March 25, 2025 • 29 mins
In a world where healthcare disparities persist, innovative solutions are essential. Join us for an inspiring conversation with Dr. Elizabeth Oyekan, PharmD, Chief Pharmacy Officer at Stanford Healthcare and Stanford Healthcare Tri-Valley. Dr. Oyekan shares her vision for enhancing population health in underserved communities through a groundbreaking care model. Discover how she leads with a focus on education, community engagement, and mentorship, and learn about her unique framework for effective leadership. With insights into the critical role of pharmacy in the healthcare system and the challenges of workforce dynamics, this discussion illuminates the path toward value-based care and the importance of mentorship in shaping future leaders.
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Episode Transcript
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(00:00):
(bright music)
- Welcome to "Stanford Medcast,"
the podcast from Stanford CME
that brings you the latest insights
from the world's leadingphysicians and scientists.
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(00:22):
to stay updated with our newest episodes.
I am your host, Dr. Ruth Adewuya.
Joining me today is Elizabeth Oyekan,
who is a healthcare leader and innovator
with over 30 years of experience
in pharmacy and healthcare operations.
She currently serves
as the vice president ofPharmacy and Imaging Services
(00:42):
and Chief Pharmacy Officerat Stanford Healthcare
and Stanford Health Care Tri-Valley.
In this role, she overseestransformative initiatives
that drive operational excellence,
patient-centered care,and strategic innovation.
She earned her doctor of pharmacy degree
from the University ofSouthern California,
and holds a bachelor ofscience in biochemistry
from Loma Linda University.
(01:04):
She further honed herleadership experience
through an administrativeand clinical residency
at Kaiser Permanente,
and the executive leadershipprogram at Harvard University.
Throughout her career,
she's held numerous executive positions,
and has been a champion foradvancing medication adherence,
health equity, and value-based care.
Her work has been widely recognized,
(01:25):
including being named
one of modern health care's women leaders,
an honor celebrating
her significantcontributions to healthcare.
Thank you so much forchatting with me today.
- Thank you very much,
it is a pleasure to be here with you.
- Your leadership journeyspans over three decades.
What inspired you topursue a career in pharmacy
and healthcare operations,
(01:46):
and what were some pivotalmoments that shaped your path?
- Growing up, my parentswanted me to be a physician.
I wanted to be an artist,
and in our culture back then,
there were only threethings my parents wanted,
either had to be a physician,an attorney, or an engineer.
I didn't want to be any of those.
In high school, one ofthe things that I did see
(02:08):
is that my uncle, who's a pharmacist,
he used to take care of the community.
More people went to him totake care of their needs
than they did anywhere else.
I saw how he had thisimpact on the community,
so I said, okay, I didn'twant to be a physician,
I was not going to be an artist,
so pharmacy became that middle ground.
(02:30):
I desired to go into pharmacy
where I could really makean impact in people's lives
and where I could hopefullymake a difference,
and my parents were actually pretty happy.
I've had decades of experiencein the pharmacy space,
and I have had a few pivotal moments.
I'll share two, what Iwould call smaller ones
(02:50):
and then two bigger ones.
During my residency,
I found a passion to create structures,
create systems, and actuallybe able to address healthcare
on a much larger scale.
Instead of the individual one-on-one,
that's the first thing I learned.
Right after I finished my residency,
I went straight into management
where I had the opportunity now
(03:12):
to oversee different programsand bring programs to life.
In 2000, I found myself
at a new space in healthcare
when I was in Kaiser Permanente,
and that was in the spaceof population health
and health equity.
Six years later,
working with my physicianleaders and my team,
(03:35):
we had done some transformationaland groundbreaking work,
which was that we were ableto develop a care model
for delivering population health
for not just rural butunderserved communities.
Based on this caremodel that we developed,
we became one of the top three
in all of the medical centers
in the Kaiser, Southern California region.
(03:57):
That care model became the prototype
for the population health.
That was a major opportunity for me
over those periods of time.
This is when I started exiting
out of the traditional pharmacy role.
Fast forward, a pivotalmoment that's occurred
is that I now went toanother medical center,
I became the overarchingpharmacy director.
(04:20):
My executive director called me and said,
"Elizabeth, we have anew opportunity for you."
So what do you think I thought?
I said to myself,
"Oh, maybe at this medicalcenter they want me
to implement population health."
She said, "No, we need you totake on surgical services."
I said, "I am a pharmacist,"
and this was the bestcompliment that I had.
(04:41):
She said, "Elizabeth, we have observed
your ability to createvision, to give direction,
to create systems and structure,
and to lead people in a visionary way,"
because what I had done whenI got to Kaiser South Bay,
is we took the pharmacy there
and we completely transformed it.
(05:02):
I kept pharmacy,
and I now had to takeon surgical services.
There were a lot of challenges,
and in two years workingwith my physician partners,
we took it to being in the top three
in the areas of quality, access,
patient experience, and finances.
That was huge, which then led me
to have opportunities including becoming
(05:24):
the first African American female
to become a regional vicepresident in Kaiser Permanente.
I oversaw the entireKaiser, Colorado region,
the operations, and thena year after I came there,
they also gave me qualities.
Then I have to share one more with you.
In 2016, I had to step downfrom everything I was doing.
(05:48):
That was the year both myparents became really sick.
In our culture, we tendto take our parents in,
so I stepped down fromthis work that I did
to become a caregiver.
I had to come toCalifornia every two weeks
for 5 1/2 years to take care of them.
This was the blessed thing that occurred,
(06:08):
is that I got to see firsthandthe wonderfulness of old age
and the challenges of old age.
I also got to see the wonderfulness
of our healthcare systems,
and firsthand, I had a huge empathy
for what needs to occur.
At the end of 2021, I have awonderful sister in England,
(06:29):
and she said, "You know what, Elizabeth?
Your family has donethis for 5 1/2 years now,
why don't you haveparents come to England?"
Just to let you know they'redoing amazingly well.
So that is what gave me the opportunity
to get back into operations.
That period where I had
to do something completely different,
which is consulting.
(06:50):
I will tell you, looking back,
was one of the bestthings that ever happened.
What it did for me is that it gave me
an even deeper sense of purpose.
It allowed me to crystallize my mission.
Why do I fundamentally existin the healthcare space?
I fundamentally exist tomake people's lives better
(07:11):
through leadership, through education,
and through community.
These are some key pivotal moments
that have transformed myability to care, to lead,
and to hopefully contributeto people's lives.
- Your journey is incredibly powerful.
Thank you for sharingthose moments with us,
starting with the intersectionof cultural expectations
(07:33):
and personal passion,and finding inspiration
in your uncle's role as a pharmacist,
but ultimately carving your own path
in healthcare leadership.
What's especially striking to me
is how your initial desire to be an artist
translated into a passion
for system thinkingand large-scale impact,
(07:54):
and that realization,
shifting from patient by patient care,
to transforming entiresystems was clearly pivotal
in shaping your leadership approach,
and of course, stepping away in 2016
to care for your parents gave you
a completely newperspective on healthcare.
It's incredible how that experience
(08:15):
has deepened your sense of purpose
and refined your missionto lead through education,
through leadership and community.
Speaking of leadership, in your book,
"The Ten Elements ofL.E.A.D.E.R.S.H.I.P. Intelligence,"
you outline key behaviors and skills
for navigating uncertainty.
(08:35):
Can you describe this for us?
- It was in 2014 when, as I mentioned,
the first African Americanfemale regional vice president
of a whole region.
People came up to me and said,
"Elizabeth, tell me how is it that
regardless of what area you are in,
you are able to be successfulin leading people?"
(08:56):
What I started to realize
was that the term "leadership"is not just a noun,
it is not just a verb,
it became an acronym for how I lead.
What does it stand for?
L stands for always lead witha purpose, lead by example.
E is engage, engage witheffective communication.
(09:17):
A is accountability.
D is develop oneself,
become a curious and continuous learner.
Very importantly, the D,again, is also develop others.
One of the things Ialways try to tell people,
"I am looking for you all tobecome better than me one day,
so my job is to helpdevelop you the best I can."
(09:38):
The next E is execution.
A lot of people have great ideas
and think that's innovation.
You know what innovation is to me?
Innovation is an extremely great idea
that is flawlessly executed upon.
R is recognize people for doing good.
We always catch people whenthey're doing something wrong,
recognize and acknowledgepeople for doing good.
(10:01):
S, solidify relationshipswherever you are.
H, health, not just physical health,
mental health, socialhealth, spiritual health,
make that part of you.
I is interdependence.
A lot of us, we become experts,
we become very independent in what we do,
but I tell people to get new thinking,
(10:23):
you have to go across silosand become interdependent.
Last but not least,leadership is personal.
That's the P, personal,whether it's work-life balance,
work-life integration, it doesn't matter,
make it personal so thatyou can remain authentic
to who you are.
I tell people it is anintelligence for you to have
(10:45):
because at the beginning of each month,
I go through that and I say,
"How am I doing with my LQ,
my leadership intelligence?"
I tell you a lot of timesI'm not doing the best I can,
but I keep trying.
While I was off with my parents,
that's when I actually had the time
to sit down and write the book itself
because people asked,"Can I put it in writing?"
(11:07):
So that's when I wrote the book.
- I really like that framework
in which you've defined leadership,
not just as a position,
but a set of intentionalactions and values,
and you broke it down intothese different actions,
emphasizing health,interdependence, execution,
but also developing others,
(11:28):
really recognizing that leadership
is not just about driving outcomes,
but also about sustainingyourself and others along the way.
Can you share a specificexample from your career
where these principles madea significant difference?
- I will give the oneabout accountability.
One of the things thatI have learned over time
(11:50):
is when things are going well,
we as leaders love to take that credit.
What about when things aren't going well?
I will tell you,
there was an instance whenI was in Kaiser, Colorado.
Patients who had employer-based insurance,
a lot of them switched overto being on the exchanges.
We, in Colorado, had assumedmaybe about 10 to 20%
(12:14):
of patients will flip over.
Guess what happened?
About 50%, all of a sudden,
we were $100 million underwater.
The question became,
"How are we going to turn this around
and still have a positive margin?"
I could easily have said,
"This is out of our control,"
because we didn't expect allthese people to switch over,
but I said, "The box stops with me."
(12:36):
In owning that the box stops with me
allowed me to open up andget my teams together,
work with our physicians to say,
"So what are we going to do?"
That actually allowed me todevelop a new perspective
on how to save money, it's called the V3,
and I'm now introducing it at Stanford,
but it is how do you lookat variation in the system?
(12:59):
How do you look at the venue management,
and how do we look at vendor management?
If I didn't own that,
and I was busy trying to figure out
where to pass or blame,
it would not have allowed myteam and I to become creative.
When you own things,
it allows you to open up your mind.
Within the first 10 months,
(13:20):
when we put the V3infrastructure in place,
we saved $40 million.
Now, I will tell you,
we did have to do some labor management
and a few layoffs,
so I don't want to make it look like rosy.
But as we owned it, we were accountable.
We were able to open up ourminds and figure out a way,
and come up with a process that again,
(13:41):
became a standup of how we do things.
- A great example of leadership in action
and seeing these principles applied
in a real world challenge,
really underscoring thevalue that it can have
in high stakes decision making,
how did your backgroundin pharmacy influence
your approach to leading,
(14:02):
and what is the role of pharmacy
in the health system strategy?
- When I finished my residency,
I went straight into management.
While I was a resident,
how I started to realize mydeeper passion of systems
is that I was asked during my residency
to start building differentpharmacy-led clinics
(14:24):
with our providers, so likea pain management clinic,
a diabetes clinic, oncology clinic.
I had the privilege workingagain with our teams
to develop five different clinic programs.
I was then told,
"Elizabeth, you helpedcreate these positions,
would you like to become the leader?"
One day I was a resident whohad all these preceptors,
(14:47):
and the next day, I was their boss.
When you ask me, "What's my background?"
that helped me becomea collaborative leader.
Because they knew that I didn'thave a lot of experience,
but they also knew whatI brought to the table.
They knew I brought structure,
they knew I broughtgood ideas, all of that,
but I worked collaboratively with them.
When I look at my leadership style,
(15:08):
even till today, it's very collaborative.
It's not like Elizabeth knows everything,
and you guys don't.
I always go back to something
that Ralph Waldo Emerson said, which is,
"Every day you meet someone,"
and it is in that I learned
everybody is superior to me in some way,
and in that I learn,
I would say it was inpharmacy it happened.
(15:29):
That collaborative ability to lead
is what has allowed meto lead in that way.
Pharmacy, you exist totransform care delivery
to improve outcome.
We, in pharmacy, are importantin the healthcare system
to improve access, notaccess just to care,
but access to therapies.
(15:50):
But also pharmacy is critical
in reducing total cost of care.
I tell people, "I'm notsure we can actually reduce,
but we can definitely bend the trajectory
in which it goes up."
The other thing pharmacy canhelp in the healthcare space
is to help everybody workat their highest scope
and to help everybody work uniformly.
(16:12):
Most importantly I wouldsay is pharmacy's role
is to reduce disparities in healthcare,
because when you lookat most of the patients
who are in the healthcaresystem, a lot of them,
it is about them havingchronic conditions,
and 80% of people on chronic conditions
are on some type of medication.
(16:32):
When I was in Kaiser West Los Angeles,
we saw that disparity,
and I see pharmacy having such a role
in helping reduce that.
So that's why I go with the Quintuple Aim
and pharmacist's role in healthcare
is better outcomes, better care,
reducing the total cost of care,
improving scope of practice for everyone,
(16:53):
and reducing thedisparities in healthcare.
- Your perspective on pharmacy's role
in the healthcare systemis incredibly insightful.
Rather than viewing pharmacyas a support function,
you frame it as a key driverof achieving the Quintuple Aim,
improving outcomes, increasing access,
and reducing the total cost of care,
expanding scope of practice,
(17:14):
and addressing health disparities.
You've highlighted howpharmacy is uniquely positioned
to shape the future ofhealthcare at a system level.
The healthcare landscapeis constantly evolving
with new challenges and opportunities.
What do you see as the most pressing issue
facing pharmacy andhealthcare leaders today?
(17:36):
- I would say the shift tovalue-based care is one,
the integration of technology,
automation into what we do,
just the regulatorypressure is another one,
but what I would say isthe most pressing issue
is our workforce.
First and foremost, here'sa new expectation now
of the workforce, coupled with everybody
(17:57):
who want to work from home
and who have different expectations.
That workforce perspective is one.
I would say the otheris the aging population
and all the changes going on.
We need additional people in the system,
and we have a shortage.
We have shortages,
and therefore for thepeople in the system,
we are seeing burnout.
(18:18):
Then the other challengeI see is upskilling.
We now have AI, we now have technologies.
I will tell you, I constantlyhear people saying,
"Oh my gosh, is AI goingto take over my job?
Am I going to be out of work?"
When I look at the number one challenge
facing both pharmacy and the healthcare,
it is our workforce infrastructure,
(18:40):
dealing with the new expectation,
dealing with shortages and burnout,
and then dealing with the upskilling
to make sure that they're already okay
to do what needs to bedone in this new landscape.
- I completely agree with you.
Workforce challenges are certainly
one of the biggest issuesfacing healthcare today.
Everything you mentioned from the balance
(19:01):
between staffing shortages,aging population,
and our ability to recruit, retain,
and support healthcare professionals
is critical to maintaining the quality
of patient care we need.
Workforce stability isn'tjust an operational issue,
but a foundational onethat impacts everything
from patient outcomes to thesuccess of value-based care.
(19:22):
At the same time,
while these challenges are significant,
they also present opportunities,
and it's clear thataddressing workforce issues
will require innovativesolutions and training technology
and team-based caremodels to really ensure
that healthcare professionalscan work efficiently
and at the top of their scope.
With that in mind, asVice President of Pharmacy
(19:45):
and Imaging Servicesat Stanford Healthcare,
you oversee hundreds of team members
across multiple locations.
Could you describe someof the work that you do
in advancing strategic initiatives
in health plans and value-based care?
- When I came to Stanford in pharmacy,
a lot of great work was being done.
But when I asked
(20:05):
"Where are we going in pharmacy
over the next 1 to 3 years,
and over the next 3 to 5 years?"
And what I have found out over time
is that everybody wants to do everything.
Everybody wants to implementall the strategies.
Then at the end of the year,
everybody's frustrated
with "Why didn't we get things done?"
(20:27):
This goes back to my mission
about education, about leadership.
One of the things I did is,
I decided to put a framework together,
a framework to help people understand
how to strategically movefrom where they are today
to where we need to be in the future.
Overarchingly, it's first and foremost is,
"Where are we today?
(20:48):
What's the good things we're doing?
What's the good, what'sthe bad?" have that,
so that we are grounded,this is where we are.
The next question becomes,"Why do we need to change?"
We look at the trends that areout in the healthcare world.
The next component became,
based on all of thiswork that's out there,
based on all of the expectations,
(21:09):
what is it in pharmacy,and what is it in imaging
that we can become the best.
That becomes, "What do we want to become?"
We have an overarchinggoal in pharmacy is that
our goal is to become aworld-class enterprise,
and in imaging it wasto ensure accessible,
safe, and innovative care to all.
(21:30):
Once we had unifying goal,overarching, we then said,
"How do we make this happen?
We have to now prioritize."
That, I would say,
has been one of the most difficult things
I've seen at Stanford
because everybody wants to do everything,
which is great, but what I've said is,
"We can do everything
but just not at the same time."
(21:50):
Mostly with our physician partners,
we have come up with,
"These are the areasthat we are focusing on."
The question becomes,
"How do we now advance this work?"
We advance it in three ways.
First of all is we have puta leadership program together
to upskill our team members.
The second thing that we have done
is we have actually comeup with what we call DMS,
(22:14):
which is directors, managers,and supervisor meetings
every single month, andfor what we've prioritized,
we have report outs.
There's that cadence ofaccountability that we have.
The third thing we have is the forum.
The forum is data,
looking at baseline, benchmarks, progress.
By us having an infrastructure like this,
(22:36):
it has allowed us to say,"This is where we're going."
By having that infrastructurein place, Ruth,
we have now accomplishedthings in pharmacy
that we have not beenable to accomplish before.
What I just shared with you is called
"The blueprint of takingtheory and strategies
and making it into action."
We're now going to beusing this new blueprint
(22:58):
in interventional platform,
and other departments want to use this
because they've now seen, unequivocally,
that using this systematic blueprint
is allowing us to get results
that we have not been able to,
and it is allowing us to make sure
that people are aligned.
- So often in healthcare,
especially in large institutions,
(23:20):
there's an eagerness todo everything at once,
but without a clear framework,
priorities can get lostand progress can stall.
The way you describe the structured,
yet flexible blueprint thataligns current realities,
future trends, and institutional strategy
is not only pragmatic, butalso ensures that initiatives
(23:42):
are both meaningful and achievable.
Another key takeaway that Iheard from what you shared
is the importance of continuallyasking, "What's next?"
And not just as a checkpoint,
but as a mechanism to keep teams aligned
while also fosteringinnovation and adaptability.
(24:03):
And that kind of forward-thinkingmindset is critical,
especially in healthcare
where the landscape isconstantly evolving.
Before we wrap up,
I really wanna touch onone more area, mentorship.
You've talked about leadership development
as part of your strategy,
but I'd love to hear aboutyour personal experience.
(24:25):
What role has mentorshipplayed in your career?
How have you been mentored,
and how do you mentor emergingleaders in healthcare?
- There are three types of people
that have helped me in my career.
One, are mentors.
When I was asked to takeon population health
and health equity, I waslike, "What am I doing here?"
(24:47):
I asked someone who was in that space,
"Help me understand what itis I'm doing in this space."
Then I started looking and saying,
not just technical skills now,
"How do I begin to growin my leadership skills?"
I started identifyingpeople in the organization
who I really admired,
(25:08):
and I would ask if they would be official
or unofficial mentors for me.
Some of them were brutal
in helping me see some ofthose rough edges that I had,
but they made such aworld of a difference.
The other persons have been coaches.
I have had coaches to helpme see those blind spots.
(25:29):
I've always said,
if Magic Johnson and Kareem Abdul-Jabbar,
which obviously this is showing my age,
but if these people havecoaches, then exactly who am I?
If these people can have coaches,
it's important that we ona daily basis have coaches
to help refine even the best path.
The one group of people that I have said,
(25:50):
people should startidentifying better sponsors.
When I worked with ourphysician leaders on my team
to transform the surgical services,
I had one leader who said,
"Elizabeth, I would neverhave had the courage
to give you surgical services
and you've had zero experiencein that space before,
and look at what you've done."
(26:11):
When I applied for the VicePresident of Kaiser, Colorado,
Dr. Ben Chu, who was theregional vice president
of Kaiser Permanentein Southern California
was on the committee for the selection.
What I found out he said was,
"You have a lot of greatpeople here for this role,
and this is a competitive role.
(26:32):
But if you want somebody whois going to make a difference,
this is who you choose."
I had no idea that Iwas being talked about
behind closed doors.
When somebody at a higherlevel to you and says,
"Elizabeth, that was areally good job you did.
What is it that you are aspiring to do?"
I always tell people,have your 90-second spiel
(26:52):
about how, number one,you're looking to grow,
number two, you're looking to improve
and contribute to the organization,
and number three, somethingunique about yourself.
Those are the three types of people,
mentors who actually workwith you to build yourself,
coaches who help refine you,
and I always say sponsors,
(27:12):
who talk about you behind your back,
but in a very good way,to lead you into roles
that you otherwise may not have access to.
- I love how you've broken this down
into three distinct, butequally critical roles,
mentors, coaches, and sponsors.
It's such a powerfulframework for career growth
because each plays a different role
(27:35):
in shaping leadership development.
Just recapping what you said
about mentors providing guidance,
and helping to navigateuncharted territory,
coaches who can refine leadership skills
offering sometimes brutalbut necessary feedback,
and sponsors, which I would say arguably
the most overlooked, are theones who advocate for you
(27:57):
in rooms that you are not in,
opening doors to opportunities
you may not have even considered.
This is such an important perspective,
not only on mentorship and coaching,
but on how leadership growth
is about more than just guidance.
It's about expanding one's perspective,
fostering self-awareness,
(28:18):
and embracing continuous learning.
Your experiences highlight
how leadership isn't a destination,
but an evolving journey.
I had more questions for you,
but I feel like this has beenan incredible conversation,
and the perfect place to conclude.
Your insights on leadership, innovation,
(28:39):
and the evolving role ofpharmacy in healthcare
have truly been inspiring.
Thank you for sharing your journey,
and the invaluable lessonsyou've learned along the way.
- Thank you, Ruth, thishas been a privilege
to share a little bit aboutme with your audience,
and hopefully people will be able to take
a few nuggets here andthere to make their own.
- Thanks for tuning in.
(29:00):
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(upbeat music)
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- Welcome to "Stanford Medcast,"
the podcast from Stanford CME
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If you're joining us for the first time,
be sure to subscribe on Apple Podcast,
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(00:22):
to stay updated with our newest episodes.
I am your host, Dr. Ruth Adewuya.
Joining me today is Elizabeth Oyekan,
who is a healthcare leader and innovator
with over 30 years of experience
in pharmacy and healthcare operations.
She currently serves
as the vice president ofPharmacy and Imaging Services
(00:42):
and Chief Pharmacy Officerat Stanford Healthcare
and Stanford Health Care Tri-Valley.
In this role, she overseestransformative initiatives
that drive operational excellence,
patient-centered care,and strategic innovation.
She earned her doctor of pharmacy degree
from the University ofSouthern California,
and holds a bachelor ofscience in biochemistry
from Loma Linda University.
(01:04):
She further honed herleadership experience
through an administrativeand clinical residency
at Kaiser Permanente,
and the executive leadershipprogram at Harvard University.
Throughout her career,
she's held numerous executive positions,
and has been a champion foradvancing medication adherence,
health equity, and value-based care.
Her work has been widely recognized,
(01:25):
including being named
one of modern health care's women leaders,
an honor celebrating
her significantcontributions to healthcare.
Thank you so much forchatting with me today.
- Thank you very much,
it is a pleasure to be here with you.
- Your leadership journeyspans over three decades.
What inspired you topursue a career in pharmacy
and healthcare operations,
(01:46):
and what were some pivotalmoments that shaped your path?
- Growing up, my parentswanted me to be a physician.
I wanted to be an artist,
and in our culture back then,
there were only threethings my parents wanted,
either had to be a physician,an attorney, or an engineer.
I didn't want to be any of those.
In high school, one ofthe things that I did see
(02:08):
is that my uncle, who's a pharmacist,
he used to take care of the community.
More people went to him totake care of their needs
than they did anywhere else.
I saw how he had thisimpact on the community,
so I said, okay, I didn'twant to be a physician,
I was not going to be an artist,
so pharmacy became that middle ground.
(02:30):
I desired to go into pharmacy
where I could really makean impact in people's lives
and where I could hopefullymake a difference,
and my parents were actually pretty happy.
I've had decades of experiencein the pharmacy space,
and I have had a few pivotal moments.
I'll share two, what Iwould call smaller ones
(02:50):
and then two bigger ones.
During my residency,
I found a passion to create structures,
create systems, and actuallybe able to address healthcare
on a much larger scale.
Instead of the individual one-on-one,
that's the first thing I learned.
Right after I finished my residency,
I went straight into management
where I had the opportunity now
(03:12):
to oversee different programsand bring programs to life.
In 2000, I found myself
at a new space in healthcare
when I was in Kaiser Permanente,
and that was in the spaceof population health
and health equity.
Six years later,
working with my physicianleaders and my team,
(03:35):
we had done some transformationaland groundbreaking work,
which was that we were ableto develop a care model
for delivering population health
for not just rural butunderserved communities.
Based on this caremodel that we developed,
we became one of the top three
in all of the medical centers
in the Kaiser, Southern California region.
(03:57):
That care model became the prototype
for the population health.
That was a major opportunity for me
over those periods of time.
This is when I started exiting
out of the traditional pharmacy role.
Fast forward, a pivotalmoment that's occurred
is that I now went toanother medical center,
I became the overarchingpharmacy director.
(04:20):
My executive director called me and said,
"Elizabeth, we have anew opportunity for you."
So what do you think I thought?
I said to myself,
"Oh, maybe at this medicalcenter they want me
to implement population health."
She said, "No, we need you totake on surgical services."
I said, "I am a pharmacist,"
and this was the bestcompliment that I had.
(04:41):
She said, "Elizabeth, we have observed
your ability to createvision, to give direction,
to create systems and structure,
and to lead people in a visionary way,"
because what I had done whenI got to Kaiser South Bay,
is we took the pharmacy there
and we completely transformed it.
(05:02):
I kept pharmacy,
and I now had to takeon surgical services.
There were a lot of challenges,
and in two years workingwith my physician partners,
we took it to being in the top three
in the areas of quality, access,
patient experience, and finances.
That was huge, which then led me
to have opportunities including becoming
(05:24):
the first African American female
to become a regional vicepresident in Kaiser Permanente.
I oversaw the entireKaiser, Colorado region,
the operations, and thena year after I came there,
they also gave me qualities.
Then I have to share one more with you.
In 2016, I had to step downfrom everything I was doing.
(05:48):
That was the year both myparents became really sick.
In our culture, we tendto take our parents in,
so I stepped down fromthis work that I did
to become a caregiver.
I had to come toCalifornia every two weeks
for 5 1/2 years to take care of them.
This was the blessed thing that occurred,
(06:08):
is that I got to see firsthandthe wonderfulness of old age
and the challenges of old age.
I also got to see the wonderfulness
of our healthcare systems,
and firsthand, I had a huge empathy
for what needs to occur.
At the end of 2021, I have awonderful sister in England,
(06:29):
and she said, "You know what, Elizabeth?
Your family has donethis for 5 1/2 years now,
why don't you haveparents come to England?"
Just to let you know they'redoing amazingly well.
So that is what gave me the opportunity
to get back into operations.
That period where I had
to do something completely different,
which is consulting.
(06:50):
I will tell you, looking back,
was one of the bestthings that ever happened.
What it did for me is that it gave me
an even deeper sense of purpose.
It allowed me to crystallize my mission.
Why do I fundamentally existin the healthcare space?
I fundamentally exist tomake people's lives better
(07:11):
through leadership, through education,
and through community.
These are some key pivotal moments
that have transformed myability to care, to lead,
and to hopefully contributeto people's lives.
- Your journey is incredibly powerful.
Thank you for sharingthose moments with us,
starting with the intersectionof cultural expectations
(07:33):
and personal passion,and finding inspiration
in your uncle's role as a pharmacist,
but ultimately carving your own path
in healthcare leadership.
What's especially striking to me
is how your initial desire to be an artist
translated into a passion
for system thinkingand large-scale impact,
(07:54):
and that realization,
shifting from patient by patient care,
to transforming entiresystems was clearly pivotal
in shaping your leadership approach,
and of course, stepping away in 2016
to care for your parents gave you
a completely newperspective on healthcare.
It's incredible how that experience
(08:15):
has deepened your sense of purpose
and refined your missionto lead through education,
through leadership and community.
Speaking of leadership, in your book,
"The Ten Elements ofL.E.A.D.E.R.S.H.I.P. Intelligence,"
you outline key behaviors and skills
for navigating uncertainty.
(08:35):
Can you describe this for us?
- It was in 2014 when, as I mentioned,
the first African Americanfemale regional vice president
of a whole region.
People came up to me and said,
"Elizabeth, tell me how is it that
regardless of what area you are in,
you are able to be successfulin leading people?"
(08:56):
What I started to realize
was that the term "leadership"is not just a noun,
it is not just a verb,
it became an acronym for how I lead.
What does it stand for?
L stands for always lead witha purpose, lead by example.
E is engage, engage witheffective communication.
(09:17):
A is accountability.
D is develop oneself,
become a curious and continuous learner.
Very importantly, the D,again, is also develop others.
One of the things Ialways try to tell people,
"I am looking for you all tobecome better than me one day,
so my job is to helpdevelop you the best I can."
(09:38):
The next E is execution.
A lot of people have great ideas
and think that's innovation.
You know what innovation is to me?
Innovation is an extremely great idea
that is flawlessly executed upon.
R is recognize people for doing good.
We always catch people whenthey're doing something wrong,
recognize and acknowledgepeople for doing good.
(10:01):
S, solidify relationshipswherever you are.
H, health, not just physical health,
mental health, socialhealth, spiritual health,
make that part of you.
I is interdependence.
A lot of us, we become experts,
we become very independent in what we do,
but I tell people to get new thinking,
(10:23):
you have to go across silosand become interdependent.
Last but not least,leadership is personal.
That's the P, personal,whether it's work-life balance,
work-life integration, it doesn't matter,
make it personal so thatyou can remain authentic
to who you are.
I tell people it is anintelligence for you to have
(10:45):
because at the beginning of each month,
I go through that and I say,
"How am I doing with my LQ,
my leadership intelligence?"
I tell you a lot of timesI'm not doing the best I can,
but I keep trying.
While I was off with my parents,
that's when I actually had the time
to sit down and write the book itself
because people asked,"Can I put it in writing?"
(11:07):
So that's when I wrote the book.
- I really like that framework
in which you've defined leadership,
not just as a position,
but a set of intentionalactions and values,
and you broke it down intothese different actions,
emphasizing health,interdependence, execution,
but also developing others,
(11:28):
really recognizing that leadership
is not just about driving outcomes,
but also about sustainingyourself and others along the way.
Can you share a specificexample from your career
where these principles madea significant difference?
- I will give the oneabout accountability.
One of the things thatI have learned over time
(11:50):
is when things are going well,
we as leaders love to take that credit.
What about when things aren't going well?
I will tell you,
there was an instance whenI was in Kaiser, Colorado.
Patients who had employer-based insurance,
a lot of them switched overto being on the exchanges.
We, in Colorado, had assumedmaybe about 10 to 20%
(12:14):
of patients will flip over.
Guess what happened?
About 50%, all of a sudden,
we were $100 million underwater.
The question became,
"How are we going to turn this around
and still have a positive margin?"
I could easily have said,
"This is out of our control,"
because we didn't expect allthese people to switch over,
but I said, "The box stops with me."
(12:36):
In owning that the box stops with me
allowed me to open up andget my teams together,
work with our physicians to say,
"So what are we going to do?"
That actually allowed me todevelop a new perspective
on how to save money, it's called the V3,
and I'm now introducing it at Stanford,
but it is how do you lookat variation in the system?
(12:59):
How do you look at the venue management,
and how do we look at vendor management?
If I didn't own that,
and I was busy trying to figure out
where to pass or blame,
it would not have allowed myteam and I to become creative.
When you own things,
it allows you to open up your mind.
Within the first 10 months,
(13:20):
when we put the V3infrastructure in place,
we saved $40 million.
Now, I will tell you,
we did have to do some labor management
and a few layoffs,
so I don't want to make it look like rosy.
But as we owned it, we were accountable.
We were able to open up ourminds and figure out a way,
and come up with a process that again,
(13:41):
became a standup of how we do things.
- A great example of leadership in action
and seeing these principles applied
in a real world challenge,
really underscoring thevalue that it can have
in high stakes decision making,
how did your backgroundin pharmacy influence
your approach to leading,
(14:02):
and what is the role of pharmacy
in the health system strategy?
- When I finished my residency,
I went straight into management.
While I was a resident,
how I started to realize mydeeper passion of systems
is that I was asked during my residency
to start building differentpharmacy-led clinics
(14:24):
with our providers, so likea pain management clinic,
a diabetes clinic, oncology clinic.
I had the privilege workingagain with our teams
to develop five different clinic programs.
I was then told,
"Elizabeth, you helpedcreate these positions,
would you like to become the leader?"
One day I was a resident whohad all these preceptors,
(14:47):
and the next day, I was their boss.
When you ask me, "What's my background?"
that helped me becomea collaborative leader.
Because they knew that I didn'thave a lot of experience,
but they also knew whatI brought to the table.
They knew I brought structure,
they knew I broughtgood ideas, all of that,
but I worked collaboratively with them.
When I look at my leadership style,
(15:08):
even till today, it's very collaborative.
It's not like Elizabeth knows everything,
and you guys don't.
I always go back to something
that Ralph Waldo Emerson said, which is,
"Every day you meet someone,"
and it is in that I learned
everybody is superior to me in some way,
and in that I learn,
I would say it was inpharmacy it happened.
(15:29):
That collaborative ability to lead
is what has allowed meto lead in that way.
Pharmacy, you exist totransform care delivery
to improve outcome.
We, in pharmacy, are importantin the healthcare system
to improve access, notaccess just to care,
but access to therapies.
(15:50):
But also pharmacy is critical
in reducing total cost of care.
I tell people, "I'm notsure we can actually reduce,
but we can definitely bend the trajectory
in which it goes up."
The other thing pharmacy canhelp in the healthcare space
is to help everybody workat their highest scope
and to help everybody work uniformly.
(16:12):
Most importantly I wouldsay is pharmacy's role
is to reduce disparities in healthcare,
because when you lookat most of the patients
who are in the healthcaresystem, a lot of them,
it is about them havingchronic conditions,
and 80% of people on chronic conditions
are on some type of medication.
(16:32):
When I was in Kaiser West Los Angeles,
we saw that disparity,
and I see pharmacy having such a role
in helping reduce that.
So that's why I go with the Quintuple Aim
and pharmacist's role in healthcare
is better outcomes, better care,
reducing the total cost of care,
improving scope of practice for everyone,
(16:53):
and reducing thedisparities in healthcare.
- Your perspective on pharmacy's role
in the healthcare systemis incredibly insightful.
Rather than viewing pharmacyas a support function,
you frame it as a key driverof achieving the Quintuple Aim,
improving outcomes, increasing access,
and reducing the total cost of care,
expanding scope of practice,
(17:14):
and addressing health disparities.
You've highlighted howpharmacy is uniquely positioned
to shape the future ofhealthcare at a system level.
The healthcare landscapeis constantly evolving
with new challenges and opportunities.
What do you see as the most pressing issue
facing pharmacy andhealthcare leaders today?
(17:36):
- I would say the shift tovalue-based care is one,
the integration of technology,
automation into what we do,
just the regulatorypressure is another one,
but what I would say isthe most pressing issue
is our workforce.
First and foremost, here'sa new expectation now
of the workforce, coupled with everybody
(17:57):
who want to work from home
and who have different expectations.
That workforce perspective is one.
I would say the otheris the aging population
and all the changes going on.
We need additional people in the system,
and we have a shortage.
We have shortages,
and therefore for thepeople in the system,
we are seeing burnout.
(18:18):
Then the other challengeI see is upskilling.
We now have AI, we now have technologies.
I will tell you, I constantlyhear people saying,
"Oh my gosh, is AI goingto take over my job?
Am I going to be out of work?"
When I look at the number one challenge
facing both pharmacy and the healthcare,
it is our workforce infrastructure,
(18:40):
dealing with the new expectation,
dealing with shortages and burnout,
and then dealing with the upskilling
to make sure that they're already okay
to do what needs to bedone in this new landscape.
- I completely agree with you.
Workforce challenges are certainly
one of the biggest issuesfacing healthcare today.
Everything you mentioned from the balance
(19:01):
between staffing shortages,aging population,
and our ability to recruit, retain,
and support healthcare professionals
is critical to maintaining the quality
of patient care we need.
Workforce stability isn'tjust an operational issue,
but a foundational onethat impacts everything
from patient outcomes to thesuccess of value-based care.
(19:22):
At the same time,
while these challenges are significant,
they also present opportunities,
and it's clear thataddressing workforce issues
will require innovativesolutions and training technology
and team-based caremodels to really ensure
that healthcare professionalscan work efficiently
and at the top of their scope.
With that in mind, asVice President of Pharmacy
(19:45):
and Imaging Servicesat Stanford Healthcare,
you oversee hundreds of team members
across multiple locations.
Could you describe someof the work that you do
in advancing strategic initiatives
in health plans and value-based care?
- When I came to Stanford in pharmacy,
a lot of great work was being done.
But when I asked
(20:05):
"Where are we going in pharmacy
over the next 1 to 3 years,
and over the next 3 to 5 years?"
And what I have found out over time
is that everybody wants to do everything.
Everybody wants to implementall the strategies.
Then at the end of the year,
everybody's frustrated
with "Why didn't we get things done?"
(20:27):
This goes back to my mission
about education, about leadership.
One of the things I did is,
I decided to put a framework together,
a framework to help people understand
how to strategically movefrom where they are today
to where we need to be in the future.
Overarchingly, it's first and foremost is,
"Where are we today?
(20:48):
What's the good things we're doing?
What's the good, what'sthe bad?" have that,
so that we are grounded,this is where we are.
The next question becomes,"Why do we need to change?"
We look at the trends that areout in the healthcare world.
The next component became,
based on all of thiswork that's out there,
based on all of the expectations,
(21:09):
what is it in pharmacy,and what is it in imaging
that we can become the best.
That becomes, "What do we want to become?"
We have an overarchinggoal in pharmacy is that
our goal is to become aworld-class enterprise,
and in imaging it wasto ensure accessible,
safe, and innovative care to all.
(21:30):
Once we had unifying goal,overarching, we then said,
"How do we make this happen?
We have to now prioritize."
That, I would say,
has been one of the most difficult things
I've seen at Stanford
because everybody wants to do everything,
which is great, but what I've said is,
"We can do everything
but just not at the same time."
(21:50):
Mostly with our physician partners,
we have come up with,
"These are the areasthat we are focusing on."
The question becomes,
"How do we now advance this work?"
We advance it in three ways.
First of all is we have puta leadership program together
to upskill our team members.
The second thing that we have done
is we have actually comeup with what we call DMS,
(22:14):
which is directors, managers,and supervisor meetings
every single month, andfor what we've prioritized,
we have report outs.
There's that cadence ofaccountability that we have.
The third thing we have is the forum.
The forum is data,
looking at baseline, benchmarks, progress.
By us having an infrastructure like this,
(22:36):
it has allowed us to say,"This is where we're going."
By having that infrastructurein place, Ruth,
we have now accomplishedthings in pharmacy
that we have not beenable to accomplish before.
What I just shared with you is called
"The blueprint of takingtheory and strategies
and making it into action."
We're now going to beusing this new blueprint
(22:58):
in interventional platform,
and other departments want to use this
because they've now seen, unequivocally,
that using this systematic blueprint
is allowing us to get results
that we have not been able to,
and it is allowing us to make sure
that people are aligned.
- So often in healthcare,
especially in large institutions,
(23:20):
there's an eagerness todo everything at once,
but without a clear framework,
priorities can get lostand progress can stall.
The way you describe the structured,
yet flexible blueprint thataligns current realities,
future trends, and institutional strategy
is not only pragmatic, butalso ensures that initiatives
(23:42):
are both meaningful and achievable.
Another key takeaway that Iheard from what you shared
is the importance of continuallyasking, "What's next?"
And not just as a checkpoint,
but as a mechanism to keep teams aligned
while also fosteringinnovation and adaptability.
(24:03):
And that kind of forward-thinkingmindset is critical,
especially in healthcare
where the landscape isconstantly evolving.
Before we wrap up,
I really wanna touch onone more area, mentorship.
You've talked about leadership development
as part of your strategy,
but I'd love to hear aboutyour personal experience.
(24:25):
What role has mentorshipplayed in your career?
How have you been mentored,
and how do you mentor emergingleaders in healthcare?
- There are three types of people
that have helped me in my career.
One, are mentors.
When I was asked to takeon population health
and health equity, I waslike, "What am I doing here?"
(24:47):
I asked someone who was in that space,
"Help me understand what itis I'm doing in this space."
Then I started looking and saying,
not just technical skills now,
"How do I begin to growin my leadership skills?"
I started identifyingpeople in the organization
who I really admired,
(25:08):
and I would ask if they would be official
or unofficial mentors for me.
Some of them were brutal
in helping me see some ofthose rough edges that I had,
but they made such aworld of a difference.
The other persons have been coaches.
I have had coaches to helpme see those blind spots.
(25:29):
I've always said,
if Magic Johnson and Kareem Abdul-Jabbar,
which obviously this is showing my age,
but if these people havecoaches, then exactly who am I?
If these people can have coaches,
it's important that we ona daily basis have coaches
to help refine even the best path.
The one group of people that I have said,
(25:50):
people should startidentifying better sponsors.
When I worked with ourphysician leaders on my team
to transform the surgical services,
I had one leader who said,
"Elizabeth, I would neverhave had the courage
to give you surgical services
and you've had zero experiencein that space before,
and look at what you've done."
(26:11):
When I applied for the VicePresident of Kaiser, Colorado,
Dr. Ben Chu, who was theregional vice president
of Kaiser Permanentein Southern California
was on the committee for the selection.
What I found out he said was,
"You have a lot of greatpeople here for this role,
and this is a competitive role.
(26:32):
But if you want somebody whois going to make a difference,
this is who you choose."
I had no idea that Iwas being talked about
behind closed doors.
When somebody at a higherlevel to you and says,
"Elizabeth, that was areally good job you did.
What is it that you are aspiring to do?"
I always tell people,have your 90-second spiel
(26:52):
about how, number one,you're looking to grow,
number two, you're looking to improve
and contribute to the organization,
and number three, somethingunique about yourself.
Those are the three types of people,
mentors who actually workwith you to build yourself,
coaches who help refine you,
and I always say sponsors,
(27:12):
who talk about you behind your back,
but in a very good way,to lead you into roles
that you otherwise may not have access to.
- I love how you've broken this down
into three distinct, butequally critical roles,
mentors, coaches, and sponsors.
It's such a powerfulframework for career growth
because each plays a different role
(27:35):
in shaping leadership development.
Just recapping what you said
about mentors providing guidance,
and helping to navigateuncharted territory,
coaches who can refine leadership skills
offering sometimes brutalbut necessary feedback,
and sponsors, which I would say arguably
the most overlooked, are theones who advocate for you
(27:57):
in rooms that you are not in,
opening doors to opportunities
you may not have even considered.
This is such an important perspective,
not only on mentorship and coaching,
but on how leadership growth
is about more than just guidance.
It's about expanding one's perspective,
fostering self-awareness,
(28:18):
and embracing continuous learning.
Your experiences highlight
how leadership isn't a destination,
but an evolving journey.
I had more questions for you,
but I feel like this has beenan incredible conversation,
and the perfect place to conclude.
Your insights on leadership, innovation,
(28:39):
and the evolving role ofpharmacy in healthcare
have truly been inspiring.
Thank you for sharing your journey,
and the invaluable lessonsyou've learned along the way.
- Thank you, Ruth, thishas been a privilege
to share a little bit aboutme with your audience,
and hopefully people will be able to take
a few nuggets here andthere to make their own.
- Thanks for tuning in.
(29:00):
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