Susan Turney, MD, MS, FACP, FACMPE, serves as Chief Executive Officer at Marshfield Clinic Health System.
On May 25th, Dr. Turney will give a presentation on "The Nexus of Innovation and Rural Healthcare" at Becker's Hospital Review 11th Annual Meeting. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place on May 24-26, 2021 in Chicago.
To learn more about the conference and Dr. Turney's session, click here.
Question: What, from your perspective, is the biggest challenge about the future of work for hospitals, and what can they do about it? (i.e. automation, desire for more flexibility, clinician shortages, etc.)
Susan Turney: I come at this from the perspective of rural health care where we are seeing hospitals close across the country, provider shortages, and subsequently, rural patients living farther away from needed health care services. According to a Merritt Hawkins survey, 93 percent of final-year medical residents say they would prefer to practice in communities of 50,000 people or more, compared to just 3 percent looking for communities of 25,000 or less. Most of the communities we serve have populations of 2,000 people or less. According to the Washington Post, “More than 100 of the country’s remote hospitals have gone broke and then closed in the past decade, turning some of the most impoverished parts of the United States into what experts now call ‘health-hazard zones.’”
So we’re seeing rural hospitals close at an alarming rate, and getting providers to work here has become more challenging. About 1 in 5 Americans live in a rural area, and these people are being woefully underserved in terms of available resources. Rural areas suffer from a dearth of public transportation, a lack of broadband internet access which limits telehealth opportunities and basic economic development opportunities, and in general, rural Americans are older, sicker and poorer than their urban counterparts. So to me, the big challenge is, how do we create a model of care that serves rural communities well despite all the systemic challenges?
I believe hospital consolidation is likely going to continue into the future as a necessary way for rural hospitals and clinics to be sustainable. But I also believe that if done correctly, larger systems can help keep smaller hospitals sustainable. We need to be able to provide health care services to patients locally for those things that can be safely done locally. The more people do procedures the better they are at them. That’s why we can do things like utilizing a rural hub and spoke model where what can be done safely in a local environment is kept local, and when it becomes more specialized, we get patients to the main hospital for more specialized care. In the aggregate of a large rural area, you can make this work. I think we can have high quality specialized care in rural areas.
Q: What do you see as the most exciting opportunity in healthcare right now?
ST: There’s a crisis in rural health care that needs solving, and it won’t be solved by a single person or organization. We need community groups, industry groups, health care providers, payors, and state and local governments to first recognize the scope of the crisis, and then come together to create meaningful change to solve it.
It should not be the case in this country that people are living in areas so deprived of medical care that they could die because they suffer an event and can’t reach the hospital in time. Improving the infrastructure of rural health care is not just an opportunity, it’s a moral imperative.
Q: What’s one lesson you learned early in your career that has helped you lead in health care?
ST: Early in my career I was mentored by one of the legends in Marshfield Clinic history, Dr. George Magnin. Despite his reputation as a giant in his field, you would never know it talking to George. He was the most patient, kind and thoughtful man, and he had an almost preternatural ability to be present in the moment, especially with patients. No matter what was going on around him or in his life, he was able to pause when he was with patients and focus entirely on them. It’s likely part of what made him such a great diagnostician.
Learning under Dr. Magnin showed me that, despite all the other distractions and difficulties we deal with, our work really is quite simple. It’s about the patient right in front of us and finding a way to help that person. I carried that philosophy through my career as a practicing physician, and I live by it today as a CEO, though on a more macro scale. I do what I do to help people, and that brings a kind of clarity to my work as a leader.
"What's one lesson you learned early in your career that has helped you lead in healthcare? The most important lesson I learned early in my career was that healthcare is a fast-changing world and the imperative was clear; in order to lead effectively I must master the art of change leadership. I learned to focus on people and processes to drive successful change. As a Revenue Officer and Chief Transformation Officer driving big change to help hospitals transform their bottom lines from red to black, I learned to engage the management team early on, along with getting key people into key positions (or removing them, in some cases) then the process part of change goes much smoother. It's important to break big projects down into small wins to build momentum and celebrate the small victories.
Where do you go for inspiration and fresh ideas? Beckers, of course! In all seriousness, the conference speakers are the best in the industry and the sessions are relevant to leaders in hospitals both large and small. And I don't have to look any further than my inbox daily for the most recent healthcare news and best practices.
What do you see as the most exciting opportunity in healthcare right now? The most exciting opportunity in healthcare today is the move to value-driven care with the patient at the center focusing on wellness and prevention instead of treating signs and symptoms with volume-driven sick visits and hospitalizations. Accountable care, the merit-based incentive payment system (MIPS) and value-based payment programs are driving providers from volume to value-based care with incentives to reward both the physician and the patient!
Healthcare has had calls for disruption, innovation and transformation for years now. Do you feel we are seeing that change? Why or why not? Yes, hospitals that are driving change and transformation are receiving high marks in quality and patient-satisfaction. They are investing in technology to coordinate care and making access easier for their patients. At the same time, they are educating and preparing their workforce to be responsive to innovative change. The age of volume-driven fee-for-service medicine is gradually giving way to value-based care. Hospitals must transform to become organizations that reward value instead of volume and develop delivery methods that use evidence-based practices, procedures and technologies to attain optimal outcomes and achieve greater efficiencies. Many primary care providers have heard the call for value and are joining ACO's and working to meet this demand. Sadly hospitals that haven’t transformed to ensure the highest quality patient-centered care and the most competitive prices are being bypassed by the primary care physicians, the patients and the payers. "