Population health director: How I got my job and where I'm going
Sarah talks about the evolution of her career from servings as an AmeriCorps member to a consultant to an administrator within a large hospital system in New York.
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My path to this particular job has definitely been a journey of many steps. From a really young age, I always knew I was interested in bodies and how they worked. At age five I actually asked to be a molar for Halloween, and at age 13 I had a cyst removed from my knee and asked the doctors to let me watch. They didn't want to. So, I went into college with this idea, I'm gonna be a pre-med student and major in biology, and go to medical school, and that's the plan. Once I started in undergrad, I started taking some of the science courses, and I was immediately humbled by how difficult they were for me. I became really frustrated and I think maybe a bit impatient. And so I tried to find ways to make it work. And I changed my major halfway through to exercise and sports science, which some of my friends were taking in order to go to physical therapy school. And I thought, well, it's not medical school but it's still in healthcare, it's still clinical, this is interesting to me and it fits me well still. Yeah, that didn't go so well either. [Laughs] There's still a lot of science to do physical therapy as it turns out, and it was really challenging. By the time I graduated college, I was feeling pretty lost, and not so confident in my ability to pursue anything clinical at all, so I looked for other alternatives. I knew I loved public service. I loved the area I lived. I lived in North Carolina. And there was a great AmeriCorps program there, so I was lucky enough to be placed in an AmeriCorps program in Durham, North Carolina, right down this road from where I lived. And I loved it. The program that I ended up doing was called Public Allies. It's a year-long placement where you get matched, basically, to a non-profit. You work, almost as a fellow, in just a year-long function, and I really wanted to get matched in a healthcare setting. I ended up getting matched with something totally different. It was education related. But I learned so much. Number one, that I'm not meant to be a teacher. Number two, that I had some of the skills that actually really helped me in this job today. So, the ability to communicate differently with different types of people, different types of learners, the ability to be flexible and think on my feet. So, it was a fantastic experience. I'm incredibly grateful that I had it. After that I did a year as a coordinator at a non-profit that's related to health research, and I liked that too, but I found myself a bit frustrated by feeling a bit limited. My organization is great, but it was only six people big, and I realized there weren't a ton of ways for me to grow. And I had kind of an on-going argument with my mom. She told me, you gotta branch out and explore a corporate, Fortune 500 company. There's tons of opportunity to grow and learn, and they have trainings and certifications, and you'll get credibility on your resume, and I thought, absolutely not, that is totally selling out. That is not helping people at all. But it turns out, that's exactly what I did. I got the opportunity to work at a consulting firm and I made a promise to myself that after I learned as much as I could in that setting I would come back and apply the rigor of that corporate environment to something I was really passionate about. And I'd find a way to come back to healthcare one way or another. Consulting was also, like AmeriCorps, a really lucky opportunity for me, and I got out of it exactly what I was hoping to, which was the opportunity to gain some real discipline and specific skills that would prepare me for leadership. So I figured if I'm not going to be a practicing clinician, there are other opportunities in healthcare to lead teams and work with physicians. So whatever I'm doing I need to be prepared for that. So everything from practicing presentation skills to interfacing with senior people and not freaking out. The time management. Through the consulting firm I was also able to get a certification in project management which was extremely helpful. The only issue I had in consulting was really the fact that I wasn't able to apply any of it to healthcare. My office was focused almost entirely on financial services. Great! I learned a ton but after about three and a half years or so I really felt that lack of connection to mission which is really important to me. So I began to talk to people I worked with exploring different opportunities within the healthcare space like where could I, as maybe a mid-level manager go in healthcare? What kinds of jobs would I even be eligible for? And through talking to different colleagues and people I knew from previous jobs, I ended up making a connection with the Chief Operating Officer of a small hospital in Connecticut, and she was very generous and offered to just meet me for an informational chat. We hit it off, and she set me up with a few different job interviews at her hospital. And so, I made the transition into a very operational role, mid-level management in surgical operations. So, working with all the non-surgical, non-clinical aspects of surgery, so the billing, the insurance, working with the staff who greeted patients at the desk, all of that. And I will say, also at this time, I was exploring ways to gain a little bit more credibility for the healthcare industry. I figured maybe grad school would help me. And as I explored different types of programs, I wasn't wedded to any one particular type of grad degree. I just knew that if I wanted to be taken seriously, I didn't really have any healthcare experience so I probably should learn a bit about the industry, about policy, about managing in the healthcare space. So I was lucky enough to stumble into NYU's Wagner Graduate School of Public Service, which fit perfectly for me. And they have a Master's degree in public administration, which is kind of like a partner to business administration, but for non-profit entitites, and they have a specialization in healthcare. So it really felt like a perfect fit so I simultaneously started a new job in Connecticut during the day, and at night I started taking graduate classes in healthcare policy and management. So the one piece of the combination of working and night school that didn't really work for me, was the commute from New York City, where I lived, to the hospital in Connecticut, and the hours that I was working because I was working with surgery, most of the time surgeons are only free to meet at like seven in the morning, so I was having really, really early days, and really late nights with class, so I got a little burned out. And I liked my job, but I started exploring opportunities at hospitals within the city and through a friend from grad school, I found a project management sort of role at the hospital where I am now. I worked at the hospital where I am now in a project management type of role for about two years and all the while finishing my graduate degree. Once I finished, I felt like I'd done a lot of great work in project management and I was kind of ready for the next step, and I started exploring other places in the hospital where I could apply, not just my work experience, but all the things I'd learned in grad school about health policy, population health, and the way the healthcare industry in changing and needs to change to be more economically viable. Through connections from grad school, through colleagues, I started exploring different types of jobs and found this department that's growing and we clicked. It was a really good marriage of my interests and skills and what they were looking for in a team that could lead different types of projects with lots of different types of people. Even though I was already an employee of this health system I did have to interview for the new job. It was much easier on the administrative side, they had all my paperwork, I had already done all my blood work, which you need to do if you work at a hospital. So, I think that the process was a lot faster for me, but absolutely had to do the full application, the full interview process. I think I was maybe a slightly more attractive candidate because I was already internal and they knew it would be an easier transition. You definitely don't need to have a Master's degree to have my job. I'm glad I have my Master's degree just because of the frameworks it gave me, and helpful ways to think about solving problems. Different management and leadership techniques that my program gave me. But my other two directors that I work with at my same level they have not yet gone to grad school. One of them plans to and the other doesn't so it's definitely not a requirement. You would need to have an undergrad degree and I think the fields of study probably most relevant to my role are things like studying business, studying economics, or even specifically healthcare economics. Studying healthcare management, or administration, or public health, or policy. All of those touch the work that we do. From here, as a director in population health you can do a couple of different things. You could theoretically stay in the department and promote to a senior director, a VP, or a senior VP and take on more and more responsibility, take on bigger teams. You could also move elsewhere in the health system and, say, lead a more operational department that's less thinking through the strategy for the healthcare system and more making sure the healthcare system is running in accordance with the strategy so I've known someone who left our department and went into dermatology, for example, and now they run a team in dermatology. You could also go outside this health system entirely and I think, I'm not quite there, but at some point in the near future I could maybe go run a non-profit. Something relevant to healthcare but maybe a bit smaller. At 31, I really thought I would have had this totally figured out by now, but I don't know exactly what's next for me. Over the course of my different jobs, and learning the different skills in each one, I've learned even more and more of what I like, and what I care about, and what keeps me excited about coming to work. And so, I know that whatever I do next, I want it be even closer to patients. I want to have a lot of interaction with people. I wanna have both management and the leadership responsibilities 'cause those are two very different skill-sets and I think we often conflate them. But management, in terms of working with people and helping them cultivate their careers. And leadership, making decisions, and guiding and organization. And so parallel to my work experiences and learning more about what I'm good at, and what I like doing at work, I've also had some experiences in my personal life dealing with illness and loss in some of my older relatives. And I had one specific experience that really stuck out to me. My grandmother was in a nursing home facility and most of the time she was sleeping, but I ended up taking a couple of weeks off and spending most of that time there with her, and I noticed that her roommate didn't get a visitor, No one on the hall got a visitor, but as they became more and more comfortable with my presence there, they started to engage me, asking me if I would mind sitting with them so they could show me their family photo album. Asking me if I would mind going to the drug store and bringing them a mint. And so, it just really struck me that a lot of times in the healthcare world, we think of patients as a collection of symptoms and diseases, and issues, and we want, obviously the goal, is to treat them, and help everyone be well, but there's this whole other human element to healthcare that I think we're always working on. You know, being in a hospital isn't great, and when you're connected to a bunch of tubes, and you're constantly talking about the things that are wrong with you, you might feel a little bit disconnected from the things that make you, you. And so, that experience really stuck with me. I'm kind of in a unique situation in that I love being around elderly people. I don't mind being around sick people. I think that's a little jarring for most people I know because it reminds you of your own mortality and it's unpleasant, but I think that's an area where I really wanna focus on my next job, so weather that means working for the geriatrics, or palliative care department here in the health system, or maybe starting my own organization that aims to provide kind of the wellness, the holistic wellness, in addition to the clinical care. We'll see where I end up.