL: What other initiatives is City of Hope driving for cancer care and research?

Walker: We have over 700 clinical trials that are focused on beating cancer. Today's cures may be just around the corner.

Currently, some of the top four cancer drugs that are used for cancer treatment were discovered at City of Hope. The synthetic human insulin discovery was [also] done at City of Hope and led to the founding of the biotech industry through a relationship with Genentech. So, we have an amazing history of discovery and that's not stopping.

City of Hope also has three Good Manufacturing Practice (GMP) facilities, which means we can manufacture the drugs that are used in the trials. It's an unusual capability.

There's another initiative that City of Hope is calling ‘Access Hope.’ The intellectual capital that I just talked about, like those 400 doctors, 800 scientists, 700 clinical trials—we believe more people should have access to that. Access Hope is a company that we formed to assist in the democratization of cancer specialty care. We now have over 2 million lives enrolled.

For instance, Amazon is one of the clients, and their employees [in Washington] can access a City of Hope expert and that expert will work with their physician in Washington to help make sure that the protocols that that patient is on are the very best, just as if they were in the City of Hope facility.

HL: As a mother of six, yourself, what advice do you have for those to further their career path while also looking to have a family?

Walker: I believe you can do both, but I also believe it's a woman's choice. I have the greatest respect for women who choose to stay at home; that is a career. If you choose to work for somebody else and work outside the home, that's also a choice. You must do what's best for your family.

I hear women ask, 'When's the best time to have a baby?' 'Should I have a baby?' 'Is it going to ruin my career?' If you're worried about having a child [will ruin] your career, my first advice would be to go find a new company. Currently, many women have proven that that's not an issue.

The other thing is don't put your personal life on hold for a career. I'm at the later stages of my career, and I've had some amazing jobs, places I have loved working for and had a long tenure with, and I decided to leave them. A big deal is made, 'Oh my gosh, what are we going to do without you?' Then you a month later you find out that the organization is proceeding, things are working out, organizations are resilient, and will continue.

Your family does not necessarily have that resiliency. So, don't put that personal development on hold for a job. You can do both, and you can claim both, but don't be deferential. Because at the end of the day, your family's still going to be there, and someday you're going to retire. Be clear where you're putting investments and what your long-term investments are.

HL: What leadership advice can you pass on to women and others who strive to serve in leadership roles in healthcare?

Walker: Healthcare is a wonderful industry and it is friendly to women. But we still have a way to go if you want to see more women in the top spots.

I'm going to talk about what I think is maybe one of the most essential characteristics of a leader that I think leads to success. Everybody has bad things happen to them, has disappointments, gets insulted. But what people like that do is they choose to take that disappointment or that challenge and choose to make it a learning opportunity; they build resiliency and strength.

So, if you [have a] disappointment … you can step back and say, 'What can I learn from this to make me stronger?' That's what successful people do. If you're going to build a leadership muscle, the one I would build would be resilience. You will prevail over time—you may not prevail tomorrow—but over time it's going to matter because those are the people that make it to the top.