Patient navigators should be available to everyone. Imagine being diagnosed with breast cancer and being told you need to see multiple doctors, each with a different treatment plan, in different offices. On top of that, you are the one who is responsible for keeping it all straight, making sure to tell doctor №3 what doctor №1 said, all while advocating for yourself. It’s honestly too much to ask of patients. Everyone should have a nurse navigator that helps patients on their journeys. Komen funded some of the first nurse navigators in San Diego hospitals and they proved so useful that the hospitals have adopted this model in all of their locations.
I had the pleasure to interview Shaina Gross. Shaina is the President & CEO of Susan G. Komen San Diego. She began her career in women’s health, providing education, access and care to low-income, underserved women in North Carolina. She also worked closely with the immigrant community to break down barriers to accessing quality healthcare. Prior to joining Komen San Diego, she was the Senior Vice President at United Way, leading community collaborations and partnerships, programs, public policy and advocacy, and grant writing. Shaina has dedicated her career towards achieving the vision that all people deserve equal opportunities to live a healthy life with access to quality healthcare.
Thank you so much for joining us Shaina! Can you tell us a story about what brought you to this specific career path?
When I was growing up, both of my parents — but especially my mother — modeled charitable behavior. There was an elderly man in our neighborhood, who was low-income and lived alone. Every Friday, we would go to the grocery store, buy a rotisserie chicken and give it to him. My mother also set up a tab at the local bakery so he could go in for coffee anytime he wanted. This was my first introduction to other people not having what I had. Even though we didn’t have a ton, I was shaped by these experiences that made me appreciate what we did have and showed me the value of helping others. When I learned that I could do this for a living by working with non-profits, it felt like the perfect career for me.
Can you share the most interesting story that happened to you since you began leading your company?
One of the most interesting things that happened to me at Komen San Diego took place in the first days of being on the job, when I realized how much I didn’t know about what the company actually did. Even after a lengthy interview process, I wasn’t fully aware of the incredible advocacy efforts taking place in Sacramento, the extent of the financial support Komen provides for breast cancer patients, or the sheer number of people who can’t afford a diagnostic test that Komen offers patients for free. I knew about the Race for the Cure and the 3-Day, but I had no idea the scope of the services Komen provides with the money they raise from these events. I also didn’t realize that the 3-Day is a national event, while the Race for the Cure is unique to each community — in which the funds stay local. It was eye-opening to see how little I knew and how so many other people in our community are also unfamiliar with the services Komen provides.
Can you tell our readers a bit about why you are an authority in the healthcare field?
I have a master’s degree in public health with a focus on community health. I’ve also worked in women’s health and in Federally Qualified Health Centers. I have both studied and seen first-hand how the social determinants of health are often the defining factors of the quality of care an individual receives. Education, income, housing, access to transportation, language ability — these are things that can impact the quality of care you can access. I have had the privilege of receiving both a formal education on these issues and having practical, hands-on experience with people living through these challenges.
What makes your company stand out? Can you share a story?
Our pink ribbon is one of the most well-known non-profit brands in the world. When you see pink, you immediately think of breast cancer. Our 5K walk is one of the largest and longest-standing charity walks. The longevity and reach of this company are incredible. At my first Race for the Cure in San Diego, I couldn’t believe how many people gathered in one place with a common goal of ending this disease. Komen stands out because we truly bring people together. Last year, we had a woman on stage who had been diagnosed with breast cancer just a few months prior. She had lost her hair from chemotherapy and was still going through treatment. With her husband standing beside her, she told our crowd of 8,000 people that this was the second-best day of her life, after her wedding. Why? Because she looked out into the crowd — into the faces of all the people who had survived this disease — and was restored with the faith she needed to believe that she could survive, too.
The Race is one moment in time — always the first Sunday in November — but the money raised on that day is what allows us to provide local services all year long. Without the Race we wouldn’t be able to pay a breast cancer patient’s rent or utilities when they are out of work or pay for the ultrasound or MRI that they can’t afford one out of pocket. The Race enables us to educate thousands of women every year across our community about the importance of annual screenings, and what steps to take if you notice something has changed with your body.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
Personalized medicine is really groundbreaking. Every day we see that current treatments don’t work for everyone. Personalized medicine is exactly what it sounds like — it is customized for each individual patient — which means it is specifically designed to treat your disease. So, the success rates are phenomenal; however, it also means that it has to be tailored and designed one patient at a time. Overall, it’s expensive and it takes time. As the field gets better at this and finds ways to expedite the process, this will truly be a game-changer for the harder-to-treat types of breast cancer, and the more complicated cases that aren’t responding to mainstream treatment protocols. There are thousands of patients who are desperately waiting to have access to things like this, so it can’t happen soon enough.
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
- You’ll be inspired by people who are going through some of their toughest times. I’m inspired by all the cancer patients who walk into our office. Oftentimes, these women and men are in bright spirits, making jokes and asking how they can help us!
- This work is emotionally heavy. We lose friends too often, and unfortunately the reason people come into our world is because they, or someone they love, has been diagnosed with breast cancer.
- This work isn’t fair. You won’t be able to help everyone even though you desperately want to, but it’s possible to power through the overwhelming days with support from family and friends — and by taking time to appreciate the little things.
- You need to pay equal attention to growing your staff as you do to growing the organization. The organization is only as strong as the team working for it, and it takes a lot of intentional time to develop employees and help unveil the individual potential of each person. You can’t just put it on auto-pilot.
- The Power of Pink — I thought pink was just a color. But I have learned that it represents a strong, unwavering community, a tribe of people who have a shared experience who won’t give up.
Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
- Quality of insurance varies based on what you can afford. Low-income people have less access to employer-provided health care and often pay higher deductibles and co-pays. Many are still uninsured because they can’t afford the out-of-pocket cost.
- We are a litigious society, which means there is a lot of extra bureaucracy to protect people. This makes the system complicated and fragmented to try to navigate.
- We don’t invest as much in social services that affect health and life expectancy. So, people end up in the healthcare system when what they really needed was access to basic needs, like nutritious food or stable housing.
You are a “healthcare insider”. Can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- Patient navigators should be available to everyone. Imagine being diagnosed with breast cancer and being told you need to see multiple doctors, each with a different treatment plan, in different offices. On top of that, you are the one who is responsible for keeping it all straight, making sure to tell doctor №3 what doctor №1 said, all while advocating for yourself. It’s honestly too much to ask of patients. Everyone should have a nurse navigator that helps patients on their journeys. Komen funded some of the first nurse navigators in San Diego hospitals and they proved so useful that the hospitals have adopted this model in all of their locations.
- Telemedicine can be a very useful tool for people who don’t have transportation or don’t work the kind of job where you can just take two or three hours off from work to go to the doctor. We need to rethink what a doctor’s visit looks like and have it work better for the majority of those who need it.
- Improved patient/provider communication. Too many patients report not feeling comfortable speaking up or asking their doctor a question. Sometimes it’s because they feel rushed, other times it’s because they are intimidated, or maybe because they don’t speak the language. Strengthening the communication between a patient and their provider is critical to treatment compliance, which in the world of breast cancer can literally save your life.
- More diversity among providers. People need and deserve to be treated by someone who looks like them, speaks their language and has a shared culture. The lack of diversity in healthcare creates an unhealthy power dynamic that contributes to poor communication and compliance.
What specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
Some of these things are happening already. We need to focus more on community medicine and innovative ways to reach patients. We need to listen to the community and make changes based on what they tell us. We need to build trust — which takes time, commitment and consistency. We should be exposing young people to career paths in medicine and providing support for them if they choose to go into the field. Stipends, flexible class schedules, online education, student support and internships are all ways to increase the diversity in the field. If we can increase the number of people in positions of power who have the same lived experience as those who are the hardest to reach, we will begin to change the dynamic.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I truly wish I had more time to read, but as a non-profit CEO and mom of a 3-year-old, I do struggle with “me” time. However, an amazing book that I recommend everyone read is The Immortal Life of Henrietta Lacks. This book is incredibly informative and sheds light on the importance of the overall patient experience and why we face additional challenges with engaging minorities in the critical work of clinical trials. In addition, one incredible aspect of my job is that I meet with inspiring breast cancer patients all the time. They inform me about what is happening in real-time in our community, and I learn from them about the barriers that we need to address.
How can our readers follow you on social media?