'Are we going to be ready?' Kettering Health leader on cardiology's challenges

Alina Joseph is not your traditional heart and vascular services leader. 

She started at Kettering (Ohio) Health Network — which has since rebranded as Kettering Health — nine years ago as a financial analyst. She took over as executive director of heart and vascular services in 2020, and she credits her family's medical history with helping her get the role.

Ms. Joseph has lost three grandparents to heart-related disease and has always been mindful of her own heart health. So when the opportunity arose for her to help others with a history of heart disease, she jumped on it.

Here, Ms. Joseph discusses her experience heading Kettering's cardiology services as someone without a clinical background.

Question: What drew you to cardiology?

Alina Joseph: I have a personal history of heart disease in my family and so when the opportunity arose to be able to lead in this particular field, it was an area of personal interest for mine. My maternal grandmother, my maternal grandfather and my paternal grandfather all died of heart-related diseases relatively early. So I knew early on in my own personal life that I needed to be really careful about what I ate and the exercise that I got and my stress level. I have been very conscious of my heart health because of that, so when the opportunity arose, I was drawn to it.

Q: What heart study, technology or innovation are you most excited about right now?

AJ: We are living in an age of technology and some of the advances that are most interesting to me are related to minimally invasive and structural heart. The things we can do with a couple of portholes that's minimally invasive in heart surgery and thoracic surgery is just amazing. And they're constantly making new advances. We are about to get involved with an additional clinical research trial and we're about to celebrate our 1,000th TAVR here at the main campus, which is just a really great milestone. We're also starting to delve a lot more in valve replacements or valve repairs.

Q: What aspect of your work or the field keeps you up at night?

AJ: Healthcare is changing significantly and I wonder, are we changing at the same rate? There is so much focus now on population health and moving from a fee-for-service to more value-based care. So when and if it changes, are we going to be ready, because right now we do not get reimbursed in a way that is supportive of keeping people out of the hospital. It's this chicken and egg kind of thing of we want to put the steps in place so that we're ready to get there, but right now, I don't know that we're fully prepared if the switch came tomorrow and we were getting paid to keep people out of the hospital. I don't know that we have the resources to do that in the way that we should. I think it's trying to stay ahead of the game while being financially viable, but not being so far ahead of the game that we're not playing the game right.

Q: What's one thing your hospital/system is doing in heart care that you're most proud of?

AJ: In 2023, we received recognition from Premier for our fourth year in a row as a top 50 cardiovascular hospital, and that's something we're super proud of. It isn't a fluke. It was nice when we got it once, and then we got it a second time. We're what we're up to four years in a row. We're really proud of that and want to continue it.

Q: Does not having a clinical background make it easier or harder to work with clinicians? 

AJ: I rely obviously very heavily on my clinical colleagues when it comes to making decisions that are on the front lines. I work really closely with our clinical partners, but at the same time we operate a business and so that's the area of expertise that I can bring to the table and when we combine those, it works really well. My partner, who's the medical director, covers the clinical side of things and I cover the business side: Are we keeping costs as low as possible? Are we pursuing new services or providing new things that are going to keep us financially afloat, as well as meeting the needs of the community?

Q: What leadership advice would you give others who want to be in your position someday?

AJ: Some of the best advice I got early in my career was bloom where you're planted. I think when people are always looking for what's next, they can't blossom and develop the role they're currently in. So I would echo that advice: Look at the role that you're in and expand it, do everything that you can to make your current role as big and impactful as possible, and then future doors will open. 

The second piece of advice is leadership is more about serving than leading. Think of the leader  that you want to follow; be that person and others will follow you. Inspiring individuals is really what leadership is all about. It's providing clarity, providing a vision, encouraging them and being the support for them, giving them the resources that they need to do their job. It's really about serving them knowing what their needs are and how to best meet those.

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