Episode 60:
Value Is What Consumers Tell Us It Is
Roxanna Gapstur, Ph.D., R.N., President and CEO, WellSpan Health
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In this episode of Fireside Chat, we sit down with Roxanna Gapstur, Ph.D., R.N., President and CEO, WellSpan Health to discuss how her career as a nurse has informed her leadership style and decision making as a health system CEO. We also discuss scale and why it matters and how remote working will impact the workforce and facility planning in the days ahead.

In January 2019, Roxanna Gapstur assumed the role of President and CEO of WellSpan Health. She has over 25 years of healthcare leadership experience working in group practice, academic, and integrated health care systems which included health plan operations. Prior to her appointment at WellSpan, Dr. Gapstur was a senior vice president and president within the HealthPartners system in Bloomington, Minn. Read more

Transcription

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Roxanna Gapstur 0:03
Being a nurse first before becoming a leader has probably informed my entire leadership style in the way I’ve approached all of my roles. Nurses touch nearly every function in a health system and need to help coordinate across many different disciplines. And that information and that walking up the journey with patients and families is something that I know I bring to bear in my decisions every single day.

Gary Bisbee 0:31
That was Roxanna Gapstur President and CEO Wellspan Health sharing her view of why beginning her career as a nurse has informed her leadership style and decision making as a health system CEO. I’m Gary Bisbee, and this is Fireside Chat. Roxanna explored why more nurses are not health system CEOs and how she thinks about maintaining the accelerated decision making that the COVID crisis as required. She discussed why scale matters and one approach that WellSpan has taken to gain scale. Remote working caused by COVID will become a workforce and facility planning asset and how wellspan is working with insurers to develop an approach to covering telehealth innovations. In response to the question about whether COVID has delayed or redirected well spends board approved strategy. Roxanna responded that value and affordability remain as top priorities, and will proceed even with the pandemic. Let’s listen

Roxanna Gapstur 1:26
For us it has not changed. We still feel very committed to that value strategy. We think affordability in this country is a major issue for health systems and preparers and that is a problem that we need to tackle. Even during a pandemic.

Gary Bisbee 1:41
Roxana discussed her views about balancing risk through payer provider partnerships, and how COVID has increased the challenges of working together as follows.

Roxanna Gapstur 1:50
I wish that I did think that what I have seen so far is a little bit of protectionism on both sides, knowing the financial issues that we all believe are going to continue to be a problem post COVID. So I think it’s made it a little bit more complex for us to think about how to work together. However, for those payers and providers who have a real commitment to the value proposition. I think we will find a way Gary, but it does make it I think a little bit more challenging.

Gary Bisbee 2:20
I’m delighted to welcome Roxanna Gapstuer to the microphone.

Gary Bisbee 2:26
Well good afternoon, Roxanna, and welcome.

Roxanna Gapstur 2:28
Thank you, Gary, it’s wonderful to be here.

Gary Bisbee 2:34
We’re pleased to have you at this microphone. Let’s start by learning about you and WellSpan Health, dig into your terrific experience and views on value health care, what’s changed at WellSpan since the COVID crisis, and wrap up with your view of leadership and leaders in a crisis. So you grew up in western Minnesota and became a nurse. What drew you to nursing?

Roxanna Gapstur 2:59
Really interesting, Gary, I always loved the sciences and I had a very influential biology teacher in high school who actually went on to become the director at the Minnesota zoo. And he really excited my interest in science and in learning more about the sciences. So I really enjoyed that and that was one of the really key things that drew me toward nursing because I was looking for a career where I could really use that information. And certainly nursing was one of those options.

Gary Bisbee 3:18
So how did leadership fit in? At what point did you start thinking about leadership and become a leader?

Roxanna Gapstur 3:35
Such an interesting part of my personal journey. I really wasn’t thinking about leadership when I became a nurse. That’s probably true of a lot of clinical people. I was really thinking about practicing and caring for patients and families and becoming an excellent nurse, and certainly even advancing my clinical training by getting a master’s degree, which I did. And sort of gradually, over time, more and more leadership opportunities came up, some of them simply informal, to start programs in a clinic, or to help lead a team on a project. And then over time, I just began to realize how much I loved leading those things and having those opportunities and how much I was growing as a person and as a leader by doing that. And so I just eventually decided that moving into a leadership role could be exciting and interesting and I took the leap when I was an oncology clinical nurse specialist to become really a director of cancer programs. And that was the very first time that I really had a formal role in leadership.

Gary Bisbee 4:39
At what point did it dawn on you that you would enjoy being a health system CEO and that you’d probably be pretty good at it?

Roxanna Gapstur 4:48
That is a great question, Gary! I’m not sure it really dawned on me until the opportunity arose. Yeah, I’ve always loved challenging myself, both in my clinical work and in my leadership roles and I just happened to have an opportunity to think about this particular position. I actually wasn’t searching for a CEO position when the opportunity came up. But when it did come up, I did some soul searching and I thought, “What an amazing challenge to have as part of my career.”

Gary Bisbee 5:05
What lessons did you learn, just thinking back to your time as a nursing executive, what lessons did you learn as a nursing executive that have informed your approach as a health system leader?

Roxanna Gapstur 5:26
I think being a nurse first before becoming a leader has probably informed my entire leadership style in the way I’ve approached all of my roles. Nurses touch nearly every function in a health system and need to help coordinate across many different disciplines. And that information and that walking of the journey with patients and families is something that I know I bring to bear in my decisions every single day. And I probably have a bit of a different lens than leaders who approach that role from a business perspective, but I think it’s always been a lens that’s been very helpful to me. And certainly with the emphasis on quality, safety, population health in the last 10 years or so, I’ve been really grateful to have that kind of a background.

Gary Bisbee 6:14
Why aren’t more nurses health system CEOs do you think Roxanna?

Roxanna Gapstur 6:19
Well, that’s a great question. I think that’s probably a complex answer, Gary. I would give a few thoughts on that. One is just gender. Of course, most nurses are women. And as we all know, women business leaders are less often in those higher C-suite positions, although we hope that’s improving. And I would also say that a lot of clinical people move into the career not particularly thinking about leadership as the end result of their career. And so getting more nurses interested in leadership and understanding what the benefits can be for leadership is, I think, something that we strive for, certainly at WellSpan, and I know is something that our entire industry could probably use. So I think there’s probably different reasons for that but those are two of the ones that I think of.

Gary Bisbee 7:04
You mentioned your leadership style a little bit ago, how would you characterize your leadership style, Roxanna?

Roxanna Gapstur 7:11
Well that’d be a great question for my team, Gary.

Gary Bisbee 7:13
Yes it would!

Roxanna Gapstur 7:15
If I was gonna answer that, I’d say I have a really collaborative participative style. I love solving everyday challenges with the team, but in realizing that a lot of my role now, of course, is also external. And so I think that collaborative approach both internally and externally has really created value for the organizations I’ve been a leader at and certainly helps with unifying the vision and driving those singular focuses for our team members. And also that collaborative approach during the pandemic has really served us well, since we have relied on other health systems and partners to help us and we’ve helped others as well. So I think it’s been a great way to empower both our communities and our teams by collaborating during a time when we all could use some help.

Gary Bisbee 7:59
This is, in a way, a goofy question but would you make any changes in your career progression, if you could have a, quote/unquote, “do over”?

Roxanna Gapstur 8:07
That’s interesting. If I could have a do over I might have thought about being a leader earlier in my career. I did have some coordinator roles early on and I even was a nurse manager for a little bit, but I then moved away from it and went back to the bedside. And so I’ve just enjoyed being a leader so very much, Gary, and having the opportunity to influence people’s careers and also patients and families in a bigger way and so I might have wanted to be a leader a little bit sooner.

Gary Bisbee 8:36
That makes good sense too. Well, let’s move on to WellSpan Health. You’ve been the CEO at WellSpan now for almost two years and about 40% of that time you’ve been handling the COVID situation. But what drew you to WellSpan Health at the beginning, Roxanna?

Roxanna Gapstur 8:53
I actually learned about WellSpan from a friend of mine who was a recruiter and, you know, wasn’t looking for a job outside of the current position that I was in in Minnesota. But I was really encouraged by this person to consider the role at WellSpan, that she felt it was a unique role and something that would really fit well for me. So that’s how I ended up looking at the role in the first place.

Gary Bisbee 9:04
Will you please describe WellSpan Health for us?

Roxanna Gapstur 9:07
Absolutely. WellSpan Health is an integrated delivery system in South Central Pennsylvania and northern Maryland. We have about 20,000 team members, about 2600 aligned physicians with about 16 or 1700 of those employed as providers, about 200 sites of care. A couple special things about our system is that we do have a large behavioral health organization and made that investment a few years ago and that is probably one of the largest, certainly in Pennsylvania, but in the nation. And then just last year, we embarked on a brand new strategic plan to lead our region in value. And we’re guided by a new vision that our board set called “Trusted partner reimagining healthcare inspiring health” and that has been very inspiring for all of our team.

Gary Bisbee 10:02
We’ll cover value in more depth a little bit later. Coming from Minneapolis and having grown up in Minnesota and now you’re in Pennsylvania, how have you found the transition?

Roxanna Gapstur 10:03
I have found the transition to be much easier than I expected, Gary. I really love South Central Pennsylvania. It’s now become our home. And as you know, I loved living in Minneapolis as well. So it’s tough shoes to fill for me to be able to move somewhere and really, really love it. But South Central Pennsylvania is a beautiful place. The culture there feels very Midwestern to us. The people are very kind and that Pennsylvania Dutch culture is not so very different from the German/Scandinavian culture that we loved.

Gary Bisbee 10:44
Let me ask the consolidation question now given where WellSpan Health is and where you think it needs to be over the next 5 or 10 years. Do you think WellSpan will need to consolidate further?

Roxanna Gapstur 10:58
That’s a great question. As you know, we recently added a new partner just in November of 2018 so not quite two years ago. Summit Health joined us and was the last of probably 4 or 5 new partners that we’ve added in the last six years. And I think in terms of future consolidation, I would never rule out consolidation but I think for us, it’s about our strategy and about where we’re going. So we would be looking for partners who could really help us accelerate our journey to value, is how I would answer that.

Gary Bisbee 11:29
Well, that gets to the next question I was going to ask, which is where does scale matter? And other than pursuing value, how would you answer that question? Where does scale matter?

Roxanna Gapstur 11:39
Well, we have a number of ways at WellSpan that we seek size and scale and some of those are through other partnerships. So for instance, we have a partnership called the AllSpire Health Partnership where we have several other organizations that have joined together with us for both GPO work and also now we’re heavily into supporting each other with the COVID pandemic. So that’s one of the places where we’ve found that scale does matter. We think networks are important and similarly, the WellSpan Provider Network, which is about 1000 independent physicians that have joined our providers in forming an ACO network has been really important for us. And I think over the next 5 to 10 years, Gary, we’re gonna see that scale does matter or scope does matter in things like infrastructure and cost reduction. And so we’re consistently thinking about what is the future of that part of the business as well.

Gary Bisbee 12:29
In terms of competition and scale, certainly there’s some large players around, UPMC would be one example. How do you think about competition and the next several years for WellSpan?

Roxanna Gapstur 12:40
Our market is definitely heating up to be a more competitive market than it was 5 or 10 years ago. And we, as you mentioned, UPMC is in our market, certainly Penn State Health, Lancaster General, and others, and all of them very great, high quality organizations. So how I think about that is that it makes us better as WellSpan to have really great competitors. So we want to be the best. And as I mentioned, we want to lead our region of value. So having those strong competitors makes us really think through our strategy and be intentional about our execution. That’s sort of how we think about it right now, Gary. And we also consider, what do we need to do for the future in terms of building up WellSpan’s capabilities, whether that is consolidation or other kinds of partnerships that, as I mentioned, can accelerate our journey to value.

Gary Bisbee 13:27
What relationship does WellSpan have with the health insurers, the health plans in the area?

Roxanna Gapstur 13:32
I’m happy to say that we have some really strong relationships with our health plans, that we have worked really hard on that, especially since I came two years ago. And so we have two newer partnerships with our Blue Cross plans, that Capital BlueCross and Highmark, which are using innovation to differentiate care and coverage in our area. And that’s pretty exciting for us. It’s also a little bit newer for some of the health plans in our area to think through some of the innovations that we are considering for the future of healthcare. And certainly some of those, you mentioned can be digital, they could be bundled care, but they could also be more joint venture and shared risk services, then what have been done in South Central Pennsylvania in the past.

Gary Bisbee 14:14
Well let’s turn to COVID for a second. Looking back 6 to 8 months ago, what have been the major impacts from COVID on WellSpan?

Roxanna Gapstur 14:22
Well, similar to the rest of the industry, we’ve certainly had impacts related to our surgeries and some of the procedures that we’ve had to delay. We’ve had definite impact on our employees and our physicians from caring for patients that could create danger to their own health. And we’ve definitely had impact in our supply chain and our data and analytics, and even in our payer relationships as we’ve thought about how to partner together to care for patients during the pandemic. So lots of different influences and impacts, as you can imagine, in such a very unprecedented time, across a long period of time now. We’re getting close to 6 to 8 months here of still dealing with the pandemic.

Gary Bisbee 15:02
Has the strategic plan or the strategic opportunities you mentioned that the board approved that a year or so ago had to do with pursuing value, has that changed either in terms of timing or direction because of COVID?

Roxanna Gapstur 15:15
Great question. For us, it has not changed. We still feel very committed to that value strategy. We think affordability in this country is a major issue for health systems and for payers and that is a problem that we need to tackle, even during a pandemic. And we’ve been thinking about all of the different ways that we care for patients and families and that we reach out to people. And certainly, as you probably know, the digital strategy has really advanced at a rate that we didn’t expect because of the pandemic. And that’s one of the ways that we think we’ve brought value to our communities.

Gary Bisbee 15:48
I have several generic COVID questions I’d love to get your input on, but before we do that, why don’t we turn to value and given your experience at HealthPartners with an integrated delivery system and health insurance model, you’re an ideal position to help us think this through. How do you define value, Roxanna?

Roxanna Gapstur 16:09
Well, for me, the value proposition is really around the Triple Aim, Gary. So it’s affordability, quality and experience. And with that, a lot of times, at WellSpan we also talk about the well being of our teams as being part of that. So, for us, that’s value, but in the end, value is really whatever our consumers tell us it is. So we think through value with that Triple Aim lens, but we also are very cognizant that we need to say relentlessly in touch with our consumers to understand how they define value.

Gary Bisbee 16:39
What did you learn at HealthPartners there that are the keys for a successful value model?

Roxanna Gapstur 16:45
HealthPartners is just, as you know, a tremendous organization with some amazing capabilities. And I learned a significant amount about how to share and focus value based tactics and strategies across an integrated delivery system. And I also learned the value, Gary, of the payer/provider partnership, and how together one plus one plus one can equal five instead of three. And I just think that financing and delivery piece being together is a very powerful combination.

Gary Bisbee 17:16
What’s the balance between health plans and health systems or the relationship in this payer/provider continuum? How do you think about that, particularly in terms of carrying risk?

Roxanna Gapstur 17:27
I think that working together to carry risk would actually be a better way to care for patients and members. I do think that that requires each party to compromise, to some extent, on the business models that we’ve used over the last several years. And I understand how challenging that can be. But I do know that there are some organizations who have started to make great inroads in partnering like that, and that we have seen some pretty interesting outcomes from those organizations so far. And I would call out, not only HealthPartners, but Intermountain, certainly Kaiser, which has a very unique model, and others who have really taken that leap and gone all in on value.

Gary Bisbee 18:10
What do you do if you don’t own the health plan like Intermountain does, or HealthPartners, Sentara, those health systems, if you don’t actually own the health plan yourself? How do you form a relationship with a health insurer?

Roxanna Gapstur 18:26
Well, what I’ve done actually, Gary, since I came to South Central Pennsylvania was work really closely with the health plans and payers who are providing membership services in our area. And have found it quite an openness to thinking uniquely about how payers and providers can work together. And so we have some really exciting conversations going right now about how payers and providers might think differently about the future. And as I said, it does require each party to compromise on their business model and to think through things differently, and to really be open to innovation, and how care is going to be delivered in the future. So I think if you don’t own a health plan, you have to be very open to unique and different partnerships which can help accelerate your journey to value.

Gary Bisbee 19:09
Given the prevailing incentives for fee-for-service medicine, what does the federal government have to do to encourage providers and insurance companies to work together to provide value?

Roxanna Gapstur 19:23
Well I think just some of the models that are coming out of CMS right now are pretty interesting. For instance, the primary care model where they’re encouraging capitation, I think that’s exciting because, as we know, how CMS thinks about those things sometimes has a big influence on how some of our private payers think about it as well. So I think they’re a step in the right direction with those kinds of models in thinking about how payers and providers could work together.

Gary Bisbee 19:49
Do you think COVID will accelerate partnerships between health insurers and health systems?

Roxanna Gapstur 19:54
That’s a really good question. I wish that I did think that. What I have seen so far is a little bit of protectionism on both sides, knowing the financial issues that we all believe are gonna continue to be a problem post COVID. So I think it’s made it a little bit more complex for us to think about how to work together. However, for those payers and providers who have a real commitment to the value proposition, I think we will find a way, Gary, but it does make it, I think, a little bit more challenging.

Gary Bisbee 20:26
Do you see a day when we would see the health systems and health insurers actually merge?

Roxanna Gapstur 20:33
I don’t see that day coming soon, I guess, unless there were some major policy decisions that really changed things at a national level. So I guess I would leave my answer at that at this point.

Gary Bisbee 20:44
Yeah, that’s definitely a reasonable way to think about it. Well, let’s go back to COVID for a bit and just talk generally, you can bring WellSpan into this where it’s important. But thinking about supply chain, which you mentioned before, the crux of this seems to be how can we develop, as a country, a more reliable supply chain? What thoughts do you have about that, Roxanna?

Roxanna Gapstur 21:08
Well I mentioned a little bit earlier, Gary, that WellSpan has a partnership with AllSpire Health Partners, which is a group of five delivery systems that work together on supply chain and this is basically all we’ve been thinking about for the past six months is how to have a sustainable and reliable supply chain. Certainly at WellSpan we’ve been thinking about that as well. And some of the things we are considering include, we’re in a manufacturing area of South Central Pennsylvania, as you probably know. We’ve partnered with some of our local manufacturers for some of our PPE and have had really great results there at very affordable costs. So that’s one of the things that we’re thinking through. Another is, what are the businesses and PPE suppliers that are already available in our markets across our 2 or 3 states where AllSpire Health Partners is located? And how can we leverage those suppliers in ways that we maybe haven’t thought about before? And then certainly with our national GPO partner, we’re also asking those same questions and thinking about it at a national and a global level.

Gary Bisbee 22:09
Do you feel that WellSpan needs to develop its own stockpiles?

Roxanna Gapstur 22:14
We have developed a bit of a stockpile, Gary, as much as regulatory rules will allow us to. But one of the reasons that we’ve considered the South Central Pennsylvania manufacturers is a little bit because of that, because we do feel that is a pretty reliable source for us and we’ve had great interest from our partners in the region. So I would like to say that yes, I think we need to have a bit of a stockpile given what happened during the pandemic. As you’re well aware, the national stockpile wasn’t quite as useful as we had hoped it would be.

Gary Bisbee 22:46
Right. Well, let’s turn to the pace of change of decision making. A lot of people feel that that has accelerated throughout COVID. We just have had to make decisions more quickly. And the question under discussion is, can we sustain that? Or will we ease back to the pace of decisions in the pre COVID levels?

Roxanna Gapstur 23:08
I think what we’ve tried to do, Gary, on our team is to think through what needs to have an accelerated timeline and what are the decisions that we can either backburner or think about more carefully and thoughtfully. I certainly think that our strategic decisions, we’ve tried to maintain pretty good discipline around those, but I would agree that the pace of decision making has been faster since the COVID pandemic. And I think it’s just really important to discern when are the times when you can decide something quickly? And when are the times when you need to slow it down?

Gary Bisbee 23:42
What about remote working? Will that become a workforce and facility planning asset for health systems do you think?

Roxanna Gapstur 23:48
I think so. What we’ve found with our employee surveys is that the 4 or 5000 people in our organization that we have who work remotely, have really actually appreciated that option and have reported a really favorable reaction to it. So we’re seeing ourselves as really working now on what long term remote work will look like for our teams, and sort of reimagining our facilities and lease arrangements to match up with that.

Gary Bisbee 24:05
Turning to telehealth, what’s the status of telehealth usage at WellSpan now?

Roxanna Gapstur 24:19
It’s really exploded, as you can imagine. So we actually increased our number of visits greater than six times the national average during the pandemic. We had a great platform anyway and we were using virtual visits for particular issues, you know, things like urgent care. But we literally went from about 200 visits a week to 20,000 visits a week within about 3 weeks. What was great was most of our physicians had already been trained and things like that so it wasn’t quite as difficult as it might have been if we were just searching for a platform and didn’t have that in place. So I think it’s been a really notable example for WellSpan and for many other organizations of how digital health is such an important part of the future.

Gary Bisbee 25:02
One of the key questions is, will the health plans be willing to continue to pay for telehealth usage? How do you think about that, Roxanna?

Roxanna Gapstur 25:11
We’ve been in conversations around that, Gary, with our local payers, for sure. And they are very interested in thinking about long term telemedicine benefits. So we’re actually coming up together with our health plans with some innovative ideas on how we could both extend the current usage, but then also, how would we think about that in the future. What kinds of visits, what kinds of patients would be better served by telemedicine? So I want to be optimistic there and say, yes, I think that’s going to be part of our long term future and healthcare.

Gary Bisbee 25:42
You mentioned affordability earlier. Can telehealth contribute to increasing affordability, do you think?

Roxanna Gapstur 25:49
Oh, I do think so. Absolutely. And I think and I hope that as we work more towards a value based model where we want healthy communities that we think through what are the kinds of things that could be done remotely and in the home. Because, Gary, I really do think that the home will be the new site of care. We all know home care has been an integral part of our health systems for many years but certainly during the pandemic that became even more clear to us. That, especially during a pandemic, when you feel it’s not safe, perhaps, to go to the physician’s office or to go to the emergency department, having the home as a site of care with remote monitoring and the other pieces in place was a critical part of how we cared for our chronic disease patients.

Gary Bisbee 26:35
So do you think health systems will view telehealth as a new business model opportunity?

Roxanna Gapstur 26:41
Well, certainly, if not new, evolving, I would say and I do think that there’s a number of things that we’ve used telehealth for during the pandemic that weren’t even physician office visits. I mean we used it for physical therapy, we used it for home care nursing, we used it for chronic disease monitoring, so all kinds of things that you maybe wouldn’t have necessarily thought you’d use telemedicine for, we were certainly able to do that. And I know many other systems as well. So yeah, I think it’s gonna be a real evolving field.

Gary Bisbee 27:10
Do you think telehealth will open the door to competitors to compete with our health systems?

Roxanna Gapstur 27:16
Well, I think they’re kind of already here. As you know, there are some really great digital platforms out there that provide fantastic care. So I think they’re here. I think they’ll continue to be here and I think as health systems we need to think about how to leverage those same kinds of strategies for our patients.

Gary Bisbee 27:35
Well it’s evident that public health is part of the national security after the COVID experience. How do you think about that, Roxanna?

Roxanna Gapstur 27:43
Public health in general, as you know, Gary, has been somewhat underfunded in our country. And I know across South Central Pennsylvania, we actually don’t have any county health departments in the areas where we are. We have one area that has a city health department, which WellSpan helps fund, so I think that infrastructure is very, very important to our national health, and that we really need to think through, for our future, how we fund that and what the best way is to collaborate on ensuring that that infrastructure is there when we need it.

Gary Bisbee 28:15
Health equity has come to the fore during the COVID crisis. What steps can health systems take to address health equity?

Roxanna Gapstur 28:23
Generally, Gary, what we’ve done at WellSpan is for all of our quality data, for all of our testing data during COVID, we slice and dice that by looking at race and ethnicity, language, and many other demographics as well, and of course, saw disparities that I know many others also saw in their areas. And how we’ve tried to deal with that is through a comprehensive framework and approach at WellSpan, where we have community health teams that work with our clinical teams to reach out into the communities. And we’ve seen a really nice decrease in positivity rates in some of our minority populations using that outreach. So we’ve been really pleased with that work.

Gary Bisbee 29:04
This has been a terrific interview, Roxanna, we appreciate your time today. I’d like to ask her a couple more questions specifically about leadership. What have you found different about being a CEO than you thought you were going to find?

Roxanna Gapstur 29:20
Really good question. I think one of the things that you imagine that a CEO would have ultimate authority and the ability to really create a path through strategic issues. And I think what I have found is that leading by influence is every bit as important as it has been in every role that I’ve ever had. And that also that transparency and trust in leadership has been critical as well. So it’s an interesting role and it is quite different than any other role that I have ever played in healthcare. And there are also some similarities, as I just mentioned, around the way that you lead and the journey that you take as you become a CEO.

Gary Bisbee 30:03
Some say that the role of CEO is a lonely life. Have you found that?

Roxanna Gapstur 30:09
That is a great question. I would say, to some extent, it can be a lonely life internally in the organization because there are some things that you need to maintain distance for, even from your closest team. However, I have found an amazing group of colleagues across the United States who have just been fantastic teachers and coaches for me as I’ve moved into this role. And so I just really appreciate that that support is there.

Gary Bisbee 30:35
What are the most important characteristics of a leader during a crisis?

Roxanna Gapstur 30:39
For me, I think it’s been to make sure that I’m transparent, that I’m communicating, that I’m creating a trusting relationship across all 20,000 employees, to be committed to my team’s well being, and to always be thinking about our team and our patients first. And then to just step back and make sure to look at the big picture. Because whenever we’re in a crisis, it’s so easy to go right to solution mode. And I think being able to step back and focus on the big picture has been really important for us.

Gary Bisbee 31:09
So how’s the COVID crisis changed you as a leader and a family member?

Roxanna Gapstur 31:14
As a leader, I think it has touched the compassion that I have for patients and families on a daily basis in a different way. I’ve talked with so many families during this crisis who have not been able to be with their loved one in the hospital while they’ve really been struggling with a very terrifying diagnosis. And that has again touched me and reminded me how important our work is. So that has been one thing. As a family member, it has reminded me that no matter how far apart we are, we can still support each other and to find all those different ways of supporting each other. It’s certainly changed me as a leader, Gary, and I can’t imagine ever believing that we would all go through something like this in our careers. And I guess I’m grateful that I was able to go through it because it certainly has brought home those lessons that I just mentioned to you. And I think the team has really risen above the challenge. And I’m just so proud of our teams and all the other healthcare teams across the United States who have really cared for our country during this very difficult time.

Gary Bisbee 32:17
Roxanna, I’ve loved this interview. Just terrific. We appreciate your time being with us today. Many thanks.

Roxanna Gapstur 32:23
Thank you so much, Gary. Appreciate it.