3 Lessons from a Physician Turned Population Health Leader

I used to be obstetrician/gynecologist, but I hung up my scrubs more than 20 years ago because I saw an opportunity to have a bigger impact on health outcomes and access to care. Don’t get me wrong, I loved delivering babies. With every birth, I felt privileged to help bring a new life into this world.

At the same time, I have always been drawn to the societal mission and system-level challenges of caring for the sick and optimizing health, especially as these relate to disadvantaged and vulnerable. In these populations, access to care is often limited, costs are a significant burden, and socioeconomic conditions contribute to health inequities.

I wanted to touch more lives by changing the system to better prevent and treat disease. As a physician practicing clinical medicine, I could make sure that my individual patients got the best care possible by paying attention to how each was unique and then addressing their specific needs. The doctor-patient relationship is sacred and rewarding. Yet, I could only deliver care to one woman or one baby at a time.

Today, practicing population medicine as chief medical officer at AxisPoint Health, I am reaching large numbers of people by overseeing the development of innovative, analytics-driven approaches to care management. These programs bridge gaps in care processes to significantly reduce health risks, lower costs, and improve quality of life. Being a healthcare leader is not without its challenges, but population medicine offers the opportunity to effect significant improvements and impact large numbers of lives. This is a very different kind of reward than the thrill and privilege of delivering babies, but it is nonetheless very rewarding.

What have I learned as I’ve navigated my career trajectory? Here are three lessons I keep re-learning every day.  

Don’t Lose the Patients in the Data

To get the skills to work in population medicine, I needed to retrain in preventive medicine and public health. As part of that retraining, I obtained a Master of Public Health in epidemiology. The skills I acquired, which include quantitative research and analysis, were invaluable. During my career, I’ve used these tools to design, implement, and evaluate care management programs and software solutions for integrated health systems, health plans, and care-management services organizations.

The potential to use data to improve population health is just beginning to be tapped. For instance, at AxisPoint Health, sophisticated predictive analytic models are helping us comb through different types of data, including socioeconomic data, to zero in on patients who can benefit most from specific forms of assistance.

But, it’s important for healthcare leaders to remember that the data and the data analytic technologies are only tools. It’s easy to get caught up in the intellectual exercise of interpreting flow diagrams, c-statistics, and spreadsheets. Ultimately, however, if these exercises are not grounded in our ultimate mission—to improve people’s health and reduce suffering caused by disease—then we’re missing the boat.

My years as a practicing physician continue to center me whenever I start to lose sight of the mission. I turn to my rich memory bank of patients to remind myself of the humanity behind the numbers on a bar chart or run diagram. I think all healthcare leaders, no matter what our specialty, need to continually remind ourselves what our work is about. A clinical background is not necessary. There are many ways for healthcare leaders to keep our mission front and center, from reflecting on a friend’s health experience to accompanying physicians and nurses on patient rounds.

Keep Your Passion Flowing

I followed the often-repeated advice, “Follow your passion,” and it’s made all the difference. I identified and focused on an aspect of health care—improving population health—that I continue to find intriguing and exciting. This helps me stay energized. And healthcare leaders need energy, because the challenges we are trying to solve are complex.  

One of the biggest challenges is that the patients most likely to experience accelerated disease progression, resulting in hospital admissions, emergency department visits, and poor quality of life, tend to have multiple chronic diseases as well as a range of other risks, from behavioral health issues to a lack of transportation to physician appointments. Another challenge is that traditional condition-management programs tend to give patients a long list of what I call “should-isms.” In other words, “You should lose weight,” “You should exercise more,” “You should take your medication on a more regular basis,” etc. A long list of “should-isms” can be overwhelming to patients with more on their plate than they can handle.

At AxisPoint Health, we are addressing these challenges with a more targeted approach to care management. First, using predictive analytics, we zero in on those patients most at risk for poor health outcomes or unnecessary hospital admissions. Then, instead of giving the patients a list of should-isms, we focus on one behavior at a time, starting with the most impactful interventions. For instance, we know from research that improving medication adherence in people with chronic diseases can significantly reduce their risk for disease progression and increased medical needs. Our case managers help patients to work around barriers to taking their medications. For instance, if the patient doesn’t drive, the case manager arranges to have medications shipped.

We are hopeful this approach will significantly reduce adverse events and poor outcomes across patient populations in a more effective fashion than typical disease-management approaches.

Follow the Opportunities

It’s an exciting time to be a woman leader in healthcare. Leadership opportunities for women are only growing. We must be willing to point out when organizational dynamics are not optimal for women to pursue leadership positions, but I have always found that looking for opportunities for growth and advancement tends to get me farther than focusing on the hindrances.

One way to do this is to bring our strengths to the table. Research shows that women leaders tend to be particularly strong at communication and relationship-building. These people skills are especially important in health care where we need to keep our relationship to the patient front and center. 

Virginia Gurley, MD, is chief medical officer for AxisPoint Health.