Imelda Dacones serves as President and Chief Executive Officer at Northwest Permanente.
On November 11th, Imelda will serve on the panel "Getting Disruptive: Rethinking Leadership Strategies of Women in Healthcare" at Becker's 8th Annual CEO + CFO Roundtable. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place November 11-13, 2019 in Chicago.
To learn more about the conference and Imelda's session, click here.
Question: What is the single most important thing you need to do in your role? (e.g. What do you have to be great at?)
Imelda Dacones: The most important thing I think we can do as physicians and leaders—really as human beings— is to learn how to effectively communicate. We have to provide a lot of information on a daily basis as physicians, but information is just the download. Communication is getting through and truly engaging with one another.
Whether I’m sharing a diagnosis and treatment plan with my patients or communicating strategic operating plans to my team and business partners, it is critical that I’m able to distill the most essential information and communicate it in ways that will get my message through. And to do this, I have to know my audience.
As physicians and healthcare leaders, we need to communicate to a diverse community of stakeholders every day--patients, nurses and other members of the care delivery team, business partners-- all of whom bring a different point of view and set of cultural circumstances that influence how we connect with one another. Being culturally responsive in how I communicate with my patients and partners is critical. For example, I would never explain a “diabetic diet” to a Hispanic patient in the same way I would to a non-Hispanic patient. Ideally, I am communicating in their native language, but at the minimum, I am sensitive and responsive to the language they speak and the cultural perspective that conditions their experience.
Q: There is a lot to improve upon in healthcare. Of the many issues that hold your attention, what is the one you consider exceptionally imperative and urgent?
ID: The existential threat we are all facing, of course, is climate change. Without a planet, there are no people. If you look at Hurricane Dorian as the most recent example, there have been over 40 deaths and over 70,000 people displaced from their homes and it isn’t over yet. And these kinds of extreme weather events are becoming more frequent year over year as temperatures continue to rise. Catastrophic floods, more severe and longer heat waves, and longer more devasting wildfire seasons all conspire to make unforeseen challenges for healthcare.
Global warming is on track to be the greatest public health crisis we’ve ever seen. Not only do extreme weather events create immediate health concerns such as increased respiratory distress, cardiovascular disease, and vector-borne illnesses, but the devastation, displacement, and homelessness these events cause are traumatic for the children and adults who experience them--compounding an already over-burdened mental health system.
And all of these climate-related health impacts disproportionately affect the poor and most vulnerable. These are folks who can’t afford health insurance, never mind recovering from the kind of devastation global warming brings. Look at the floods earlier this summer in the farmlands of the Midwest and the impact they had on the hardworking people who make their living off those farms.
On a more micro level, I worry most about things I feel most powerless to affect as a clinician but absolutely determine the health and wellness of my patients. I know how to treat my patient’s diabetes. But I can’t help them get well if they can’t afford their rent and they are living out of their car. I worry about how much can we really make a dent in wellness and health of our communities if we don’t at the same time impactfully address their most important needs---clean water, healthy air, nutritious and sufficient food, reliable shelter, love. And I worry about how as a society we’re going to come together to address these basic needs in the current climate of increasing division.
Q: Healthcare leaders today need skills and talents that span beyond those emphasized during formal training and higher education. What is one specific competency that you learned or sharpened in real life?
ID: Whether it's 2019 or 1950, one competency healthcare leaders need to learn outside their formal training is change management. Individually, self-change is the work of every human being. Our life journey is to try to evolve into a better version of ourselves. Professionally as a clinician, we communicate, plan and do change — how to be well, stay well, do procedures, and manage and treat chronic conditions, etc. Every life-changing diagnosis I’ve had delivered to my patients, it’s been about change and the whole conversation becomes managing that change. To do that one must be able to appeal to both to their hearts and to their minds. There is both an art and a science to it, and we learn it in the exam room—we learn change management one patient, one person at a time.
The pace of change today is unprecedented. Physicians and healthcare leaders need tools and frameworks to help them adapt and manage change from the most simple to the most complex situations they may face in their jobs—whether it’s about convincing a patient to stop smoking or use insulin even for just a few months to get their diabetes in check, or it’s about building out innovative new programs to improve access in primary care.
For me, the book Switch by Chip and Dan Heath provided the easiest framework for change management I’ve seen. In it, they describe how to effectively engage the hearts and minds through the story of the elephant, the rider, and the path. They suggest that we cannot effectively manage change without dealing with the elephant (our emotional mind) the rider (our rational mind) and the path (the new direction that we need to take.) I recently handed out over 250 copies of this book to physician leaders within my medical group. As technical people, we tend to overlook the emotion, the elephant, and focus on the rider, the rational. This book does a great job of highlighting the need to engage meaningfully with people’s hearts before you go for the mind.