Putting people first, in all the ways I have mentioned, is not just my passion. It is my job. As a chief executive I am the individual responsible for connecting the dots. Focusing on people, then, ultimately equates to improving performance. Taking a genuine interest in your people pays incredible dividends for the organization—in fact, it’s the best performance strategy you could possibly have. When staff are engaged, they will engage with customers directly and in a positive way. When they are engaged, they will help you improve your organization. They will produce new ideas, they will create greater efficiencies, and they will drive financial success.
I put people first and I would like to believe that I attract other leaders who do the same. This is the legacy I want for myself at Henry Ford and everywhere that I have been fortunate enough to make my mark.
CHAPTER SIX
Being Different: The Strength of Diversity
I grew up in the ’60s and ’70s, when it seemed as if the nation was on fire with change and conflict. Like so many others at the time, I became fixated on the civil rights movement, the race riots around the country, and the aftermath of the assassinations of John F. Kennedy, Martin Luther King Jr., and Bobby Kennedy. I recall that feeling of sadness and utter disbelief when King was shot. It was jarring. Yet, I always felt comforted to have parents like mine, who were open-minded and progressive in their thinking about race. I always felt they stood on the right side of the divide. My mother, in particular, as both a teacher and an individual, was aligned with King’s message on judging people by the content of their character, rather than the color of their skin, and his perspective on combating racial inequality through nonviolence.
More than anything, they both set a positive example for me and my sisters and brother, and they wanted us to understand the implications of what was going on around us. In fact, civil rights and the related issues were common topics at the dinner table when we finished discussing our day at school. I loved to spread the newspaper out on the floor—it was so big that I couldn’t hold it but I pored over as much of it as I could. Because it was such a caustic and vibrant time, I have certain personal memories that have stuck with me, and that show how the era is imprinted on my mind.
The first memory is of a lovely woman, Isa May, who cleaned our house once a week and helped care for us kids when my mother was in the hospital. One day, during the race riots, Isa May couldn’t get a bus to her house and we went with my dad to drop her off. I remember looking around at the neighborhood where she lived and feeling the anger rising from people. It was eye-opening to realize how some people in my hometown lived and the emotions they felt, and at the same time I recall feeling concerned about Isa May’s safety.
The second flash encompasses memories of some of the kids I grew up with in my town, and how I came to see that their world was different from mine. In elementary school I had a very good friend who was Filipina: Marie Lim. I used to go to Marie’s house to play and she came over to mine. There were very few Asian kids in the public schools at that time and there was lingering anti-Asian sentiment left over from World War II. It took me a while to see that sentiment—but when I did I realized that it was palpable. I had another friend whose parents were deaf. The eldest child in her family, my friend had an incredible maturity and was always doing things that seemed beyond her age. She assumed responsibilities and took care of her family in ways that I never had to. Finally, I remember Marvin Weinberger, a Jewish boy who played the violin with me as part of a quartet. Even in Akron, Ohio, I saw firsthand that Jews weren’t yet accepted in many places in the way that I was.
The third major recollection that I have centers on an incident that occurred while I was in college, when my youngest sister, Joan, was a teenager and my parents were living in Lynchburg, Virginia. Joan became friends with an African American girl from our church, and we were all acquainted with the family. We knew the father of the family particularly well, because he worked two jobs, including waiting tables at a club where my parents belonged. One day my mother saw him at the club and gave him a hug. Things changed for us in that instant. The room fell silent. By the looks she received you would have thought she had committed a crime. After that, people looked upon my parents with a degree of suspicion. This was the South in the ’70s, and white people didn’t go around hugging African American waiters. After that, my parents couldn’t get out of Virginia fast enough. A few years later they moved back to Ohio, but that experience in Virginia was one that none of us could forget.
These are some of the episodes that forged my thinking about difference and diversity. The truth is that I lived a fairly sheltered life as a young child, but my own advantages only served to underscore for me that not everyone around me enjoyed the same equality. My parents judged people based on the content of their character, and their words and deeds, rather than the color of their skin. But that, again, is part of what helped me see that the world did not always work that way.
What I Know About Diversity
I am always so proud when I recall my mother’s socially progressive perspective on race and gender roles. She was way ahead of her time. But the vision I had of her wavered for a moment, a little later in life, and it threw me for a loop. My mother was extremely sick at the time and she was undergoing dialysis at Akron City Hospital where I had previously worked. I was there with her, offering support, along with my dad. We wanted to get as much time with her as we could. It was a difficult year for me, even beyond my mother’s illness. I had been outed, through the anonymous letter sent to my boss and the hospital board members at Riverside Methodist Hospital—and the experience was still fresh on my mind. Then, out of the blue, with other people standing nearby including former colleagues that I knew, my mom looked at me, and said in a loud voice: “Nothing would appall me more than if you were a lesbian.” I couldn’t believe it. I felt shattered and traumatized—it was overwhelming for me.
Later, on that same day, when I was back in her room, she said something that offered a clue about where she was coming from. She said, “Nancy, I am so afraid for you.” And I could tell that she meant it. She had spent her whole life telling me that I could be anything I wanted—I could do whatever I set my mind to. She was so proud of my career and I think she lived vicariously through me in that sense. It was the type of career she always wanted for herself, unencumbered by gender barriers and stereotypes. And then, to know that I was gay—she was terrified that it might cost me my career and that I would lose everything.
I said, “Mom, I’m going to be okay.” I think that made her feel a little better. But the reality was that I was not sure it would be okay for me right then. It was one of the times when I wondered if I would be able to achieve my potential and do the things I wanted to do. Having kept the truth secret for twenty years, I felt like I was living two lives. This was a time of reckoning.
Personally, I was feeling isolated. Almost no one knew for certain that I was gay because I hadn’t come out to my family. They strongly suspected, of course, because I had lived with my first partner for fifteen years. And even long before that, as a kid, I loved wearing boys’ clothing, and I forever wanted to play with my brother’s toys. My mother always went along with it, no questions asked. She even bought me the men’s watch I picked out when it was time for me to have a nice dress watch. But we never talked about it. Professionally, I felt like I couldn’t entirely be myself either. I believed for a time that the only way that I could confidently pursue my dreams was to compartmentalize my life and work. I looked around at the people in my profession, and “hospital administration” didn’t exactly seem like a gay enclave. In fact, business in general was not a place where you found many openly gay people. It was a lonely existence from this perspective, and the secrecy had put a lot of stress on my relationship with my partner. In addition, having my career derailed—even for a moment—was jarring. I never thought I would get married and have a typical life with a partner, and that put a very heavy burden on
me to succeed in my career and provide for myself.
But it all came together for me personally and professionally. There were many moments when I could see that my mother fully accepted me. She gave my partner presents, for instance, and she was genuinely happy when we were together around her. Then, right before she passed away, she made a toast to me. We were at a lovely resort in West Virginia, the Greenbrier. This was about ten days before she died, and we knew she wasn’t going to live much longer. She raised her glass and she said, “Nancy, they don’t deserve you.” I will never forget that as long as I live. I could tell that she really understood what I was going through and it lightened my load immensely.
My dad, who never really said much at all about my sexuality then, is open about his acceptance of me today. At his age (93), it’s pretty remarkable. He tells me all the time how happy he is that I married Pam and that we have a family.
Although that was a difficult time in my life, it was a positive turning point for me. After my experience at Riverside Methodist and my struggle to be honest with my family and friends, I realized that I was ready to be more open. Hiding my true self was counter to everything I believed. If the times had been different, perhaps I would have acted sooner, I’m not sure. Regardless, I was ready to be out in the open. That is what I have done ever since and I have never looked back—and I’ve most certainly never regretted my decision. Somewhat surprisingly, I have enjoyed enormous support from my mentors, colleagues at HFHS, and family. In turn, I have been able to step up and support many other people by fostering a culture—particularly at Henry Ford—that values people for who they are and helps them leverage their unique gifts to be their best.
Leaning In
As much as I struggled with being open about my sexuality, I had very little doubt and trepidation about putting myself out there as a female leader surrounded by male counterparts. Although I agree that being a woman makes it more difficult to reach the highest peaks in an organization, I managed to not let that hold me back. In some cases, in fact, I have had access to significant opportunities because I was a woman. Having a big job at a young age offered advantages. When I was COO at Akron City Hospital, for example, I was invited to be a member of the board at the First National Bank of Ohio. I was one of two women on the board. More notably, I was thirty-two years old, while everyone else was well past fifty.
In terms of public boards, I’ve often been the first or the second woman to serve. Unfortunately, though, we still have a very long way to go in bringing women into the highest levels of leadership. What’s interesting is that if you look at board recruitment today, people are out there searching for women to improve their record on diversity. At Walgreens we have three women on the board now, and it’s a game changer. When you’re the only woman, or even one of two, you’re always in that mode of needing to put your best foot forward. You are proving yourself. When you have three women on the board, your voices are collectively forceful enough to bring a different perspective. You can take more risks. And it’s much better for customers when a board more accurately represents the consumer dynamic.
Personally, I grew accustomed to being surrounded by men. I wanted to help change that, of course, and I’ve done a lot over the years with that goal in mind. But when I was in my thirties and forties I just thought, “I’ve got to prove myself. I’ve got to be better than the rest to make sure I don’t lose this spot.”
That said, I am quick to admit that I had an advantage for most of my career that many women can’t claim: I wasn’t married with kids. I didn’t think having children was an option for me, so that eliminated the trade-off aspect many women face and simplified the work–life conundrum that I would otherwise have had to manage. In my career, and in most careers in health care, you have to be willing to move because the next job opportunity is not always going to be in your backyard. But it’s tough to move a family. It’s tough to pull kids out of school. I always had geographical flexibility, which allowed me to develop my career more easily.
With that advantage, I have always leaned in, and I believe that there is some truth to the overall lean-in philosophy. By that I mean I believe women overall would benefit, and advance further in organzations, if more of us courageously pursued our career coals. A few years back, in fact, I noticed that some women were not expecting as much from their careers as men; therefore, they were not pushing as hard for opportunities. I also saw that some women had very narrow criteria for what they would do next, so they were not as available for opportunities. Finally, women at one time tended to avoid negotiating for themselves. Instead, they were looking out for others, carrying the heavier burden on family issues, and tended to be too easily satisfied on the pay side. More recently, I’ve gotten a very different sense of young women. They are learning from the women who came before them, they are asking for opportunities, and they are more aggressive in pay negotiations. As a result, we’ll hopefully see some of the pay disparities narrow over time. And as the pipeline of women leaders increases, these new executives and political leaders will create a path for others. In addition, they will continue to change the structure and norms of organizations.
This is not to say that my career advancement has been a breeze. In fact, the first fifteen years were the trickiest in terms of routing around gender biases. It wasn’t exactly an open door for women getting into hospital administration. And it was a double whammy for me—a gay woman. When I was in college, for example, and even after that, there were numerous individuals in the field who were not particularly supportive of a woman advancing into leadership. They tried to dissuade me and at times belittle me. The good news is that it spurred me on. Somebody telling me I can’t do something is always the best motivator. In addition, once I got my graduate degree and was working on my residency and fellowship, I found mentors who were interested in me and supportive of my aspiration to lead a large organization. They went out on a limb for me, and their support is one of the reasons I work so hard.
Why Diversity Works
I have always tried to foster a workforce that demonstrates a strong commitment to diversity. The personal experiences I elaborated upon above are an obvious part of the reason I believe that diversity, in all its forms, is vital to organizational success. However, there are other reasons as well.
First, it has become clear to me that a diverse workforce allows people to maximize their unique potential, which makes organizations more competitive. For example, diversity enables people with disparate talents to showcase them—in a large, complex organization, complementary talents are always more desirable than overlapping ones. The converse is also true: a homogenous culture delivers people with similar capabilities, thereby leaving organizations deep in the same few skills and experiences and very exposed elsewhere.
Like many CEOs, I have seen firsthand that diverse teams are a catalyst for innovation. Solving seemingly intractable problems, after all, requires bringing different types of people together. To me, diversity goes beyond race, gender, ethnicity, and sexual orientation. Hiring individuals with nontraditional backgrounds, for instance, brings into the organization the type of intellectual diversity that channels breakthrough thinking. Gerard van Grinsven is an excellent example of this thinking; he had no health-care experience whatsoever, so he was not the most likely candidate to lead our new Henry Ford West Bloomfield Hospital when I hired him. Yet, his status as an “outsider” was a main reason the hospital achieved its ambitious goals of becoming a premier health and wellness facility. We had plenty of health-care experts on staff at the time. It was Gerard’s unique expertise in creating luxury-inspired experiences for Ritz-Carlton that made all the difference in allowing innovation to flourish. In other words, Gerard and other unorthodox hires at Henry Ford have worked in our favor specifically because they disrupted the norm—not despite the fact that they did so.
We have seen the same dynamic when our health plan and medical groups collaborate to solve problems. The people at
the health plan have a completely different perspective than clinicians do, and vice versa. When you get them together, both groups maximize learning: physicians are exposed to the rapidly changing dynamics of payment and benefits management, and individuals from the health plan come to understand the vast challenges of providing quality care for patients. Putting all the pieces together has yielded innovations for us related to health education and wellness, improved technology for prescribing medicine, and even better disease management.
The last, and arguably most important, reason to value diversity (particularly in an environment like that of Henry Ford Health System) is to meet the needs of the community. Detroit’s population of roughly 713,000 people is 83 percent African American and 8.6 percent Hispanic or Latino. In addition, Arab Americans of Lebanese, Palestinian, and Syrian ethnicities call Detroit home.1 And this heritage goes way back: by 1916, in fact, Henry Ford had more than 550 Syrian employees, including many recent Muslim immigrants, working in his factories in Detroit.2 If our organization did not reflect that long-standing diversity, we would not be in a position to earn the trust of our multicultural patients. For example, most Muslim women require female doctors, and all-female attendants, at childbirth. It’s very intentional, then, that we have female physicians, advanced practice nurses, and midwives who are engaged in clinics to serve the Arab American community.
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