Penny Wheeler: Even in value-based care, leaders of varying backgrounds can thrive

In the era of value-based care, many health systems are looking for ways in which they can develop their physicians into administrative leaders who can guide the organization, not just a physicians’ group.

In the era of value-based care, many health systems are looking for ways in which they can develop their physicians into administrative leaders who can guide the organization, not just a physicians’ group.



One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2015.


In the era of value-based care, many health systems are looking for ways in which they can develop their physicians into administrative leaders who can guide the organization, not just a physicians’ group.


While Allina Health CEO Penny Wheeler, MD, can certainly relate to such endeavors, she’s not ready to brand the clinician-to-chief-executive transformation as the sole formula for all organizations.


“Some doctors are scrambling to get their MBAs, but I wonder if there is going to be a time when people who have been in the administrative ranks will get certifications in clinical care process and care model design,” says Wheeler, an obstetrician/gynecologist who has led Allina Health to a Truven Analytics ranking as one of the top large health systems in the country.


Both types of knowledge are needed in the C-suite, Wheeler says, and can come from an administrator who has an empathetic mindset and has spent time learning how to reduce clinical-care variations, or from a physician who has accumulated experience in finance and operations.

“There is a convergence these days,” she notes, “of needing to understand clinical-care models and clinical-care processes, and having the operational and financial acumen to know what kind of team you have to assemble to lead.”


The learning curve can be steep regardless of which side you begin on. Wheeler was named chief clinical officer of Allina in 2006 and freely admits it took her time to adjust.


“You can go from feeling pretty adept at doing a complex hysterectomy with a lymph-node dissection in the operating room to feeling like you don’t know how to run your email account,” she says with a laugh. “When you’re relatively good at something you trained your whole life for, and then all of a sudden you feel like you’re on a separate orbital plane, that’s hard.”


What kept her going, she says – and what led to her growth as an executive that ultimately put her in charge at Allina – was the purpose and mission she had, which did not change in the move from the exam room to the administrative offices.


“It’s just a sheer privilege that we get to be in a role where, by our actions, we can improve the lives of thousands,” Wheeler says. “That’s an incredibly fortunate position to be in.”


The opportunity to make a larger impact on communities in breadth and scope is an important consideration for physicians who are considering a move into an administrative role, she adds. Just as critical is the understanding that a clinical background provides a necessary balance in an organization’s decision-making.


“This is what turned the equation for me,” she says. “Instead of emphasizing what you don’t know yet about business or operations, emphasize what you do know. There was one time when a light bulb went on for me in a meeting of the executive leadership team. I was the only physician in the room and realized, ‘I am the only one that has been next to a patient for 20 years and knows what it feels like to provide their care when you have 23 other things going on that you need to attend to.’ ”


Wheeler’s advice for new physician leaders is just as applicable for all administrators:


Realize that you can’t do it all. “As physicians, we’re used to being the one that our patients put their trust in. But in a business environment, you really have to rely on those around you, so you need to assemble a team that thinks differently than you do and complements your skill set.”


Time is your most precious resource. “Your time is your currency. A lot of people make demands on your time and you have to think about what’s important – advancing the performance in terms of our mission – so you should spend your time on what is most impactful.”


Invite your team to be truthful. “When you get in these positions, people want you to be happy and want to highlight the good performance we’ve had. They might be more reticent to talk about where things aren’t going well or failing, so you actually have to ask for difficult messages. Invite people to be open and honest because, if they’re not, somebody’s life could be affected adversely.”


Wheeler has been instrumental in championing Allina’s collaborations with other providers, from an accountable-care alliance with HealthPartners to transitional care facilities built with Presbyterian Home & Services and Benedictine Health System.


“I really hope collaboration between systems beats out competition, so we can avoid unneeded duplication of services,” Wheeler says. “When we say we compete in healthcare, I think sometimes other countries look at us like we have an arm growing out of our head. I think that, to the extent we can do it effectively, collaboration is important. Even when you see acquisition and merger activities occurring in healthcare, I think it’s going to be more about adding complementary services across the continuum.”


Yet the transition from a fee-for-service to a value-based model brings its share of growing pains. Wheeler points to a recent program Allina developed to provide care coordination for cancer patients. In terms of care, it was a huge success – it kept 95 people from needing to be readmitted to the hospital and saved the community $1.2 million. There was just one problem: Allina lost $600,000.


“Right now, we’re in an environment where you actually lose money by doing the right things sometimes,” she says. “It is a conundrum for all of us in healthcare. I think we’re going to experience some whitewater rapids getting to where we need to be, but it will be good for the people we serve when we do.”


Still, Wheeler says, these and other winds of change stirred up by reform “make it an exciting time to be a leader. There’s no better time to be in healthcare because the sails are up in the air and you can turn this big Queen Mary of healthcare in a better direction for the people we serve.”



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