UnityPoint Health's ambulatory division chief Dr. Dave Williams: 'Don't get distracted by the ups and downs of the industry'

Alia Paavola -

Dave Williams, MD, joined Des Moines, Iowa-based UnityPoint Health in 2001 as a general pediatrician.

After spending years practicing medicine on the front lines, he took a stab at a leadership position, which he says was a bit of an accident.

"I kind of stumbled into a leadership opportunity by accident. I remember vividly being in the parking garage of our hospital and my boss at the time asked me to do a one-year position as a leader in our region," Dr. Williams said.

But it turned out to be no accident, and leadership was something Dr. Williams excelled at.  

Since joining UnityPoint Health, Dr. Williams has held several leadership posts, including regional medical director for the central Iowa region and CEO of UnityPoint's ACO.

Now, he serves as president and CEO for UnityPoint Clinic and UnityPoint at Home, the ambulatory division of the health system.

Recently, Dr. Williams spoke with Becker's Hospital Review and answered our seven "Corner Office" questions.

Question: What piqued your interest in healthcare?

Dr. Dave Williams: While this is likely not a unique answer, I hope most of us get into healthcare for the same reason, which is to serve others. When deciding which position and career to pursue, I knew healthcare is one where you can make a meaningful difference in people's lives every day, while having a pretty good lifestyle outside of work to raise a family.

Healthcare leadership for me came after practicing medicine for a while. I began wanting to help people understand the business of healthcare beyond just finances. I've always been really intrigued by what a focus on quality, patient experience and clinical results could do for our overall financial picture. So, I think it was the opportunity to bring that clinical voice, or the voice of a practicing doctor, into leadership forums that intrigued me about hospital administration.

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

DW: I would eliminate our payment system. Fee-for-service medicine, which I've practiced in my entire career, is set up with perverse incentives. If you look at it as a pure financial picture, we get paid to keep people sick, complete tons of tests and procedures and conduct the procedure in the most expensive location we can, which is the hospital. Traditionally, that's how we've been financially rewarded as a healthcare system, and it is wrong.

I don't fear the shift to value-based medicine. I encourage it. Because I really see value-based care as our solution. I would love to get paid for our clinical outcomes and for keeping people healthier. I would love to align the incentives of the entire healthcare industry.

Q: What do you enjoy most about Iowa?

DW: I've lived in Des Moines since 2001, and it is a hidden gem. I think people from the coasts of the U.S. think that I live in a barn, which I do not. I live in a city with a metro area of more than 600,000 people that has great infrastructure. We have sporting events. We have culture. We have great restaurants. But what I don't have is the hassles and headaches of any big city. While I enjoy big cities, I get mad if my commute home from work takes more than 15 minutes, for example. So, I think we have a lot of the benefits of a bigger town but not a lot of the hassles. I also have three kids, and it's been a great place to raise a family.

Q: What would you consider your greatest talent or skill outside of healthcare leadership?

DW: I think I do a good job getting people together and using humor to lighten any tensions or stress. Another talent I would say is that I am good at surrounding myself with really talented, successful people. I can find people that are committed to a mission and help me become better. That talent has helped me hire great people for my team, select my friends and choose my wife.  When you surround yourself with people that are better than you, good things happen.

Q: How do you revitalize yourself?

DW: Downtime and family time is key. Additionally, sweating and getting the endorphins running in the bloodstream is important. While I am not a fitness model in any way, shape or form, I seem to take on a new fitness kick once every five years. I was a kickboxing instructor for a few years, I ran a marathon a few years before that, and currently biking is my thing.

Q: What is one piece of advice that you remember most clearly?

DW: I was in my mid-20s, in my first year of general pediatrics in a small pediatric practice. We had two or three months in a row where we had bad financial results. As a new physician, I didn't know a lot about the business. I was worried that I might not be able to put food on the table for my family.

And one of the founding partners of the practice, pediatrician Chris Moen, MD, pulled me aside and just said, "Dave, you're going to have your ups and downs financially. What's key is staying focused. We must take great care of the kids. If we do that, everything else is going to work out."

And lo and behold, he was right. We ended up having a very successful year despite those few bad months. What I learned from that is, don't forget your core business, take great care of the people, and don't get distracted by the ups and downs of the industry.

Q: What do you consider your greatest achievement at UnityPoint and as a physician so far?

DW: My first answer goes back to my bleeding pediatric heart. My greatest achievements were those everyday moments while I was in pediatric practice. It's humbling when people let you take care of their kids and you get to watch them grow up. You really make lifelong relationships with those families. So that, quite honestly, is the first thing that came to mind.

At UnityPoint Clinic and UnityPoint Home, what we've been focused on is achieving clinical results in support of the Triple Aim, which includes quality, experience and cost of care. As a team, we rocked this last year.  We set our quality metrics on a path to get to the top 10th percentile in the nation. We hit our goal or max performance on all those quality metrics.

As far as patient experience, UnityPoint Clinic was in the top 10 percent of the nation on the Press Ganey Survey, which is a large patient experience survey tool. Additionally, we measured our cost of care at UnityPoint Clinic against the rest of our ACO network and found that we offered care to people in commercial populations and Medicare populations at a lower cost. So really, when you look at lowering the cost of care, improving the patient experience and boosting quality results, I can truly say that UnityPoint Clinic really achieved the Triple Aim in 2018. That's a proud moment.

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