Studies by transformative companies like Google and renowned institutions like the Harvard Business School indicate that diversity of thought fosters innovation. In Texas, female executive voices bring new perspectives as the state continues to make strides in health care innovation and improving patient care.
The Advent of Women in Leadership Roles Expands the Industry to Previously Untapped Talent
Donna Boatright, chief executive officer of Rolling Plains Memorial Hospital in Sweetwater, has seen a lot during her 44 years in the health care industry. While expertly navigating her career through a series of leadership, technological and societal transitions, Boatright also holds a track record of supporting students entering the nursing field.
Born and raised in Sweetwater, Boatright left town for college, but eventually returned home to complete her basic education and received a nursing job offer after graduation. After several fulfilling years on the job, and raising her children with her husband - her high school sweetheart, Boatright earned an advanced degree and began climbing the ranks. She was first promoted to assistant director of nursing, then eventually to chief nursing officer, a position she held for 28 years before becoming the hospital’s first female chief executive officer.
In the beginning of Boatright’s career, rural health care looked very different than it does now. While making a 40-minute drive from Sweetwater to Abilene is a common practice today, people didn’t make the trip as often 40 years ago. “You might make the trip once a month or so, but you sure didn’t routinely go there to go to the doctor,” said Boatright.
To provide local access to a variety of medical services, rural hospitals like RPMH used to operate as generalist hospitals. Physicians were trained to offer a wide range of services, and duties could vary from managing a busy intensive care unit to repairing abdominal aortic aneurysms – something most hospitals in a rural community would never offer now. “At the time, we had to do so many different types of medicine and surgery. There just wasn’t much of an emphasis on specialization, especially in small town America,” Boatright said.
As the hospital industry began to move toward specialization, a second transformation was also underway: more organizations began offering women the chance to hold leadership positions. “The advent of women in leadership roles has expanded the field to previously unrealized talent,” said Boatright. “After the Joint Commission, and nursing leaders in education across the country, elevated the CNO position to the same level as other C-suite titles, more people started to recognize that frontline experience equips leaders to think critically and build problem-solving skills that are essential in hospital leadership.”
To invest in Texas’ future frontline leaders, Boatright and her staff founded a scholarship program for nurses, by nurses. To date, the program has put many thousands of dollars to work bestowing scholarships across four school districts and to hospital staff in the Sweetwater community.
Implementing Data-Based Decisions Drives Efficiency
The number of female physicians is on the rise too. The Texas Medical Association reports that the proportion of female first-year enrollments in Texas rose to 52.3% in 2018, up from 50.1% in 2017, and edging out the previous record of 51.4% hit in 2003.
From the time she was 9 years old, Dr. Angela Shippy knew she wanted to be a doctor. She contemplated pursuing neurosurgery and later developed an interest in obstetrics and gynecology, but ultimately, she turned her attention to internal medicine. “I developed an interest in internal medicine to obtain deep understanding and knowledge, and internal medicine really is the entry point to many specialties,” said Shippy.
After residency, Shippy practiced as a general internist, then joined CHI St. Luke's Health-Baylor St. Luke's Medical Center in Houston as a hospitalist where she established her reputation as a straight shooter and leader amongst colleagues. One day, her leadership in a meeting caught the attention of the CEO, who suggested she would make a great medical director for the hospital.
Despite her initial inclination to turn him down, Shippy took the CEO up on his offer. “Eventually I realized, this is the primary hospital where I work, and I would love to be part of the team making leadership decisions,” said Shippy.
Dr. Shippy and colleagues at Memorial Hermann Health System.
For the next several years, Shippy served as St. Luke’s medical director and vice president of medical affairs, and later as HCA’s chief medical officer for the Gulf Coast Division. In her current role as chief quality officer for Memorial Hermann Health System, Shippy oversees quality, lab services and pharmaceutical services, leading those responsible for clinical operations that directly impact patient care.
At the end of the day, Shippy reminds her team that their number one job is always to help others. “A disease or illness and the subsequent diagnosis and treatment may be complex, but our jobs as practitioners and health system leaders is to make it easy and simplify the navigation for patients and families,” said Shippy.
As more women become physicians, there are more opportunities for females to lead in their areas of expertise.
“When we have diversity of thought, we can get to better solutions. If everyone around the table looks the same, has the same training or shared point of view, you’re missing out on solving a problem with a unique, innovative approach,” said Shippy.
“Women bring distinct points of view and a different way of looking at the world that ultimately leads to enhanced solutions. Now, more than ever, we have to make a concerted effort to continue this pipeline. We need to make sure we’re making room at the table and ensure that diversity of thought continues.”
Texas Produces a Special Kind of Strong Female Leader
Jennifer Banda is a lawyer, mother, lobbyist and sixth-generation Texan. Banda got her start in health policy at the state capitol for the Texas Senate and House of Representatives, ultimately joining the Texas Hospital Association as vice president of advocacy and public policy. Nine Texas legislative sessions and 16 years later, she is tremendously proud of her strong, dynamic team at THA. “We have a group of independent, strong-willed, collaborative, intelligent, funny and determined leaders,” said Banda.
Developing health care policy is a grueling task, certainly not for the faint of heart. Last year alone, Banda’s team tracked 1,500 bills related to hospitals. Banda emulates best practices she collected from observing her first boss, Patricia Gray, the former chair of the Texas House Committee on Public Health. “Patty was a great example of someone who led by forming consensus when possible,” said Banda.
By keeping consensus top of mind, Banda’s team has consistently driven positive legislative outcomes for THA. “We have 475 very diverse member hospitals, and it’s challenging to develop priorities that represent and provide positive outcomes for all of them. One of the best parts of the job is reaching that collaboration,” she said.
According to Banda, diversity in elected and hospital leadership is a must-have. “No matter if it’s gender, race, education, upbringing, being a parent or not being a parent – a person’s background informs their leadership style,” said Banda. “Diversity of thought makes our legislative process better, the state of Texas better, and our hospitals better. When a leader can genuinely understand the problems in a community, they have the ability to better understand patient needs.”
Jennifer Banda, vice president of advocacy and public policy at THA, and part of the team that advocates on behalf of Texas hospitals.
In 1995, Banda’s undergraduate honors thesis asked whether having women in elected office made a difference in legislative outcomes. Her experience in the field has confirmed what she defended nearly 25 years ago. “As you would expect, women bring different life experiences, processes and strengths to the table. They also bring additional focus on issues key to women, like maternal and child health. Today a woman writes the state budget in the Texas Senate. We have a woman that leads the health care portion of the budget in the House,” said Banda. “Women are leading and bringing a greater variety of problem-solving skills and compassion to the table.”
More than anything, Banda says resilience, grit and a fighter mentality sets Texans, particularly Texas women leaders, apart. “My mom always says if you made it to Texas six generations ago, you had to fight to get here,” said Banda. “Texas women hold their own, speak their minds, and have a reputation for being tough, yet compassionate.”
Now raising two next-generation Texans, Banda says it is important for her children to know and learn from strong women. “It’s not just for my daughter,” she explains. “My son needs to see strong, female leaders too.”
Relentless Forward Motion Keeps Texas Hospitals Ahead
A wife and mother of three, Pam Bradshaw began her nursing career in 1990. After starting out in critical care, she branched out into other areas of medicine and eventually joined the U.S. Air Force – serving on active duty for six years, including overseas in Japan.
After separating from the military in 2002, Bradshaw returned to Texas. “Back then, I never thought I wanted to do anything but be a bedside nurse. I loved everything about it,” said Bradshaw. When offered new roles over the years, occasionally Bradshaw detected doubt in the back of her mind. In these moments, Bradshaw recalled the best advice she ever received from one of her mentors: “If you have the opportunity, you have to take it. If there’s something that comes along and you’re encouraged to try, they see something in you that you aren’t seeing in yourself and you need to listen.”
This advice propelled Bradshaw to take on a myriad of roles, including CNO at United Regional Health Care System in Wichita Falls and CHRISTUS Spohn Health System in Corpus Christi. Currently, she serves as chief operating officer and CNO for Shannon Medical Center in San Angelo. All of the hospital’s nursing, ancillary, lab, radiology, therapy and human resources services report to Bradshaw.
While a day in the life of a hospital executive is anything but predictable, leaders like Bradshaw do what it takes to ahead of the curve. “I spend a lot of time thinking about what’s coming next and engaging my team to be proactive instead of reactive,” Bradshaw said. “You have to be a leader, not a manager. While managers stay down in the weeds, leaders serve as an innovative voice to help the team to move forward and stay ahead. If we stay in place, we’re falling behind.”
Under Bradshaw’s leadership, SMC has made several evidence-based quality improvements, resulting in lower readmission rates and fewer central line and catheter infections. This bold stroke generated excellent outcomes and led to numerous accolades, including SMC’s nationwide recognition as one of the 50 top cardiovascular hospitals in the country.
Leadership Can’t Exist Without Mentorship
While many hospital executives get their start in direct patient care, some bring different areas of expertise to the table. In Phyllis Cowling’s case, working on health care audits for a large, international accounting firm ignited a passion for the health care industry. After earning her Master of Business Administration from the University of Texas at Austin, Cowling joined then Garland Memorial Hospital as an internal auditor. Just five months later, Cowling was appointed as the chief financial officer at just 25 years old.
For 18 years, Cowling served as CFO for various organizations before taking the helm at United Regional Health Care System as President and CEO 15 years ago. “I got lucky. It’s a little bit of being in the right place in the right time and having mentors who saw something in me that I didn’t see in myself,” said Cowling.
One of Cowling’s mentors and heroes is the Texas Hospital Association’s Board of Trustees’ past chair, Gary Brock. Today, he serves as a special advisor to Baylor Scott and White. But back then, he was the very first CEO Cowling ever reported to in that small Garland hospital.
“He made me a CFO when I was five months out of graduate school,” said Cowling. “There was a large part of me that simply refused to let him down because he put so much faith in me. His transparent leadership gave me the ability to better understand leadership from his point of view, which was incredibly helpful to me.”
While CFOs run the risk of being pigeon-holed as the “finance person,” Brock encouraged Cowling to step outside the finance lane. “I got to dabble in marketing, played in customer service, and had operational departments reporting to me. That gave me an incredible breadth that served me later in my career.”
Another mentor was Ted Shaw, president/CEO of THA. “Early on in my career, he encouraged me to become active in the Healthcare Financial Management Association. I got to work with CFOs and learn from them. Down the line, I became extremely involved in HFMA and ultimately had the honor of serving as the national chair.”
As she grew her career, Cowling’s mentors reminded her to stay grounded, never let her insecurities weigh her down and avoid becoming overconfident. “Ultimately, staying true to myself, being able to accept constructive criticism from others and maintaining a strong work ethic were the keys to my success,” said Cowling.
Cowling highlights communication as being a vital aspect of any leader’s success. “Listen to your team members and your community – starting with that first step is a major part of solving problems and setting your organizational direction,” she said. Part of setting that direction is cultivating a strong culture: service before self. “We embrace that others trust us in their most vulnerable moments. Whether they, or a loved one, are ill or injured, people trust us to take care of them,” said Cowling.
When people ask Cowling what it means to be a female leader, she explains she’s a leader who happens to be female. “It’s the leadership that’s the key. No matter if you’re male or female, it’s leadership,” she said. “Over the course of my career, I’ve seen more confidence by women in leadership and consequently, a growing voice. Female voices bring a different perspective into leadership that makes Texas more well-rounded.”
At the end of the day, Cowling strongly believes learning from others who have a greater breadth of knowledge is an incredible gift. Striving to be like the leaders she admires, Cowling constantly seeks ways to improve service to her community. “Never settling is central to achieving goals and meeting the needs of the state,” said Cowling. “Best of all, the more mature we become in our careers, we have the opportunity to mentor others. It’s the very best kind of cycle.”