MGMA CEO on Leadership and Emotional Intelligence

Halee Fischer-Wright, MD, shares her career journey and her experience leading as a woman physician and CEO, as well as advice for aspiring future 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.

Halee Fischer-Wright, MD, is a well-known business consultant, physician leader, and president and CEO of the Medical Group Management Association (MGMA). She also co-authored Tribal Leadership, a New York Times bestseller, and authored Back to Balance: The Art, Science, and Business of Medicine.

Before joining MGMA in 2015, Fischer-Wright served as chief medical officer for Centura Health's St. Anthony's North Medical Center in Colorado. Prior to that she served as lead physician and then president of Rose Medical Group in Denver. She started her career as a practicing physician.

Recently, Fischer-Wright spoke with HealthLeaders about her career journey and her experience leading as a  woman physician and CEO, as well as shared advice for aspiring future leaders.

This transcript has been edited for clarity and brevity.

HealthLeaders: How would you describe your leadership style and how has your background as a physician impacted your style?

Halee Fischer-Wright: People's leadership styles don't traditionally stay in one domain. When I first started as a physician leader, I would describe my style as autocratic. I think that's how, as physicians, we're often mentored, because we're taught that we're leaders, but we're not taught about leadership. You're tasked with making decisions right off the bat.

As my career path has moved me into leadership positions, my natural gravitation was toward more of a transformational style. In other words, I was always thinking about the future, I wanted to change everything. I was always moving the goal line farther and farther ahead. For people that work with you, that can be a real challenge.

As I head into the middle part of my career, I want to be more of a coaching style. I see that I'm making that transition between transformation and coach style. What I mean by that is identifying the unique traits in my staff and giving them the opportunities to express their strengths in a way that benefits the enterprise. That's a win for our employees. It's also a win for the enterprise.

HL: Health organizations are making the difficult decision on whether to mandate vaccinations for the workforce. What advice do you have for those leaders on making this decision?

Fischer-Wright: Almost all the medical societies and clinic clinical entities have suggested and signed up together to mandate vaccines for clinical settings. The challenge that I have to acknowledge is, because I am a traditionally trained physician, I am incredibly biased for the vaccine for our clinical setting for mandatory vaccination in people delivering clinical care.

 I also say on the other side of my mouth, my organization is an administrative organization. We've struggled with the decision, should we mandate vaccination or not? Ten percent of my staff have not received vaccines, and not for reasonable medical reasons; they're not immunocompromised, pregnant, etc. But one of the things we're faced with is the economic reality of if we mandate our vaccine, then we may lose staff members.

What I recommend is asking, "Do you think it's the responsible thing to do to mandate vaccination?" If you're in an administrative facility, you'd have to decide what are the pros and the cons, and ultimately, what is the right thing to do?

HL: Prior to the pandemic, healthcare workers were feeling burnt out and healthcare organizations were facing staffing shortages. This of course has been exacerbated by the COVID-19 pandemic. What advice do you have for hospitals and health systems that are facing decreased staffing levels and increased burnout?

Fischer-Wright: One thing that I'm talking about quite a bit in media interviews is there's no trend that we're seeing now at this phase of COVID that we didn't see before COVID hit the world. What we have seen, though, is an increase in the velocity of those trends, and certainly burnout is one of them.

Often when you do a deep dive into burnout, besides being overworked and working too many hours, you take a look at the jobs that people are doing and how much of that job is either redundant or unnecessary. For hospitals and health systems that are facing this, my recommendation is to reevaluate the workflow. What part of that job doesn't need to be done? Can we streamline? What are inherent redundancies and inefficiencies?

What part of those jobs can be reallocated into a technological solution that decreases the work for the healthcare provider? There are ways to implement technological solutions that are focused on end user satisfaction, which is not the traditional history of the electronic health record.

I acknowledge that the length and intensity of the pandemic in the United States has been exhausting and traumatic for healthcare professionals. Whereas a year ago, we were recognizing healthcare workers, but we're not talking about how healthcare professionals are heroes today.

A lot of times when we talk about burnout and healthcare, we talk about lifestyle. This is far more than lifestyle, we need to talk about how our expectations of our healthcare providers, which haven't dramatically changed since the 1970s, are out of alignment in a 2020 to 2030 world, and how do we build those systems to that alignment so that we don't burn out our staff?

HL: What originally drew you into working in the healthcare sector?

Fischer-Wright: I was the first person in my family to graduate from college. Neither one of my parents had gone to college. When I was a child, I was curious, I loved science. When I saw my pediatrician, who is incredibly well respected, I loved how he was a part of the family, even though he wasn't part of our family. I loved that when my mom was worried about our health, he was the person who comforted her. I loved that he was the smartest man in the room. My pediatrician was my role model. When I was in medical school, I did a rotation with my pediatrician 20-some years later, and the cool thing was he was still the smartest guy in the room.

HL: What has been your experience working as a woman physician leader and CEO?

Fischer-Wright: I'll be honest with you, it's been a challenge. At the highest echelons of healthcare, up until about five years ago, if you were a woman at a meeting, the assumption was either you were a nursing leader, or you were an assistant to one of the physicians that were present.

There was a meeting that I attended during my first year as CEO of MGMA, and two of the other attendees at this very prestigious meeting had asked me to go get them coffee, because they assumed I was someone's assistant. And that wasn't unusual.

I am convinced, and I do think that you are seeing it play out in COVID, that women bring a unique set of assets to the role of being a CEO. We all have come to understand that a little more emotional intelligence equals a lot more success in the enterprise. That's where women can show up, they can hold the enterprise responsibility in one hand, and women have perhaps a little more experience with emotional intelligence.

One of the things that I often speak about though, is women are not present in the same percentage as men, and we're not compensated the same. My husband is a physician, and I remember that with my first high executive level position, we were negotiating my salary. I basically said, "This is what this job pays, and this is my expectation." And she said, "Well, you don't need that much money, your husband's a physician." We're still navigating some of that.

HL: What advice do you have for women who want to serve in leadership roles in the healthcare sector?

Fischer-Wright: It's crucial that women participate in leadership roles in the healthcare sector. I think it's crucial because we are going to have to redefine what healthcare is post-COVID, where is that care going to be delivered, our traditional models of admitting patients to the hospital, and taking care of patients in a practice are probably going to shift over the next decade to 20 years. The creativity, innovation, emotional intelligence, and leadership that women can bring to that conversation are crucial for us to be successful in navigating those transitions. I encourage any woman who is willing to pick up the mantle of leadership; I heartily encourage them.

The one piece of advice that I have given even to women in my own organization is there is something to learn from men, and that is, do not assume that you're going to be automatically recognized for the work you do. You have a personal brand and you do have to promote your personal brand.