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Leading with Care
This article originally appeared in the Bentley Magazine.
Surviving a heart attack. Beating cancer. Managing diabetes. These outcomes are a reality for many in the United States, which devotes more of its GDP to health care than other nation in the world (17 percent according to the World Health Organization).
Meet two women whose leadership of Boston-area hospitals includes keeping people healthy—and out of their emergency rooms.
Ellen Moloney, MBA '91 is the Interim President at Newton Wellesley Hospital in Newton, Massachusetts. This 30-year health care veteran has been instrumental in the design and planning of programs in areas such as cancer care, ambulatory care, women's imaging and cardiovascular health.
Deborah Bitsoli '87 is the President of Morton Hospital in Taunton, Massachusetts. Her 25-plus years of health care experience includes overseeing hospital operations to improve patient and employee satisfaction, and managing multi-specialty physician practices.
How do challenges in the U.S. health care system affect your decision-making?
Deborah Bitsoli: One of the most significant issues is the rising cost of health care caused by variances in reimbursement rates to community-based hospitals versus larger health-system conglomerates. New regulations determine how — and how much — we are reimbursed for services. In addition, consumers are facing higher insurance costs.
Hospitals are also tasked with balancing the need to keep people healthy and increase volume. We’re focused on prevention and wellness — doing everything possible to keep patients out of the hospital. Outpatient department volumes are going up, while inpatient volumes are going down. Hospitals can only survive and grow if they regularly review and assess patient demand for specific service lines and adapt accordingly. Examples are diagnostic imaging and ancillary testing services, innovative surgical services, or programmatic enhancements like weight management or diabetes education.
Ellen Moloney: We’re fortunate to live in a country where health care is accessible. But new technologies and pharmaceuticals can drive up cost. And with intense pressure to reduce the cost of health care and declining reimbursement, hospitals are under the microscope and must operate as efficiently and effectively as possible. That leads to difficult choices about offering services that are an important part of our mission, such as psychiatry and behavioral health care, but which are reimbursed at such a low rate that it often results in a financial loss for the hospital.
With that in mind, we are focused on population health management. We work closely with primary care physicians to better manage patients with chronic disease so they don’t end up in the emergency department or being admitted to the hospital. This strategy allows us to reduce costs and still provide very high-quality care.
What are your approaches and priorities as a leader?
EM: Never forget where you came from. I started out as a medical technologist in the laboratory and worked my way up within health care organizations. I’ve never forgotten what it feels like to be that staff member.
Leading is about building trust and building relationships. That’s done by being a good communicator — especially a good listener — being accessible and following our mission. We have a “greeter” program at Newton-Wellesley where senior managers serve as greeters at hospital entrances twice a month. For me, it’s a great chance to connect with patients and their families, to hear what we’re doing well and what we’re not doing so well. It’s also a great opportunity to get out there and talk to physicians and other staff members. It’s about visibility and accessibility. Having a calm and steady demeanor, and being prepared, are also important.
DB: One of my personal priorities is instilling a culture of patient quality and safety among frontline staff across all disciplines. At Morton Hospital, we encourage staff to maintain a “questioning attitude,” meaning we want them to pay attention to every detail when it comes to providing patient care, and feel empowered to speak up if something doesn’t feel right.
Just as important is investing in and supporting your workforce: Give them the tools and information needed to do their job, and to do it well. I try to take time to recognize my team for their hard work. It’s one of the most important things you can do to grow your organization.
How have you come so far as a woman in a leadership position?
DB: I think believing in myself and taking advantage of every opportunity to learn is what brought me to where I am now. I started my career in health care at a young age, working in various departments and learning from others by asking questions. In doing so, I was able to greatly expand my health care knowledge and management skills. I’ve never felt any limitations to what I could do. I believe if you have the passion, skills and qualifications needed, you can do anything you desire to do.
EM: I’ve “grown up” in hospitals and health care, where a large majority of employees are women. I’ve been fortunate to work with female leaders who have been successful. In the Boston area there are some phenomenal female leaders doing great things; that speaks volumes. Within our health system, there are terrific leaders, female and male, who are always willing to take the time to help other leaders grow and be successful. I’ve learned to be comfortable with being uncomfortable and to not be afraid to fail.
How has a business education informed your career?
DB: Having already worked in support roles in health care, I needed tools and knowledge from a business perspective. The classroom environment and approach to learning at Bentley taught me problem solving skills and how to work well with teams, especially with regard to written and verbal communication. It also advanced my understanding of organizational development. This foundation was invaluable as I pursued my career goals.
EM: I have a bachelor’s degree in biology, so when I enrolled in the Bentley MBA program I was a sponge. I hadn’t been exposed to some of the things I was learning, like marketing and management. I remember an effective speaking course that prepared me well for positions I’d hold in the future, regarding how to be ready to speak on the spot. The professor had a deck of index cards with various topics noted on each. Students would have to randomly choose a card and give a two-minute talk on that particular topic. It was very uncomfortable — I’m certainly not an extrovert — but it was the best class. It really helped when I was sitting in a meeting and thinking about how to respond to someone.
What should the general public better understand about health care?
EM: It’s great that people have access to health insurance. But it’s important for them to be informed about their specific plan because sometimes they are surprised by its conditions, such as a co-pay or high deductible that may require out-of-pocket expenses.
DB: It’s important to understand the value of preventive care and establishing a relationship with a primary care physician. This can ensure that you’re up to date on recommended tests and screenings based on your age and level of health. If you don’t have a primary care doctor, make it your commitment to find one.
When Brenden Botelho ‘20 and Jonny Boains ‘18 took internships in the Mass. Office of Energy and Environmental Affairs, what was the biggest community problem to tackle? Adapting to climate change.