“5 things I wish someone told me before I became a CEO” with Marjorie Bessel MD Chief Clinical Officer Banner Health

As a part of our series about powerful women, I had the pleasure of interviewing Dr. Marjorie Bessel. As Chief Clinical Officer she is the highest-ranking physician executive for Banner Health, one of the nation’s largest nonprofit health care systems. She is responsible for driving clinical quality of care and overseeing performance and safety improvement. Unique to her role are additional responsibilities not typical for a Chief Clinical Officer: She oversees all information technology and informatics and is the executive sponsor for physician wellness and addressing burnout, which she has made her top priority. She leads a comprehensive new initiative, Cultivating Happiness in Medicine, to support physician well-being across Banner. She joined Banner over a decade ago and has held positions of increasing responsibility. Her clinical background is as a hospitalist. She earned her MD degree from Rush Medical College at Rush University.

Can you tell us a bit about your “backstory”? What led you to this particular career path?

Early in my career, I thought I would be a frontline physician. I loved that work, I loved seeing patients (and still do), and I enjoyed the immediate gratification of helping folks recover from injury or illness or by providing great preventative care.

I never really thought that I would be Chief Clinical Officer of such a large integrated delivery network as Banner Health. It’s really with great thanks to so many folks who mentored me, and perhaps saw a glimpse of something from a leadership perspective, that I’ve been able to get to where I am. I’m incredibly thankful to those folks.

While I never envisioned that this is where I would end up, I’m so happy that it is where I ended up. When you take on leadership roles, your ability to influence and profoundly impact entire populations of patients reaches a level, in terms of number of lives, that not even a highly efficient frontline physician can touch. When my work now changes how we deliver care, helps us offer safer care or a better quality service, or improves workflow for lots of physicians and Advanced Practice Providers (APPs) who work with and for us — the ripple effect of that is just much, much larger than I could ever achieve seeing one patient at a time at the bedside. My current role brings me the great satisfaction that comes from being able to have the largest impact on patients that I possibly can.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

I talk about this when I am speaking to groups about leadership development. Early on, I chaired a pharmacy committee at a medium-size community hospital. I was asked to have a group of physicians come into compliance with FDA guidelines for a medication they were using. Lots of stakeholders were involved. A very prominent stakeholder group told me I needed to send out a memo since I was the Committee Chair. Being a new leader, I made the mistake of doing that without a full stakeholder analysis, without making sure that I had confirmed with all the different stakeholders that the memo’s content had been well-researched and that all the appropriate conversations had occurred. My memo went out, and it landed poorly with another very prominent group of stakeholders who had not been involved in vetting the message and felt the exact opposite of the message in the memo. Luckily, they had a relationship with me and liked me enough to basically just laugh at and with me about it. They came to the table to help fix the issue I had created and come up with a solution that was more palatable for all the different stakeholders.

It’s very much a rookie mistake, but I would probably be lying to say that I’ve never repeated a mistake like that — not allowing stakeholders to weigh-in significantly on an issue that will impact them. I hope by telling people this story, we’ll all think about making sure we do a full stakeholder analysis before we hit Send or make a decision. There are always many different perspectives on anything that we grapple with at a leadership level in a large organization. Even if we think at first that it’s a black-and-white issue, it almost never is. Somehow, you’ve got to bring all the mixtures of gray together to create a solution that is at least mostly palatable to all the stakeholders involved.

What is it about the position of executive that most attracted you to it?

What I loved about being a frontline physician — and still like, when I can squeeze that in — is the incredible level of responsibility, which I cherish to have on behalf of the patients that I treat. Truly, those individuals put their lives in your hands as a physician and trust that you do your absolute best to help them get to the best level of health that they can, given the condition or injury they may have.

What I like about being an executive at this level is that the intense level of responsibility is the same as that of a frontline physician, each and every day. The decisions I make, with and on behalf of my team, impact the care we deliver and carry that same, huge level of responsibility. That ripple effect is amplified when you’re at this level, and having that level of responsibility is something I think about each and every day. It has the upside that I can have a deep and positive impact, but it also brings a huge level of responsibility. If you don’t do your job well, if you don’t think through everything, if you don’t involve all the right stakeholders, you end up making a poor decision. The negative part of that can be obviously very, very profound.

Most of our readers — in fact, most people — think they have a pretty good idea of what an executive does. But in just a few words can you explain what an executive does that is different from the responsibilities of the other leaders?

At this level of leadership, your focus has to be on vision and long-term strategy, not on day-to-day activities. Any time I find myself getting into the weeds, I know that I am probably not doing my best that day. There are other folks I need to equip and trust to do that activity, and they’re relying on me to get out of their way and allow them to do that work. They’re relying on me to set the long-term vision and strategy for the overall health of the organization.

What is the one thing that you enjoy most about being an executive?

I enjoy thinking about and watching in my rear-view mirror the longer-term vision and strategy, as they come to life, and seeing the profound ripple effect and impact that they have. We put longer-term strategy into place, and then, a couple of years later, you see how it has benefited the organization and the communities we serve.

As an example, at Banner we’ve done some work in infection prevention that has positioned us well to handle circumstances later on. A number of years ago, Phoenix had a very large measles outbreak. I worked with our team to develop a longer-term look at how we would protect ourselves against a larger measles outbreak down the road. When that threat did re-emerge, I could see that the work we had done years prior came to fruition and really helped us protect our patients and employees from another measles outbreak threat.

It’s back to my point about delayed gratification. I didn’t hear back from anyone who had measles in the first outbreak. I didn’t have the kind of satisfaction you get when you’re on the front line, taking care of somebody or making them feel better immediately. But the work that I did positioned us a couple of years later to mitigate an outbreak in a much different and better way, helping many, many patients.

What are the downsides of being an executive?

The downside is that I don’t have that more immediate gratification of taking care of somebody who feels better the next hour, the next day, or the next week. Most of the activities I work on — vision, strategy — are longer-term activities. You cannot do as many things at this level that give you the gratification that in an hour, something may be profoundly different and better. You have to be okay with delayed gratification.

What are the “myths” that you would like to dispel about being an executive. Can you explain what you mean?

I think many folks believe that the hours you work as an executive are much more limited, with fewer early mornings or late evening activity, and, you know, it’s not true! There are a lot of essential meetings in off-hours, which is very similar to what I experienced as a frontline physician.

I think another myth that’s fairly pervasive is that a higher-level role gives you the ability to make things happen much more easily than if you’re in early or middle management. It may seem very easy to be a high-level executive — that you just tell people to do stuff, and the power and authority of your position makes it easier to have people do things that you need or want. That, of course, is not true at all. The higher up you go in leadership, the more you need to lead by influence and by creating aspirational and inspirational strategy and vision for folks so that they want to do the work, versus being told to do it. That’s a huge message I would share with people who are at an early stage in leadership.

In your opinion, what are the biggest challenges faced by women executives that aren’t typically faced by their male counterparts?

In health care, the roles of Chief Medical Officer or Chief Clinical Officer are not occupied by females in great numbers. Female Chief Clinical Officers or Chief Medical Officers at large integrated delivery network systems are a minority. The reasons for that are probably numerous, but I try not to think about them in my day-to-day life and responsibilities. I would encourage female physicians and females in business, broadly, not to let gender or any other identifier get in the way of reaching for their dreams, achieving what they are capable of, and making the impact they would like to have in their careers. I would encourage all others who want to have important leadership roles not to let anything get in the way of achieving that.

Certainly, not everyone is cut out to be an executive. In your opinion, which specific traits increase the likelihood that a person will be a successful executive and what type of person should avoid aspiring to be an executive?

People who are successful in executive roles are able to create a vision and a strategy for the long run and inspire folks to line up behind it. They must be very comfortable with delayed gratification, and, when gratification comes, they must eagerly, willingly and excitedly share it with all of the team members who helped reach the goal line.

What advice would you give to other women leaders to help their team to thrive?

Stay true to yourself, which I think is applicable to whomever you are. You need to stay focused on what is important for you in your professional and personal journey. You need to have the fortitude and the resiliency not to let barriers or obstacles get in the way of achieving your goal. For female physicians, I would not allow any comments or feedback that you hear — that you feel may be unwarranted or unjustified, or directed at you only because you’re a female — to dissuade you from reaching for your goal. And I would say the same to anyone who receives that type of feedback, based perhaps on gender, religion, race, etc. Do not let it dissuade you from reaching your dreams.

How have you used your success to make the world a better place?

I’ve been able to use my role to make the world a better place by organizing and drawing awareness to a very profound and important issue: physician and Advance Practice Provider (APP) burnout. The statistics around this issue are really very profound. Burnout is having an incredibly negative impact on the healthcare industry. In my role, and those of my peers at other integrated delivery network systems, we absolutely have the ability to change that. My role has offered me the opportunity to stand up a system team on behalf of Banner Health to address this — to engage others in awareness and activities that will have a positive impact on bending the curve of burnout. In the near-term, it will make day-to-day life better for physicians and APPs at Banner Health, and I believe that this, ultimately, will absolutely make the world a better place.

Thank you for these fantastic insights. We greatly appreciate the time you spent on this.