The following is a transcript of an episode of From the Front Row: Student Voices in Public Health, the University of Iowa College of Public Health’s student podcast.

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Rasika Mukkamala:

Hello everyone, and welcome back to From the Front Row. Today, we are delighted to have Meg Duffy on the show. She’s currently a principal at Root and was a University of Iowa alumni, in both of the Master of Healthcare Administration Program and the Master of Public Health and Policy. She also previously served in leadership roles at DispatchHealth, Centura Health. And CHI Health. Last week, she served as a panel member for the Women in Leadership Symposium for the MHA program. I’m Rasika Mukkamala, co-hosting with Lauren Lavin. And if it’s your first time with us, welcome. We’re a student run podcast that talks about major issues in public health and how they’re relevant to anyone, both inside and outside of the field of public health. Welcome to the show. Meg, can you start out by telling us a little bit more about yourself and your why for healthcare?

Meg Duffy:

Sure. Thanks for having me, Rasika and Lauren. I’m excited to chat with you today. Happy to share a little bit about myself and my why in healthcare. I was a smart little kid and told by a lot of people, “Oh, you should be a doctor and think about healthcare.” So that was always sort of in the background for me, like many MHA students. So I did the pre-medicine thing, and through my junior high-high school years, I actually suffered from a bunch of misdiagnoses related to an autoimmune disorder that, today, is fairly common, celiac disease, but at the time, was less so. And it’s so easily addressed with a gluten-free diet. But at the time, again, I was young, and I had multiple procedures, misdiagnoses, the care was hardly coordinated from one place to the next. I think I saw six different doctors in a matter of a year or two, that all had different opinions on what to focus on or what could be going on.

And so, I learned a lot about healthcare during that time and thought, “Gosh, I don’t know that I want to be a doctor. I see the great impact they have with patients and the intimate relationship that they can nurture there, but I want to have a bigger impact. I don’t want folks to have the experience I had with this fragmented sort of misdiagnoses and no refunds on that care over and over and over again.” I just thought it was nuts as a kind of young consumer of healthcare. And so, as I was considering what to do with my future, I was exposed, at the University of Iowa, working in a laboratory there, kind of an epidemiology microbiology lab, I was exposed to the College of Public Health.

And the whole fear, outside of just simply being a clinician and many folks, was appealing to me to think about the bigger impact that I could have across the industry. So I obviously went on to do my MHA and my MPH in policy, and I can share a little bit more about my journey since, but that’s what got me into healthcare and kind of why you guys probably even have me here today talking with you.

Rasika Mukkamala:

Yeah, I’d love to hear more about your background and what you’ve been up to since you’ve been an alum of University of Iowa.

Meg Duffy:

Yeah, well, as I said, I wasn’t quite thrilled with the way healthcare was functioning, experience as a patient. And so, I thought, when I was in grad school, “I don’t know that I even want to do a hospital internship. I don’t want to do other things. I want to get exposed to all kinds of things before and figure out where I might fit in the industry and whether or not I want to pursue a fellowship.” So I had worked with Chris Klitgaard at the time, what was Precision Revenue Strategies, a couple different iterations back, of the revenue cycle firm that he has today. And I worked on Capitol Hill for Senator Grassley during the gang of six negotiations on the ACA. And so, I got to see lots of different elements of healthcare, but I still quite couldn’t figure out how it operates. So I chose to do an administrative fellowship.

So glad that I did. In that year, learned a lot, but was always attracted to the chief strategy officer and his comments and his perspective around the table. And so, ultimately, worked on a number of strategy projects and went into strategy. I did have an interim stint in operations, over a pediatric urgent care. So I got to feel what it was like to be in operations, but always was just drawn to strategy and how you could forecast, kind of think about all the possible futures, get folks aligned about how we can be prepared for those potential futures, and then, work accordingly with the collective to come up with things that, individually, I think, are nearly impossible to come up with. And so, strategy just always appealed to me. And I was in, let’s see, Omaha for my fellowship and stayed there for almost a decade after in kind of progressive leadership roles.

As we evolved as a health system, we went through four different brand changes, because of M&A activity while I was there. Moved to Denver, joined what is Centura Health, a JOA between Advent Health and Common Spirit here. Ran strategy for eight hospitals in the Denver metro area for a couple of years and then, joined the startup space. Because I was just itching to make a difference. So I’d been in strategy this whole time. We were preparing for the future and trying to innovate, but organizations have a really hard time doing that. It’s really hard to make change. The payment model limitations kind of stifle innovation. And so, I was really intrigued about what the startup world could offer me and how innovative and what kind of we could be and what kind of impact we could have. And so, I joined what is called DispatchHealth, a company that’s based here in Denver, where I live, now across the country.

And they got started doing urgent emergency care in the home. Now, they’re doing hospital level care in the home, really delivering the full continuum, bringing the power of the hospital to the comfort of home. And so, worked there for a couple of years, and now, I find myself in consulting, wherein I have this macro level perspective, I get to see line of sight across many different organizations, providers, and payers, and all kinds of different entities in healthcare. And I start to see these larger themes, and it’s been a really, really fun journey. So that is sort of a long answer to my experience and where I find myself today, but always in strategy and now, part of an organization that globally activates strategy for healthcare organizations and those even outside of healthcare.

Lauren Lavin:

Wow. I feel like you’ve been everywhere and have had so many experiences. So you talk about strategy a lot, and that’s such a broad term. Can you define what strategy means for us and for our listeners?

Meg Duffy:

Yeah, I get that question all the time, particularly from those that maybe don’t work in healthcare or don’t work in a business corporate environment. “What is strategy?” And I was told, many years ago, by a mentor, and I know we’ll talk a little bit about mentors, that his view of strategy, which I’ve since adopted and probably kind of augmented to make my own, but his view was, you look at the periphery of the world, you look at what’s happening on the fringes, and you think about what’s actually going to have an impact on how we deliver care, how we work day in, day out, in 5, 10, 15, 20 years from now. And so, he was always trying to be one or two or 10 steps ahead of the competition, leapfrog those that are just trying to respond to trends that are happening today that we’re all aware of, but rather, stay really, really as far ahead as you can.

And the challenge is nobody’s got a crystal ball. So you really have to pay attention to what’s happening, watch those dynamics, and think about the potential futures. And you could say there’s many different plausible possible futures, and there’s a lot of things that you can do to be successful in those. And so, if there’s two or three things that, regardless of the future you think are going to set you up for success, because of what’s happening on the fringes or what you’re seeing within the populations that you serve, those would be sure fire strategies. So that’s kind of the way that we would think about the world at a really macro level perspective.

Start with as broad as you can, top of the funnel, and sort of narrow from there, rather than what a lot of organizations do, which is kind of just cast forward from their current state. And they say, “this is where we are, and let’s incrementally get better. And what are the things we should be doing? Because our competitors are doing this or that in the market.” And it’s very reactive. And so, my approach to strategy is much more proactive, much more kind of pie in the sky, but then, you have to find a way to make it pragmatic and actionable and kind of bring it back to connect where you are to where you want to be in the future. So it’s watching the fringes, watching what’s happening on the periphery of the world we live in.

Lauren Lavin:

Yeah, that’s actually really great advice, especially over these last few years. I think people have seen that being reactive does not keep you ahead of the game, so that’s good.

Meg Duffy:

That’s right.

Lauren Lavin:

Okay, so we also, we were looking at your LinkedIn page and we saw that you own your own business. Can you tell us about, one, what that is and, two, what being a business owner, especially in healthcare tech startup, all of that looks like?

Meg Duffy:

Yeah, yeah, I’d love to. So hey, being in strategy in Omaha and getting kind of mentored and coached in what is strategy over the years there, I was exposed to really unique creative methodologies to bring groups along in a journey and a process to define that future state. And one of the things that I was always attracted to was how you visualize your strategy or your journey to that future vision. And we would often employ the most talented visual practitioners that would come in and participate and be part of our strategic planning processes. And so, at the beginning of the pandemic, right before we even knew what was happening, I actually went and got certified as a graphic facilitator at a place called The Grove in San Francisco and was really excited about this notion of leveraging what I kind of overlooked, which was my art major in undergrad.

I can tell a little story if we have time about how that happened, but to leverage my art background and my science kind of affinity with healthcare and try to become a graphic practitioner, whether it’s in the organizations that I work in and just help bring strategies to life or maybe ultimately someday have my own business, where I’m able to do facilitation and graphic recording and some of those things that I love, that are tools and skillset sets that come really handy in strategy. And so, I started my business, got that certification, the pandemic hit.

Nobody was having conferences or meetings or in-person activities, where they needed anybody doing graphic recording or any kind of visual facilitation. And so, I sat on that LLC for a couple years and didn’t do anything with it. And then, as I was transitioning out of DispatchHealth and preparing to join the consulting world, I had a former CEO of mine call me and say, “I could really use your help, and we need some additional talent in our strategy team for just a short period of time to help me stand up structure and process around reviewing strategic initiatives, How are we going to vet those, what are the templates we use for doing the due diligence, the proformas, the narratives that are associated with those?”

So I said, “Sure, I’ve got this LLC, and I guess I can put it to work for the first time.” So I sat on it for a couple of years, did nothing with it, and then, worked for two months for a health system in Tulsa, Oklahoma this summer, last summer, before I started at Root, now part of Accenture. And so, got to get a flavor of what it would be like to be on my own consulting, and in full transparency, someday, that would be the ultimate goal. I would love to say, 10, 15 years from now, where I’m at a position in my career where I could really add value to maybe organizations that can’t afford some of the big consultancies or don’t need some of that level of support or outsourcing of talent or whatnot, but rather be consultative and supportive in the ways that I think physician practices and other types of provider groups may need, but don’t always have the ability to afford.

So it’s a space, I think, there’s opportunity and would love to grow eventually. So I’m not super active with it right now, because I’m fully employed at another consulting firm. And so, don’t do it too much with it, don’t have time for that. But eventually, I would love to continue to grow my MD consulting practice.

Rasika Mukkamala:

That’s awesome. I don’t think I’ve ever heard of someone mixing art with healthcare in that innovative way. So that is so cool. And I think it’s cool that you have an art background and that you were able to pull from that. That’s so unique.

Meg Duffy:

I was a senior in high school, and I went to Berkeley, California, to a national youth leadership forum on medicine. And there was a panel of residents, and everybody said, “What should we major in?” And the residents said, “Don’t do a science.” Every single one of them said, “Do something you love. Music, art history, I don’t care. Do something you love. You’ll get enough science if you do go to medical school or do any kind of clinical practice. Do something you love in undergraduate. Not only will you enjoy your time and be more well-rounded, but you will stand out in a stack of applicants someday, by having a little bit of a different background.” And I love art. And so, I just leaned into that and took all the pre-med requirements to kind of ensure that I was still working towards some sort of postgraduate opportunity. But I majored in as a studio art major.

Rasika Mukkamala:

Wow, that’s awesome. That’s so unique. So you kind of already talked a little bit about how mentors have played a role. Can you talk in specific of how you’ve leaned into your mentors, both in your personal and your professional development?

Meg Duffy:

Yeah, so I have a number of thoughts here. I think mentorship is kind of one of those nebulous things where you learn a lot about it, and until you are a mentor, it’s harder to understand perhaps what to look for and what to expect from somebody that’s maybe a busy executive. And so, the way I’ve thought about mentorship is less formal than some, over the years, and I’ve kind of leveraged my relationships, made it more organic and informal, and tried to pace myself with people that are five to seven, maybe years, five to 10, I was going to say, but five to seven maybe years ahead of me professionally in their career, graduated the program that much ahead of me or something like that within the alumni network that you can pay attention to, stay connected, to get advice from. Because their advice is going to be more relevant and meaningful than somebody who’s maybe perhaps more mature in their career.

And with the dynamics today evolving so quickly in the work environment, not for those to be discounted, but I just found it really valuable to pace myself with somebody that’s a little bit closer in stage professionally. And then, I would say, always show gratitude just for those that are willing to spend a little time, give a little feedback, because it sort of hopefully just demonstrates they’d be more willing to provide that in the future. I’ve really been super informal about my mentorship, but I’ve had great mentors from leaders that I directly report to or just others that I have a relationship with within the organizations that I’ve worked with.

Rasika Mukkamala:

Yeah, that’s awesome. So we have a lot of listeners that are young professionals. Can you give them some advice on how to seek out mentors or what to look for in a good mentor?

Meg Duffy:

Yeah, I think you can tell quickly if someone’s willing to spend some time with you. And that’s the first thing. If they’re not accessible, if they keep rescheduling, if they sort of overpromise and underdeliver, they’re not committed to giving back yet at that stage in their career or whatever it may be, they just may not have the capacity to mentor in the way that you’re looking for. So I think accessibility. And then, the other thing is real, for me at least, what I look for is real talk, straight talk, honesty, brutal honesty, because it’s hard enough to decipher the passive aggressive tones or read between the lines or the political things that you’ll run into as you get into the work environment.

And so, for a mentor to beat around the bush just makes it that much harder to try to glean their advice and discern what to do in certain situations you may face. I find, if you’re willing to be vulnerable, other people usually are. And so, sometimes you have to put yourself out there a little bit first, maybe awkward, but it’s usually trust building. And then, your mentors may be more willing to open up as well.

Rasika Mukkamala:

Yeah, no, that’s awesome. I think, especially at Iowa, we have so many opportunities to network with the alumni, and so, I think the hardest part is starting sometimes with the cold email or just messaging someone on LinkedIn, but I like what you said about it’s a mutual street. And as much as we, as students, want mentorship, it’s also about the time and the energy that the mentor is putting in. And so, putting that into perspective and better understanding where they’re coming from, I think, will help our young professionals as well.

Lauren Lavin:

Yeah, and I think you gave really great advice about that five to seven year window. I think it’s really easy when you’re looking for a mentor to be like, “That’s the job I want in 15 years. I’m going to go straight to them,” which again, like you said, don’t discount that. If you get that, cool. There’s a lot of steps, as you’ve even shown with your career, that happened between now and 15 years from now, that you could probably glean more information from the person five years ahead of you than 15. So I think that’s…

Meg Duffy:

And they might be a little more accessible.

Lauren Lavin:

Exactly. Yeah. So no, totally agree. Loved that. Okay, so then, as we think about women in healthcare and women in leadership roles, I guess, what do you think organizations can do to support and encourage more women to take on these roles? And if you are a woman looking for a leadership role, what can you do?

Meg Duffy:

So I think it’s actually this pandemic, there’s silver linings to what we’ve now discovered and learned and what’s happening, I think, in the workplace, that’s allowing for more flexible work environments, inclusivity in the cultures, real deliberate, I think, methods of trying to engage and retain people, because it’s just been, across all industries, a real challenge these last few years. And so, that benefits females, I think, significantly, particularly if you’re trying to balance family or other work life responsibilities. And so, I think just this notion in our society of recognizing being human-centric and what that means. At Root, Accenture, we call it our “truly human values.” I don’t know if you guys have noticed, but in my signature line, there’s this truly human notice that says, “This email came to you, because this is a good time for me to work.

This doesn’t mean that it’s a good time for you to respond, and I recognize that and it’s okay, and take your time and on your terms and so on and so forth.” And I think, I felt that, particularly at this company I work at right now, that’s a global, super diverse company, bring your whole person to work, you are human, it’s very inclusive. And so, I just think the nature of our society continuing to recognize DE&I and the need for flexible hybrid work environments will only further support and benefit females trying to be in leadership roles in balancing things, as it’s been much more challenging in years prior.

So that’s the first question, right? The second question, did you say advice for the next generation? Okay, so let’s see, as you’re looking for… I would say some of my advice is not too different, but maybe apply some more so to females, because some of the unintended consequences of not following this advice that I’ve seen maybe magnified as a female. So I guess what I’ll say is be really clear and steadfast in your boundaries. You set that precedent early, and you set it one of two ways. You either have them or you don’t. And people respect you more with them. And a lot of guys easily set those boundaries, and I don’t know why it’s so hard for us as females sometimes. And so, I’ve learned that, over the years. And when I started at Root, my team said, “Welcome Meg to the team. Let’s talk about what’s going to make us successful here. Tell us a little bit about yourself and what’s worked for you in past working environments, so that we can all work better together.”

And I said, “Help me keep my boundaries. I’ll help you if you’re out of the office, I’ll respect that,” so on and so forth. And they’ve been wonderful. And so, I think I set that tone early on, and it’s made all the difference in this first six, seven months, compared to how I would’ve been bending over backwards in the past to prove myself. And it’s not necessary always. It’s really not, and it’ll burn you out. So that’s one. The next thing I would say is never apologize for having personal commitments, priorities, obligations. Again, it’s back to the boundaries. Don’t apologize for it. It just, as a matter of fact, it is. You’re very capable as a professional to manage your PTO or whatever it is, especially if it’s a flexible environment.

I would say, if you make a mistake or any kind of failure, it’s okay and own up to it, of course, take the responsibility, but move on. Move on. Do not belabor the point. Don’t, for lack of a better term, beat that dead horse or whatnot. Don’t stay in that moment. Move on. Don’t get too personal. These are a lot of don’ts. Don’t get too personal. I have found it can lead to some of, in the Women’s Leadership Symposium the other day, some of the conversations were about uncomfortable questions or things that may be asked of you as a female in the workplace. And if you refrain from getting too personal, you can avoid some of those situations. And then, lastly, which maybe this is, I don’t know if everyone would agree with this, but I try to avoid ever telling my age or giving a sense of my age.

I speak in decades or roughly, because when you’re young, they’ll say, “Oh, you’re so young.” Or if you’re getting older, “Oh gosh.” There could be judgment on neither side with an age bias. “Oh, where are you in the cycle of childbearing?” Yeah, I would refrain from any… If people ask, I just wouldn’t tell them. I think those are my little pieces of advice. Those are a lot of don’ts. The biggest do I would say is just be really authentic and be yourself. You can see right through someone who’s not, in my opinion. And so, it only benefits you. Relationships are so important too, and I think that you might be asking me a question about something I’ve learned or I thought I knew. And I can share more about that.

Rasika Mukkamala:

So I had a follow up to what you were talking about earlier. So I know you said not to get too personal at the workplace. How do you balance that with, for example, a lot of MHA students seek fellowships and they may go to places where they don’t know anyone except the people that they work with, so how do you balance that personal aspect and not knowing anyone in the city that you live in? How would you deal with that? Or what advice would you give for that?

Meg Duffy:

Yeah, I think I say “Be authentic.” And I say “Don’t get too personal.” So it almost feels conflicting, but I would say, it’s certainly okay to be friendly with your professional colleagues and create those sort of professional relationships, but maintain that level of professionalism that you don’t necessarily ever have with people that you’ve met outside of work, because you haven’t worked with them, you know them in a different capacity. And so, people can evolve though, as professional colleagues into really good friends. One of my best friends that’s going to be at my wedding celebration, that was there for my engagement, is somebody that I worked with in Omaha. And had we not worked together and gotten to know each other in the workplace, she wouldn’t be in those big life moments with me and one of my best friends. And so, I think it’s just you’d be really cautious and patient and careful in your building of relationships and you just kind of don’t spill too much too soon, because you don’t always know who you can trust, unfortunately. Because everyone’s got their different motivations.

And so, I caution that. I would say definitely get involved in YP groups and other community groups and meet folks that way, that maybe you don’t have a direct working relationship with, that wouldn’t be impacted if you were to do more things personally. Oftentimes, people in the workplace can judge you too. So if you get very close with one or two people, it can be seen as cliquey by others, and it can just impact your ability to be strategic in your decision making and your influence. And so, that’s part of why I caution, it can impact your effectiveness in your role, unfortunately. And so, you have to just be patient and, I think, discerning in your relationships.

Rasika Mukkamala:

No, that’s super helpful, and I think you’re absolutely right. There is a total difference between the relationships that you have outside of work and inside of work. So I think that’s some great advice that I’ll definitely be using in the future. So I just wanted to ask our last question. We ask this to all of our guests, what’s one thing that you thought you knew but were later wrong about? And it can be about healthcare or not healthcare, anything you want.

Lauren Lavin:

So many things.

Meg Duffy:

Yeah, so many things, but I would say the one that’s sort of a theme running through the conversation already is I was told early on by a lot of people that it’s all about relationships. And I didn’t love it, because I don’t know, it takes effort and time. And it can be a little awkward and uncomfortable to build these “relationships.” “And why shouldn’t I just be worthy of their trust and so on and so forth? Because I’m smart and I’m a hard worker and I show up and I’m articulate. Come on, why do I have to try so hard to build a relationship, not getting too personal?” Which is sort of this interesting dynamic. You can talk about the weather only so many times. I discounted really truly how valuable relationships are. And what I have learned is that it really is all about relationships.

And unfortunately, that may mean that somebody who has a better relationship has the more likelihood to get the next opportunity, even if they’re not, in your eyes, the most eligible candidate. And so, I just would say, don’t forget the power of a phone call and one-on-one conversation, because those relationships pay off years and years later down the road. Your network is the most powerful thing that you have going forward, and you just continue to build it and nurture it. And regardless of which organization you go to, your network always will have your back. And so, you kind of got to give back to your network as well. And yeah, I have numerous examples where the relationships that I’ve developed and been lucky enough to stumble upon have paid off for me in dividends. So yeah, don’t forget the power of relationships.

Lauren Lavin:

Well, that’s such a great note to end on. And so, with that, we will wrap up our episode with Meg, and we hope that everyone enjoyed this episode on strategy and leadership and the little tidbit about relationships at the end. And we want to thank Meg for joining us today and then, for all of our listeners for tuning in. We hope that you enjoyed this new episode, and if you did, share this episode with others, who might be interested in learning more about healthcare strategy and leadership. This has been Lauren and Rasika From the Front Row. See you next week for a new episode.

Speaker 4:

That’s it for our episode this week. Big thanks to Meg Duffy for joining us today. This episode was hosted, written, and produced by Rasika Mukkamala and Lauren Lavin, and edited by Anya Morozov. As always, you can learn more about the University of Iowa College of Public Health on Facebook, and our podcast is available on Spotify, Apple Podcasts, and SoundCloud. If you enjoyed this episode and would like to help support the podcast, please share it with your colleagues, friends, or anyone interested in public health. Have a suggestion for our team? You can reach us at cph-gradambassador@uiowa.edu. This episode was brought to you by the University of Iowa College of Public Health. We will be switching to a biweekly schedule for the summer. So until two weeks from now, stay healthy, stay curious, and take care.