It all comes down to relationships: MGMA CEO Dr. Halee Fischer-Wright on the business of healthcare

Halee Fischer-Wright, MD, became president and CEO of Englewood, Colo.-based Medical Group Management Association — the largest association for medical practice administrators and executives — March 23.

Prior to joining MGMA, Dr. Fischer-Wright served as CMO of St. Anthony North Health Campus in Westminster, Colo., part of Englewood, Colo.-based Centura Health System. Early in her career, she started her own medical practice and spent time as a consultant. She also served as president of Rose Medical Group, a 680-physician group in Denver, for 12 years.

Dr. Fischer-Wright, a physician leader and nationally recognized healthcare executive and speaker, took the time to discuss her career Dr. Halee Fischer-Wrighttrajectory, healthcare's core issues and what she loves most about her role as MGMA's chief.

Question: As a clinician, what initially made you want to switch to the administrative and advisory side of healthcare?

Dr. Halee Fischer-Wright: I started working as president of Rose Medical Group pretty early in my career, but continued to practice medicine for over 20 years. While I was working as an administrator, I was also a business consultant. Eventually, there were just too many hats. I arrived at a place in my career where I knew I was going to have to either commit to the physician group in a much larger way, or I could take the next step up and become a hospital administrator, which is ultimately what I chose to do.

The whole reason I wanted to do that is I wanted to make an impact and improve healthcare. What I saw in the healthcare landscape was physicians feeling more disempowered, frustrated and dissatisfied, as well as their patients. I was utterly convinced down to my toenails that there had to be a better way of doing things than what we were doing.

Q: What are some of the most important lessons you've learned from your past experiences practicing medicine, managing a physician group and serving as a CMO? How do these influence your approach/strategy at MGMA?

HFW: Every important lesson that I've learned in the multiple different settings that I've been in every capacity have taught me that everything is about relationships. If you're having problems, it's about your relationship. If you're doing well, it's about the relationship. If your organization is thriving, it's about the relationships within the organization and the culture. It doesn't matter what iteration when I reflect back, but what I would say is that medicine is a customer service business, and we are in the business of relationships. It doesn't matter if you're a staff member, physician or administrator, or if you're running a large healthcare association with 33,000 members, it's about the relationships.

When I was a CMO I was actually hired to create culture change in our organization. I was brought on basically to take an antiquated medical staff — one that was very much still physician-driven — to become focused on team-based and patient-centered care.

When you bring about that transformation, what comes with it is your triple aim themes of better quality practice of medicine, lower cost medicine and patient satisfaction. Those things all come into play.

There is also the question we ask all the time: Which one of you is the bad doctor? Meanwhile, if you actually take a look, someone has to be on that end. When I was a CMO, we worked toward changing the culture, but more importantly, what we looked into and ultimately delivered was actually a new model of care. At least it was innovative for Colorado — it was a patient-centered medical home. I think there will be a lot of innovations around patient-centered medical homes as we move forward, so it's basically the North Denver spin on PCMH, but it was a dramatic transformation from what was going on before I arrived — to think from the position of what matters from the patient.

When I first joined MGMA I talked a lot about how we are in the business of helping people. We are a data organization, a membership organization and we are an advocacy organization. Really, if you get right down to it, we take care of people. If you really want to take that metaphor to the nth degree, we take care of patients in a lot of ways through our data and advocacy. Our goal is to help patients and we do that through our members. What we're talking about is transforming care models.

Q: Your appointment at MGMA is relatively new. How have you been acclimating your new position and work environment?

HFW: I used to have a saltwater fish tank, and whenever we would bring new fish in we would have to put the fish in the bag, let the temperature equilibrate, let a little water in, a little water out — that's not how this has been at all. Pretty much someone just took the bag and dumped me in. I think that's probably the best metaphor. But it's been great.

The benefit that I had is that I went through a very prolonged recruitment process. I think MGMA had solicited candidates for a CEO position starting in September, and the recruitment process really became probably my second job. It was so intriguing and exciting to ask myself, if I was in this position, how would I recreate the world? I had the opportunity to think about that for months and months. What happened was I went through the interview process and just layered on more information. It kind of just coalesced, and I worked with the board as well and the interview team. We discussed what was important, what needed to be focused on and what needed to be driven.

My first day was technically March 23, but I did an eight-hour board retreat on March 20, so acclimation is still ongoing, but it's been delightful. It's exciting. The people that I work with challenge me, and I feel like this is probably one of the best organizations I could possible work for.

Q: If you could eliminate one of the healthcare industry's issues over night, what would it be?

HFW: Just one? [Laughs] As I think through all of the regulatory challenges that we're going to face and have to face, they all come back to quality. What I would like to do is eliminate all of the 2,743-odd different quality programs out there and just come up with one. One that is clear on what quality is, how to measure it, how to be rewarded for it, and how — if you don't deliver it — you get punished. One of the things I've been saying is that quality in medicine is like love. There are all sorts of different kinds of it and everyone experiences it a little bit differently, but you can't say love is this in a declarative sense. In my world we would be much more clear on what quality is.

Q: What is the most memorable piece of advice you have ever received?

HFW: My mom always said, no matter what, do your best. What I think about most is that I have this amazing organization with 115 employees that has been relatively quiet for five years. How do I help to create — because I can't do it myself — an organization that is the best place to work and inspires people to be their best and change healthcare? I know I can't change healthcare without creating the best place to work. What I think about day in and day out is how can I create a place where people give their discretionary effort and feel fulfilled and happy in the work that they do?

Q: What do you most enjoy doing outside of work?

HFW: I love spending time with my family and friends. Both my husband's and my family all live in the same area, so we spend quite a bit of time with our family. I like to run, cook, decorate and we collect wine. I read a ton. I love movies. I love the kind of movies that honestly just make you giggle. They may not be Oscar nominees, but they make you giggle.

Q: What about your job makes you motivated and energized to come to work everyday?

HFW: It's the people. For instance, part of the executive team went to the Great Places to Work conference recently in Dallas. To me this is serious business. It's the work that has to be done for us to fulfill our potential as an organization, so I'm very serious, very intent, always thinking and reading about this.

I got off the plane from the [Great Places to Work] conference and my abs hurt because I had been laughing so hard. It wasn't the conference, it was the people I was with. What I love is that I am doing very serious and important work with people that I love being with and who have their own vision and their own expression they want to manifest. I'm very humbled with the opportunity to be able to help them achieve that as well.

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