The corner office: Cook County Health's Dr. John Jay Shannon on the 'national embarrassment' of healthcare disparities in the US

For the wealthiest country in the world…to not have figured out access to basic healthcare as a fundamental right for individuals, I think is a little bit of a national embarrassment.

John Jay Shannon, MD, became CEO of Cook County Health & Hospitals System in Chicago in June 2014, but that was not his first encounter with a safety-net healthcare system.

He joined the medical staff of John H. Stroger, Jr. Hospital of Cook County, formerly Cook County Hospital, in 1990, serving in various capacities. He then went to Dallas, joining that city's safety-net system — Parkland Health & Hospital System — as executive vice president and CMO.

Dr. Shannon returned to Cook County in 2013 when he became chief of clinical integration at Cook County Health & Hospitals System, a role he held before he assumed the CEO spot last year.

When he's not at work overseeing Chicago's safety-net health system, Dr. Shannon spends time with his wife Robin, who is a nurse. They have three adult children, Ryan, Dylan and Caley.John Jay Shannon MD CCHHS Web Res

Here, Dr. Shannon took the time to answer Becker's Hospital Review's seven questions.

What's one thing that really piqued your interest in healthcare?

I had a good family medicine doctor growing up who set a couple of bones and stitched me up a few times, and my mother was a nurse and one of my sisters is a nurse. I also enjoyed science, physiology and working with people. It was between that or teaching, and I found out you could do both if you go into medicine. It was a natural fit.

Having said that, I started out thinking I would take over that family medicine doctor's practice. But then I got to medical school and found there were a lot more interesting things to study in the 1980s than there were in the 1940s when my doctor went to school. That's when I found my interest in internal medicine.

What do you enjoy most about Chicago?

Obviously, the weather. [Laughter.] Chicago is a blast. Besides the fact that I grew up here and my very large family is mostly around this area, I get a huge kick out of the diversity of Chicago; the busyness and complexity of the city.

Love the diversity, particularly as it relates to my job. I like the diversity of the staff and patients who are in our health system. Much of my career and training has involved working with urban poor populations. Chicago is a great place to be practicing.

The city has diverse talents and opportunities. We have a hill to climb as relates to healthcare disparities in this city. It's a great place for me personally, but it is also a satisfying place to be professionally.

If you could eliminate one of the healthcare industry's problems overnight, which would it be?

Access to care would be the one. It's very interesting; I've practiced in public health systems virtually my entire career as a physician, and it's very striking when you see the gap between healthcare access and healthcare quality across the spectrum of the United States. It turns out to be a very local phenomenon. I meet with colleagues who are at other safety-net institutions, and it's striking to hear how different they are. Hospitals are a product of that city, county and state, with our federal policy kind of in the background. Even in the safety-net community, there is a big difference between one and the next. That's peculiar.

For the wealthiest country in the world…to not have figured out access to basic healthcare as a fundamental right for individuals, I think is a little bit of a national embarrassment.

The second part is really about recognizing that healthcare access is only one part of the problem. One thing people are increasingly recognizing is that the traditional delivery of healthcare, which most health system CEOs grew up with, has a modest impact on the health of a community. It's other things — like access to jobs, a safe environment, access to public transportation, clean air and water — that really drive a lot of the advances that we see in healthcare. When we look at our health status in Chicago, Cook County or Illinois, and measure it to that of an average American or to that of Americans in different metropolitan areas, we are not leading the pack. We have a lot of work to do in that area.

As a broad comment on where we are in Chicago and the system, access to care is necessary but not sufficient to improving healthcare for the underserved residents of Cook County. Medicaid expansion has been transformative for us as a system: We have gone from having a majority uninsured population that we care for to a majority insured population. So now I spend time talking with staff that our patients now have a choice. [Medicaid expansion] has been a boon for patients, but it's also a wake-up call for the system: Not only do we have to provide good care, but we have to do it in a…patient-centered way so we can retain the patients.

What do you consider your greatest talent or skill outside of the C-suite?

I do a great Elvis imitation. [Laughter.] No, just joking. I have to tell you, one of the things my wife has been unimpressed with is how much time I have left over at the end of the work day.

I can compete with just about anyone when it comes to parking it on a beach and reading and taking it easy. I am not a person who, when not at work, is training for an Ironman or composing a symphony. I'm good at unplugging and disconnecting when not at work.

How do you revitalize yourself?

I'm part of a big family. I'm lucky that my father is still alive and I have a large extended family, and I'm married and we have grown kids who are terrific. I'm lucky in my life with my family and friends. I also bike and read.

What's one piece of advice you remember most clearly?

It's less advice than a rule for living: Be happy with your work.

As my career developed, I was given great opportunity, both with where I was and the kind of individuals I worked with. I learned a lot from patients and mentors and have been lucky that although my career has led to increasing levels of complexity and responsibility, I've always found the work very, very satisfying. The fun of my position now is the very talented leadership team of mission-driven people I work with. They have different ideas and perspectives on the best strategy to help the system and people we serve. They're a very strong group of teammates, so even when stuff is flying, we're able to enjoy ourselves at work.

Aside from having big goals and things to accomplish, you better get satisfaction out of your work, and I do.

What do you consider your greatest achievement at Cook County Health & Hospitals System so far?

I think the most important accomplishment is having assembled a leadership team that is gelling, talented, and has good experience from in our system and outside our system that can address huge complexities coming in healthcare in next couple of years. The biggest source of pride and satisfaction today is the leadership team I'm working with.

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