Welcome to Forum 360.

Thank you for joining us on our global outlook with a local view.

This is Leslie Ungar, your host today.

Teri lash-Ritter’s journey to the C-suite took a detour or two, you could say or maybe three.

That in itself may be a valuable lesson to be learned in today's conversation.

But if you think of titles that we figuratively wear, kind of like NASCAR's drivers literally wear their sponsors names on their uniform.

Our guest today would wear a lot of names.

Mother, wife, medical school student, dietitian, resident, MBA holder, faculty member, participant in medical missions, chief experience officer, family medicine physician, urgent care provider and gardener.

That would pretty much cover a NASCAR uniform.

Today we have a rare cat seat to the sea level of health care.

Because we have the fairly new CEO of Akron General Cleveland Clinic, Dr. Teri Lash-Ritter.

We're going to concentrate on vision, leadership style, how she approaches challenges, and a little bit about her personal journey.

So we welcome you to Forum 360.

- Thank you.

- Now you can think of yourself in a NASCAR.

- I can, I like it.

I might have to buy one.

- It just came to me Let's kind of fast forward in reverse in your personal journey.

You're a dietitian with, I believe, one child at the time?

- Two children at the time that I started medical.

- Two at the time, I don't know if you had one while you were in medical school or you... - I had two when I started medical school and one when I was a resident.

- Okay.

Okay.

So two, and you decide to go to medical school?

- Yes.

- So take us through that decision making process of deciding to go to med school after being in the workplace and a wife and mother.

- Yeah, I would be happy to.

So I was thrilled to be a dietitian.

I truly still love lifestyle as the core of health.

And I was working at Aultman Hospital in Canton and was married.

And, you know, there was like, this little, voice in the back of my head saying, you could do more.

You should do more.

You know, there's more out there than just this little piece that you're doing in your current career.

And, you know, I kind of tried to push that voice aside because that was inconvenient.

You know?

I was out of school, I was done with school, never going to go back to school.

And more focused on family and you know, moving into all the adulting things.

And, so I had two kids and you know, just really felt this calling to my core to do more, to really take more holistic care of people.

And so, you know, I slowly started talking to people that I worked with and residents and doctors and my colleagues in the dietetics departments.

And, you know, I just felt such support to do it.

And so I put some- -Were they going to take your exams for you?

That much support?

- Not that much.

More like a go for it, you know?

We'll stand back and cheerlead you.

But yeah.

And my husband was very supportive and said, you know, if you feel called to do this, then let's do it.

And so I applied and some, a little bit of me hoped not to get in, right?

Because I tried, I tried, but I couldn't do it.

And no, I got accepted into Neo Med as a direct entry, which was a six year program then.

So they had some spots that would open up to, you know, more traditional students that already had their bachelor's degree.

And so I got accepted.

And, that's where my medical journey started.

- Now, what do you say to people...

I go back to when I was senior in college or so, and I had a friend who was thinking of applying to dental school.

And I still remember clearly sitting in her kitchen and she said to her father, if I go to dental school, I'll be 24 by the time I graduate.

And he said, you'll be 24 with or without that additional degree.

So what do you say to people that it seems like a long journey, you know, how do you help them process that in the whole realm of their life?

- That's so funny that you use that verbiage, because that was exactly what I came to in my thinking.

I had kicked around going to medical school earlier, but same thing.

I'll be too old by the time I'm done.

I'm ready to get out of school, get my life started and, you know, so at the age that I thought I would be so old to be finishing up medical school, I was then just starting.

But that's what you come to is, is you're going to be whatever age you're projecting out in the future anyway.

And what do you want your life to look like then.

And so I think it's just, you know, putting yourself in that place of, you know, going through the work to get where you want to be and coming to terms with that being the right thing to do.

- But Maria Shriver, of all people, wrote a book kind of about balance that you don't have balance at any one time.

But if you kind of look at your life, your 20s, you know, you may do more professionally, your 30s, you may do more personally that you have balance if you look at your whole life.

But balance, balanced balance.

We hear about balance.

What are you with all the labels to cover a NASCAR uniform have to say about balance?

- I think balance is a mindset.

Honestly.

You know, I've been balancing, I'm going to put that in air quotes, you know, since I started medical school with two kids, right?

And I think it's an acceptance and being present in what you were doing in the moment, that feels like balance to me.

So I think there's also an acceptance that some days, some weeks, you know, work or school is going to take priority and more of my time will be dedicated to that.

And then there's also times where family is going to take priority, and more of my time will be dedicated there.

And then there’s somedays that are just a big mash up of all of it.

Which is most days, you know, and if you love what you do, it doesn't feel like it has to be the scale where things are perfectly matched.

And so I think but that's what I would say to somebody who's debating about going back to school or whatever is you need to be doing something, investing your time where you find fulfillment and value.

And so if you're doing that, this scale becomes really, I'll say, easy to balance.

Yeah.

- Yeah.

I have a client that's in health care in California now, but her family is still here they haven't moved yet.

And she got on a plane and flew back for her daughter's last recital.

That the last minute she felt guilty leaving, not missing it.

- Yeah.

- How many dance recitals or ballgames did you miss?

And how do you explain that to your kids?

- You know, my kids were of course, very young when I was in medical school and residency.

And I’ve asked them, you know, because now they're adults.

You know, how they look back at that time and they feel like I was there.

I was there for the things that mattered.

And so, sure, I missed, you know, ballgames and I missed well, they were all boys until my fourth, which is a daughter.

But, you know, whatever sport they were playing or school event.

They, I think took from that a value and seeing the hard work that I did and where it's gotten me today.

And so I think they felt like I was there still, you know?

It's just part of life is managing moms schedule around some of the other things that was, you know, important in our family, so.

- Now I think that most people, most of us have not gone to med school.

So we kind of look at it from the outside, you know, kind of like a little kid pressing your nose up against the window.

But tell us something that would surprise us about medical school.

- I think that anybody who really wants to be a doctor can get through medical school.

I think we think of medical school, you have to be so super smart to get through medical school.

You have to have perseverance to get through medical school because it is, it's a lot.

But I think if you have that passion and perseverance, anybody can get through medical school, which I think some people would find surprising.

So, I always felt like being a mom and getting to come home and just do something different actually helped my brain learn in a more efficient way than some of my fellow students who just kind of lived it 24/7.

You know?

I studied all night well, when you really talk about it.

We went here, we went there... And my study time had to be very focused.

And so I think that would be surprising to people and that it's, gosh, it changes how you think about things.

It's not just knowledge, but how you observe others and how you observe kind of life.

- So that leads to my next question.

I had a friend who has since passed away, but he was a dentist.

I called him like a Renaissance man because he had all these other degrees he was so interested in education.

But back in the 80s he was a practicing dentist, but he flew to Chicago once a week to get his MBA.

Because everyone didn't have MBA programs like they do now.

And I said, you know, did you just do it because it was interesting or do you apply it in your practice?

And he said, it changed everything, even the way I ordered toilet paper.

I still remember that saying, so tell us, okay, now after medical school, now you feel a need to get your MBA.

- Yeah, that was years later after I was starting into leadership.

So I started out, purely in education, but I would spend my entire career teaching residents and medical students and, you know, maybe get up to being a program director.

And, you know, life has a way of of shifting your journey and taking left and right turns when you don't necessarily think that's the direction you're going.

And so after I joined Cleveland Clinic and I got my first leadership role, I started, you know, joining these meetings where people are using a very different language, right?

We're not talking about medical language anymore.

We're talking the language of business.

Well, you always have a dyad, right?

You have an administrative business person.

You're the clinical voice in the room.

And, I just did not like feeling like I couldn't fully understand that language.

And so I went to get my MBA because I wanted to understand the language of business and apply that.

Because if you don't speak the language of business in healthcare, it's a lot harder to advocate and get what you need for patients.

And so I felt that I needed to understand that language, and that's why I went and got my MBA.

- Now, was any part of that that you would be treated differently with an MBA by MBA holders, than you would without it?

- Not really.

You know, I felt like...

I don't know, I don't get hung up on titles and maybe other people do more than I do, and I'm just not observant of that.

So, you know, I don't know what I don't know.

But from my perspective, physician leaders, I think, can learn, you know, everybody learns in a different way.

So some people could have been in those meetings and then studied themselves and learned what they felt like they needed to know to understand the business world of medicine better.

But that wasn't the way I learned.

And so is it the title or is it just showing that you understand and can apply critical thinking to the business side.

- Now is there a kind of a changing pattern?

It used to be, it seems like anyways, from the outside, you know, 20 or 25 years ago that CEOs were administrators.

They weren't usually physicians unless it was Cleveland Clinic.

And you would (unintelligible) Toby Cosgrove.

But for the most part, they were administrators.

Now, it seems like we're kind of in a different pattern where they also need to be physicians.

- Yeah, clinical physicians, I think sometimes nurses now too are moving up into the C-suite which is wonderful.

But I do think Cleveland Clinic, I mean, that has always been, right?

Physician leaders, we are a physician led organization.

And I think others have modeled after that.

Seeing the benefit to being able I'll say, kind of speak dual languages, right?

Of business and medicine because when the decision comes down to something in the room, it's always what's right for the patient.

You go back to that is your base.

When you are a clinician, I'll just say whether you're a nurse or a physician or an advanced practice professional.

Whereas if you've only ever lived in the business world, I'm not sure that it would ever come down to that decision point.

- So if someone asked you, one of your kids, if your kids were younger today and they asked you, or if somebody asks you, you know, we understand health care we understand they say the C-suite.

But, you know, in words that we can understand what is your job to make health care in a hospital better?

Like, what do you do?

- So I think...

I prioritize at all times doing the right thing.

By doing the right thing, we provide care that's the highest quality care, the safest for our patients, gives them the best experience on what oftentimes is not the best time in their lives.

And I think setting that culture, setting this structure for those caregivers to function at their highest level because they're the doers, you know?

And so the way I can impact what's actually felt by patients is by setting the caregivers up for success in connecting with patients and providing the care that's going to be the highest quality care they can get.

- We are talking today with the somewhat new CEO at Akron General Cleveland Clinic, Dr. Teri Lash-Ritter, and with a myriad of labels that she has acquired on her journey to the C-suite.

Is a hospital stay.

Well, I was going to ask you, as a hospital stay, going to look different in 5 or 10 years.

But I guess I first should ask, are there going to be hospital stays?

I mean, so many things from the time I was growing up are now done as outpatient.

What is a hospital stay going to look like in 5 or 10 years?

- You know, that's a great question.

I wish I had the the answer to that.

I think as much as we want to get away from having to have people be sick and in the hospital, we're not there on the other side of preventative care yet as a nation, and I'm not even speaking locally or specific to Cleveland Clinic, I think we're still trying to understand how because- it's a lifetime of health promotion and supporting, movement, good nutrition, sleep, stress control through the entire spectrum of life.

That's going to get us to the point where we don't have to have so many hospitals because people are sick.

And so in 5 or 10 years, I wish we could change that cycle.

But I think that we will still need hospital beds in 5 or 10 years.

I do think, you know, there's there's, some things we're trying to do more and more at home.

People want to be home.

They, thrive in their own environment.

They're less at risk of infections and other things, when they're at home.

But, you know, not everybody has that support at home to be able to do that.

And, you know, we're increasingly reliant on technology to help us with those things.

But we're still on that journey.

And I'd say still pretty early in that journey.

- You know, we hear a lot about uncertainty and challenges in health care.

And again, I think as an outsider, hard for us to understand.

We think, okay, well, the sicker people are, the better health care should be doing because there's like sicker people.

So let's look at uncertainty first.

How do you help your staff at whatever level they're at?

How do you help people deal with uncertainty?

- I like to frame uncertainty as opportunity.

If, something is 100% clear, but in your mind is not right or not correct, you don't have anywhere to go with that.

When things are gray now you have an opportunity to say, here's my perspective and make change.

And so I try to frame uncertainty not as a negative but as a positive.

So if there's uncertainty, then there's still opportunity for us to advocate for the way we see it, that it should be done or the way, that we, think is best for patient care.

And so I would say uncertainty can be opportunity, you know, on the side of uncertainty around like payments from Medicaid or Medicare, those kind of uncertainties, you know, are we reaching out to officials to advocate for, you know, and not cutting payments to hospitals?

So there's always something that you can do when there's ambiguity.

- So what about challenges?

Can you help us understand what are challenges in health care today from, from your perspective, that perhaps we would not understand?

- I'd say the thing that keeps me awake the most at night is that we have hospitals that are closing, and therefore the hospitals that are open become busier and busier and busier.

And we ask more and more and more of the caregivers who are taking care of patients, because we want to take care of everybody who needs help.

In doing so.

We set up, you know, lists and checklists and things to keep patients safe.

Right?

Because if I have more patients than I need assistance in making sure that everything that needs to be done for a patient is being done, and it takes away some of the joy, I think for our caregivers, it becomes tasks rather than connections.

And so if I could change anything or, or overcome any challenge, I would want to restore that joy.

You know, doing all of the checklists and things, using technology to help us and restore that relationship and provide joy again for our caregivers.

Those- that's the biggest challenge to me.

The thing that keeps me awake at night.

- Kind of going down that lane.

Several now, years ago, I had to write a speech introducing a then CEO of one of the health care facilities.

So I thought I was being very clever, and I found a woman that was related to someone I knew that was like head nurse of a floor.

And I thought I'd ask her for some kind of background, you know, information I could use.

So I call her and I tell her what I'm doing.

And she said, well, I'd be glad to help.

She'd been there for, I don't know, ten years, 15 years or something.

She said.

I, you know, I'd be glad to help you, but I've never met him.

I've never seen him.

I'm like, what?

- Yeah.

So maybe that's not fair to think that that, you know.

But how many thousands of people you you have but what does engaging with everyone at at Akron General Cleveland Clinic, what realistically can that look like from the C-suite?

So one of the things that I've already done is, implement what I call a daily- We have daily management boards and daily rounding.

And so I'm out every day talking to our caregivers.

So that's one way that I’ve just put a system in place- - So rounding for non-hospital people.

- Right.

- Rounding means?

- So rounding means I come up on the floor and I talk to the caregivers who are on the floor, and I say, what's going well today?

And let's look at what you guys are working on, because, you know, there's boards of here's what we're working on, here's how we're doing, and how can I be supporting your work so that you can have success in the things that you're working on?

You know, I still around on inpatients meaning take care of patients, on the inpatient side as well as in a, within the residency, working with the residents to take care of outpatients.

And so the caregivers are very used to seeing me, right?

I've been there for almost ten years and up on the floors.

And so they know me and know me from taking care of patients as well as from the chief medical officer role.

And so I think if you're not visible and you're not listening, you are, not going to be as good a leader as you could be.

That's that's like the core to me is talking to everybody and finding out how I can be helping them in the work that they're doing.

It's a little bit more challenging.

We have so many outpatient areas, and so I'm honestly still trying to work my way around to all of those, but I will get there.

- So if someone was describing your leadership style, how would someone describe it?

I would say, visible, approachable, genuine.

And then I have a very strict policy around clarity.

So one of the main things that I, remember always is that clear is kind.

I never want anybody that I'm having a conversation with going home tonight wondering, what does she mean by that?

What should I be doing?

What's her expectation?

I think, clarity, even when it's a difficult or a crucial conversation you can do in a kind way.

But clear is kind, because in the end, you both understand what's happening next, what the expectation is, and then can have the follow up conversation, to check in to see how it's doing.

And so, I think that people would say that I'm clear.

- So if there was from those, if there was one leadership skill that you would say that was necessary to achieve success, what would that one skill be?

I'm going to say being a good listener.

And not not listening to listen but being curious around it.

So some things can be hard to hear when you're a leader, you know, it's not always going to be puppies and sunshine coming back to you.

Right?

Because you do have to make hard decisions.

But remain open and curious about what people are saying to you and dig deeper, find out, because you will become a better leader and you will, move the organization in the right direction.

If you're doing that - In the couple minutes we have remaining, I'm going to kind of veer in a little bit of a different direction.

Was there a major event or some major realization that when you decided you wanted to go to medical school, was it something from the time you were a child?

Was there one moment that you can a defining moment that you can remember?

- I would say, I would go back to when I was working as a dietitian and, honestly, this was not related to my work, but more related to one of my kids who was, having a lot of trouble with ear infections.

And we were back and forth to the pediatrician, and I had a very wonderful role model in the pediatrician, That was my son's pediatrician.

And I watched him with my son, and I thought, I want that.

I want that connection.

- That kind of reminds me of the connection.

If you remember Jerry Maguire with, you know, I want that - I want that, I want that, yeah So it really wasn't related to the work I was doing, but just watching how he worked with my son and thinking, that's what that's that's my calling.

- So it might be my last question So that's, a phrase you remember, I want that is there a phrase that either has provided inspiration for you, or is there a phrase that you kind of go to phrase that you use to provide inspiration for others?

- Oh my gosh.

- Well, why are you thinking about that?

How do you compliment a C-level person?

Like, what is a compliment that you'd like to receive?

Like, you know, you can there's other kind of professions you can compliment, but how do you compliment, you?

- You know, it's funny, but some, you know, a lot of the people who are now, I'm now working with in the community, are it's interesting because the feedback on me, you know, people are giving you feedback on yourself now.

Is that she's like a real person.

And I say I am a real person.

- And is that a compliment?

- I take that as a compliment because I want to be genuine.

I think that I want people to be able to come to me and tell me what's really happening, because without that, I don't know how I would lead.

- From today's guest, a real person and conversation you can select from a myriad of takeaways, detours in life, the different labels that we wear that sometimes we have to water our flowers at night.

Thank you to Dr. Teri- Teri Lash-Ritter, CEO of Akron General Cleveland Clinic, for joining us for Forum 360 with a global outlook and a local view.

I'm Leslie Ungar.

Forum 360 is brought to you by John S and James L Knight Foundation, the Akron Community Foundation, Hudson Community Television, the Rubber City Radio Group, Sha Jewish Community Center of Akron, Blue Green, Electric Impulse Communications, and Forum 360 supporters.