Q&A: Penny Wheeler
Dr. Penny Wheeler was named CEO of Allina Health System in January after serving as president since 2013 and chief clinical officer since 2006. She is the first female and first physician to lead Allina. A board-certified obstetrician/gynecologist, she has also served as president of Abbott Northwestern Hospital’s medical staff, chaired the Allina Health Quality Committee and served on the Allina Health Board of Directors. Not-for-profit Allina generates more than $3.5 billion a year in revenue, with 26,000 employees, 5,000 associated and employed physicians, and 4,100 volunteers serving people at 90-plus clinics, 13 hospitals and 16 pharmacies.
You’ve been such a leader here for so long; what’s different for you in the new role?
PW > I was just talking with one of our former board members and we were saying that [when you become CEO] you’re better looking and your jokes are better. [Laughs.] But you need to make sure people are telling you exactly what’s going on, where you have fumbled and what you can do differently as an organization and where the gaps are. When you get to areas of broader responsibility, asking the right questions becomes more important than having the answers. Asking better and better questions is what my role is now.
How do you ask the right questions in situations where you need to act almost immediately?
PW > Ask questions about possibilities: How will this make us better? Ask questions about risk: What are the downsides of doing it or not doing it? What are the potential unintended consequences? And you have to ask second- and third-order questions, especially if you lose eye contact or you see someone squirming. You have to be satisfied people have told you the truth. Then you can move forward with greater alacrity.
What are your goals, this year and longer term?
PW > We are very focused on enhancing the principal relationship people have with our organization, with the primary care providers—not only when [our clients] are sick and come to our clinic, but [with the people] who can support them the 99 percent of the time they are outside of our walls.
We’re also focusing on how to get rewarded for doing the right kind of work. Our financial success doesn’t always align with the people we’re serving. That’s our biggest challenge. We’re going from filling beds to be successful to emptying beds to be successful. That also means, for our people who lead our hospitals and for our specialists that rely on volumes of services, changes with their own personal compensation and well-being. Those are very difficult things to change and to change quickly. It’s for a noble purpose, but it’s a difficult change.
For example: In the area of cancer care, over six months we were able to keep 95 people from being admitted to the hospital, and instead kept them home with their families in their own beds. We delivered quality care while saving the community $1.2 million, but we lost $600,000 as a result.
How are you doing becoming less dependent on in-patient customers?
PW > We’re still pretty patient-reliant and we would like to become less. I’d like to move to a future where home is the hub of health care: You put the right kinds of tools in people’s hands and their families’ hands so they can take the best care of themselves from a preventative care perspective and also if they get sick.
How are you going to make that happen?
PW > It’s going to be a transition march. It’s one of the reasons I’m so committed to a couple principles, like collaborating. People were talking about building a neo-natal care facility across the street from Children’s Hospital and I said, “Are you kidding me?” Let’s do this together. We built a mother-baby center together and we now have an ongoing partnership with Children’s. This also is probably the only place in the country where there’s collaboration between an accountable care organization [Allina] and another competing health care organization [HealthPartners] through our Northwest Metro Alliance. The more we can collaborate, the more we can align market rewards toward only adding services that are valuable to the people we serve.
How else are you moving away from the fee-for-service mindset?
PW > A lot of it is in the way that we think about things. One way you get physicians and other care givers really jazzed is talking about how can we work together to improve the care and outcomes of the people we serve. Then you need the infrastructure to support that. That’s where our Health Catalyst partnership comes into play. [Allina invested $100 million in Health Catalyst in January as part of a 10-year initiative to build a new, data-fed model for improving outcomes.] We can’t have people not knowing how well they’re doing in quality of care and costs.
What’s been your biggest mistake, and what did you learn from it?
PW > One was when I moved from being a full-time practicing physician to being chief clinical officer. I didn’t understand the significant change involved in moving into this role. It was like landing on a different planet. I initially thought this is a little bit like being a parent: If you give a lot of love and a lot of encouragement and you support them in every way you can, smooth sailing, right? I always say I was a good parent until I had a child. I was a better leader until I had a leadership position, because until you are one, you can’t possibly understand the issues and complexities that come with the role.
Another was a big change initiative horizontally orienting the organization around clinical service programs. What I didn’t realize was that while I had the clinicians going along with it pretty well—they just wanted to get together to improve care and be part of that—I didn’t take the operational leaders along very well. I didn’t recognize “What does that mean for a hospital president whose primary relationships had been with that medical staff?” So leaving people out who cared, that was a big mistake I made. Now I try to make sure that if we have a change going on, I start with: What are we trying to do and who really cares about it?
What’s been your biggest success?
PW > When we’ve done something to solve a problem for the community and have done it in a collaborative way: for example, creating the mother-baby center with Children’s Hospital. It’s a wonderful asset for the whole community, and it’s grown—23 percent in the first year and more after that.
I’m also incredibly proud of the merger we had with the Courage Center for people with disabilities. Here’s a wonderful 80-year-old resource. If we merged those assets then we have [a range]: If you need acute care because you’ve had a stroke you have that, if you need post-transitional care because you have to recover longer, you have that. You have innovative programs, like teaching [a paralyzed patient] how to use his limbs again. Then you have vocational programs and community programs. So it’s really a continuums-based merger. Somebody once said if you really want to do well for a person with disabilities, get them a job. So it goes way beyond our acute health care space to actually supporting them in a way that the disability becomes just an afterthought.
What are the questions you always like to ask to make sure you get the talent you need?
PW > I ask, “Give me a time when something didn’t go the way you thought it would go.” I just let people run with that. If they start saying it was because this guy didn’t do this or that, then it’s like, “OK, no thank you, we don’t want you.” If it’s, “Here’s what happened and here’s what I learned from it,” then OK, interesting. I ask them, too, what the biggest misconception is about them, and sometimes that gets very revealing: It gets to what they think might be a challenge for them, either from an outward place or something they are challenged with personally. My predecessor, Ken Paulus, used to ask, “What would your mother say about you?” In Minnesota, sometimes you get people unwilling to brag about themselves, so this question can come in handy sometimes.
What do you do in your free time?
PW > I like to bike a lot. I just got one of those fat-tire bikes. A friend of mine who’s an executive at Best Buy is a biking buddy and we’re out just about every Saturday morning. We bike all the trails around here and did the Century Ride last year for diabetes. I also like to hike, inline skate and cross country ski. Exercise is a “have to have.”
When do you turn it off, and how?
PW > Parenting is probably how I do it the most. You can’t be anything other than present with the child, now the teen, who’s right in front of you. Exercise, especially with people you really like, is the other way. That’s a treat.
Dale Kurschner is editor in chief of Twin Cities Business.