Dr. Claire Pomeroy, M.D., M.B.A. is Vice Chancellor for Human Health Sciences, UC Davis, and Dean, UC Davis School of Medicine. She'll be honored on May 3, 2010 with a Trailblazer Award at Leadership California's Legacy of Leadership Awards.

Q&A:
Dr. Claire Pomeroy, M.D., M.B.A.

Academic Leader Advocates for Communities on Healthcare Edge

by Carol Caley

As California and the nation face critical issues around healthcare access and quality, Dr. Claire Pomeroy is recognized for her amazing record as a healthcare professional. Her extraordinary leadership has focused on access for underserved communities and support of women seeking careers in medicine.

Q: Your responsibilities at UC Davis are so wide-ranging. From a Vice Chancellorship of Human Health Services, to Dean of the School of Medicine, to teaching, to healthcare advocacy, your responsibilities are great. You have no less than FOUR missions in your job description. Do you thrive on pressure?

A: For me, this job is inspiring and energizing. I don’t view it as a load. I view it as a great opportunity, an honor to be part of this. The fact it’s so multi-faceted, it makes me thrive.

In my job I get to oversee the Medical Center, the School of Medicine, our new Betty Irene Moore School of Nursing, and our faculty practice plan. That makes us an integrated academic health system, with outstanding clinical programs and academic programs. We have a budget of $1.4 billion that I oversee, with about 9,000 employees and faculty. We play an important role in the community. We’re an economic driver, we’re discovering new knowledge, we’re educating the future work force. We get to do all that in a public institution with a great social mission. Yeah, I thrive on that! That’s exciting.

I love the fact that we’ve defined a niche of combining academic excellence with passion for social justice. We transform healthcare and improve health. Very few people have a chance to truly define the future for what medicine and the health of our country is going to be. Given the disparities and poor outcomes we have, and the huge amount of money we spend, this is an incredibly important societal challenge. I love being right here having an impact on it.

Q: What is your greatest passion among all your responsibilities?
 
A: For me there are two things: One is improving the health of our communities, from local to global, and two is making sure that we keep our eyes on the prize. Yes, we do research, and we do it as part of the mission of improving health. My job is making sure that people in this organization have resources and opportunities to reach their full potential, to propel this organization forward. They’re incredibly talented. My passion is to see them make a difference.

A: I’m proud of each one of those things. But I’m most proud of is helping to shape a vision for our organization, and to create a culture that supports that vision. For me, our core values are distinct and special. We talk about strategic thinking and academic excellence and a sense of urgency, compassion, quality, and a commitment to diversity and equity and justice—it’s articulating and inspiring a vision and the people who work here around those core values that I’m most proud of.

Q: How do you foster that kind of vision in people, how do you create that culture?

A: As a leader you have to live it yourself. You have to put others, and the institution, above yourself. You have to willingly role model those core values. It’s all about building trust. It’s about communicating: sharing the vision, celebrating the successes, being open and transparent about the challenges. People in our country today, and in this organization, are willing to make significant personal sacrifices if it’s for a cause. Rallying people around that cause by communicating effectively is the role of any leader who believes like I do in servant leadership. I spend a lot of time listening to feedback. I take that information and try to honestly assess how we can make our organization better. Then work on reaching consensus and going out and talking about it. That’s how you build a culture. You live it yourself, you listen carefully, and you communicate about it for as long as you need to.

In terms of what I’ve been most proud of, I will say that the new Betty Irene Moore School of Nursing is a really big one for us, and was fun for me. It was the next stage in the maturation of UC Davis’ health system. We were a school of medicine and a hospital. This was our recognition of the importance of interprofessional training, of team learning, and of team care. When we received the $100 million philanthropic grant from the Moore Foundation, we could transform the way we do every part of our mission. It’s going to transform the way we teach students, because they’re going to learn in teams; it’s going to transform the way we do research, because we’re going to bring different perspectives together; it’s going to transform the way we do clinical care, with more patient-centric approaches. It’s been transformational for our organization.

The commitment we have to disparities is something I’m truly proud of. We have the Center for Reducing Health Disparities, and we have our Rural-PRIME Program that reduces geographic disparities by using telemedicine to improve access and quality. We reduce disparities through our advocacy and public policy. For me personally, the ability to strive toward a more equitable healthcare delivery system is a very important part of what we do. As thought leaders, we can be the people who design better systems, who educate the future practitioners to work effectively in those better systems. It comes down to the ultimate outcome, the reduction of inequities.

“As a society, can we rise above political agendas, business agendas, personal agendas, and do what’s right for society as a whole? Are we ready to do that as a country?”

Q: What experiences led you to choose medicine? How did you find your path to practicing in an academic environment? Did you encounter any barriers along the way? Did you have to make any hard choices?

A: I am a person who always did want to become a physician. As a child, I had physician role models who cared deeply about those of us who came in to be taken care of. I grew up in a very dysfunctional home. I ended up in the foster care system, so that background is the genesis of my passion for equality and justice. Physicians have this wonderful opportunity. People come to physicians and there is an immediate trust because of their position, immediate responsibility on the physician’s part and immediate belief on the patient’s part that that responsibility will be met. That always appealed to me, to be there for people during their most vulnerable moments.

Q: That took great self-confidence, for someone whose family had not come through for them.

A: Exactly. I went to a six-year training program. I applied when I was seventeen, a senior in high school. I remember at the time being absolutely convinced that I was going to be a primary care physician and help people.

I believe that people find their role models in unexpected places, even if it’s Dr. Kildare on TV. I had wonderful teachers who nurtured my dreams. As I went through my medical training, I gravitated toward HIV medicine, and in light of what I’ve just shared with you, that’s probably not surprising. This was at the beginning of the AIDS epidemic, when prejudices and stigma made folks with HIV very vulnerable, very much in need of advocates. For me that was the logical career path, to advocate for people with HIV/AIDS, in a time when society wasn’t supporting them. Over the course of my career, I began to understand more and more how one could really make the biggest impact. I loved one-on-one interaction. But I came to believe that I could help more people by changing the system. I stayed in academic medicine because that’s the place for thought leaders, where innovation can happen, a place to drive toward a vision of the future of what medicine could be. So for me this environment was very stimulating, and the place where I could make the biggest impact.

Did I encounter barriers along the way? Of course! For me, the barriers were there, but they pale in comparison to keeping your eyes on the prize and the immense gratitude for the opportunity. People always say, Isn’t it hard? I always say, nothing is as hard as being 15 and living on the street. I’ve done the hard part. This is the fun part. I understand that there will be obstacles along the way. My family had mental health issues. I always knew that as soon as I could take care of myself I would leave. I ended up on the streets as a young teenager. I’ve begun to talk about this now, talked to foster youth to help them understand. Living on the streets and in the foster care system, I supported myself. I worked all the way through high school. Those were challenges. Growing up in a household that wasn’t nurturing, that was frightening and scary, those were challenges. The business details of what I do today, those aren’t obstacles. If I had dreamed when I was a kid of what I would be doing at the age of 54 or 55, this would be it. I’m getting my dream. There are things to be overcome and worked through, but I love what I do. I’m very fortunate.

Trailblazers Shine Light on Road Ahead for Female Leaders

Leadership California’s new Trailblazer Award honors the achievements of California women leaders who exemplify a spirit of exploration, passion and groundbreaking achievement, and whose efforts light the way for others to follow.

The Trailblazer Award looks back to the founding members of Leadership California, a group of women who helped others to become groundbreaking leaders.

__________________
 

Claire Pomeroy on National Healthcare Policy 
“Healthcare reform is way overdue in this country… the system is crumbling”

"IN MY OPINION, HEALTHCARE DELIVERY in our country is unacceptable. We spend too much money for too little. It’s unacceptable from the point of view of social justice. People don’t have basic access to services they need to ensure health. That’s not the kind of country I want to live in. That’s not the kind of healthcare delivery system that I want to work in.

EVEN IF YOU HAVE MONEY TO PAY for healthcare today, you tend to get fragmented care, because we don’t have a continuum of care. Your primary care doctor may not have good ways to communicate with a specialist. You’ll have a longer wait in the ER, because they’re overwhelmed. You’ll be at increased risk of transmissible infectious diseases, unless there are public health efforts to prevent or cure them in everybody.

EVEN PEOPLE WITH LOTS OF INSURANCE don’t get the kind of preventive care and wellness care they need. It’s a broken system. The worst case scenario is that you have no insurance and you can’t access it, or you go bankrupt because you’re middle class and you can’t afford a serious illness. But even the rich are at risk because the system is crumbling.

HEALTHCARE REFORM IS LONG OVERDUE in this country. The proposals in the Senate and the House are a small start. They will improve access for more uninsured people. We should be ashamed at the number of uninsured people who don’t have access to care in this country. The current proposals probably will curb some insurance company practices that have been unconscionable, but they don’t fundamentally transform how we deliver care. They don’t talk about how we can incentivize prevention and wellness compared to our current system that incentivizes acute intervention. They don’t talk about the fact that we are currently rationing care on the basis of socio-economic status. They don’t talk about cost-effective, timely access to primary care services, and they don’t talk about the fundamental drivers of health, the social determinants of health. They’re about tweaking the current paradigm, not about fundamental transformation. Those proposals were valid attempts to get started on a road, but there’s a risk that we will have something so watered down that it doesn’t have a significant impact at a time when there’s a huge need. It’s clearly not going to be enough. It clearly will leave many people without affordable access to quality care. I do hope that something still passes, because it is essential that as a country we say we have a commitment to trying to fix this problem.

MANY PEOPLE HAVE POINTED OUT that the proposals that are being argued about now are about insurance reform. They’re not health reform. This is the conversation that we need. It’s hard to have a good conversation about how to deliver care when we have 46 million people without any health insurance and without any access, and people are going bankrupt.

WE HAVE HIDDEN COSTS that people don’t understand they’re paying. It’s very hard to have these conversations when the per capita spending here is three times what it is in many other developed countries. The real message is lost in the politics. That hurts everybody. As a society, can we rise above political agendas, business agendas, personal agendas, and do what’s right for society as a whole? Are we ready to do that as a country? I fear that a year from now, if we’re having this conversation, we’ll look back and say, we failed to do that. But let’s at least get started.”

—Dr. Claire Pomeroy