This week on the podcast, Brent sits down with Marcy Doderer, President and CEO of Arkansas Children's where she leads the state of Arkansas' only pediatric health system serving the children of Arkansas and beyond. They begin by discussing the unique aspects of pediatric healthcare, including the wide variations in patient size and conditions that drive increased costs. Marcy shares how she is focused on innovation to find new solutions while maintaining incremental improvements in care delivery. She offers leadership advice on authenticity, being a student of your work, and how everyone can lead from their role. Marcy also talks about the mission-driven culture at Arkansas Children's and her aim to partner across the state to elevate child health.
Podcast Episode
Episode Transcript
Marcy Doderer 0:01
But to actually heal a child, you need inventive spaces, creative spaces, and artful
spaces that allow the child to still be a child in the midst of all their health care.
And that costs money. Our spaces are designed differently. Our technology is different
and it's all costly.
Brent Williams 0:20
Welcome to the Be Epic podcast, brought to you by the Sam M. Walton College of Business
at the University of Arkansas. I'm your host, Brent Williams. Together, we'll explore
the dynamic landscape of business, and uncover the strategies, insights, and stories
that drive business today.
Well, today I have with me Marcy Doderer, who is the President and Chief Executive Officer at Arkansas Children's. Welcome, Marcy.
Marcy Doderer 0:48
Thank you. Glad to be here, Brent.
Brent Williams 0:49
Well, I'm glad to have you on the podcast. We've known each other for several years.
It's great to reconnect and hear about the wonderful things that you've been doing
at Arkansas Children's.
Marcy Doderer 0:59
We do have a lot going on. That's for sure.
Brent Williams 1:02
And you just celebrated 10 years in the role, right? What's some of the highlights?
Marcy Doderer 1:06
So 10 years this week. I moved here in July of 2013. And I don't think I wasn't that
I didn't expect to be here for 10 years, but I'm not sure I fully expected 10 years,
I certainly didn't know where we would be 10 years from now.
Brent Williams 1:21
Well, what what are some of the highlights of of the 10 years as you look back? I'm
sure you've kind of reflected.
Marcy Doderer 1:28
Absolutely. And probably one of my proudest accomplishments with Arkansas Children's
is that we are now a two Hospital Health System. That may not sound exciting to some
people but Arkansas Children's Hospital have been in Little Rock for over 110 years
now. And five years ago, we opened Arkansas Children's Northwest in Springdale, a
small community Children's Hospital, really perfectly situated in the Northwest Arkansas
region and serving the needs of those children every single day. It has been so successful,
we're in growth mode, and will soon put shovels in the ground to expand that facility.
Brent Williams 2:04
Well, wonderful. Well, you know, you sit in an interesting space in Arkansas being
the only system health care system that primarily serves children and pediatric community,
what are some of the unique aspects of serving that particular population?
Marcy Doderer 2:22
We've always been in the business of child health and child health care, we think
about health care, as you know, being able to catch the sick and injured when they
come to us for care. But we also want to make sure we're actively engaging with partners
across the state to elevate the health of children in Arkansas. We've done this pretty
remarkably, by trying to get further and further from Little Rock and out and about.
So we have primary care clinics in Pine Bluff and Southwest Little Rock, an active
clinic and Jonesboro, a home visiting system that touches all 75 counties, and of
course, the two big hospitals, and another clinic in Benton County. So we're trying
to be as close to kids as we can. Our ultimate aim would be to be within 60 miles
of every child. And it's not because we wish to own and operate every kind of child
health business there is but because child children are really our future. That sounds
pretty cliche, and maybe a bit trite, but we are experiencing a moment in time where
the human race is not replacing itself. Birth rate is declining pretty steadily year
over year. And there will not be enough kids to become adults to take care of you
and me when we're old. And so our stance is that we really have an obligation to stand
up these kids and help them reach their fullest potential, 700,000 kids in Arkansas,
we we as a health system might only take care of 180-200,000 of them individually.
But I think we could actually be instrumental in creating a fabric of services to
ensure that kids get the health and are can achieve the health status they really
need.
Brent Williams 4:02
You know, Marcy, I'm sure you're highly aware clearly of population decline because
of being focused on pediatric health care. I'm aware of it because being focused in
higher education, of course, you know, that as children grow and graduate high school,
that's who's coming to the university. Do you feel like business leaders that you
engage with are really aware enough of on this issue that's out there?
Marcy Doderer 4:34
From my perspective, it's not top of mind for very many business leaders. They're
looking deep in their here and now and certainly coming out of the pandemic, global
business environment has been extraordinarily difficult to lead in and lead within
and I'm not sure people have stopped to think about long term impact on population
trends and their workforce. Every business I think across our country is worried about
the workforce of today, we've struggled to fill critical positions, unusual things
like pediatric ultrasound technologist, but also mainstream things we can't find staff
accountants. You know, so the workforce of today is challenging, it's only going to
get worse. And I think if we could elevate this conversation among the business community,
and the education community, together, we could figure out how we're going to take
fewer people and make them better prepared to deliver the kind of work we will need
10 years, 20 years, 50 years from now, service industry, retail industry, the medical
industry, technology, whatever it might be, every one of those industries will have
fewer people to work in their spaces. So what can we be thinking of now that actually
replaces the need for the human hand in a way that still allows work to be engaging,
fruitful, inspiring, and attractive to people who will be working.
Brent Williams 6:05
Absolutely. And if and I guess as you're, as you're thinking about that, and in your
own business, or you know pediatric systems throughout, you know, the world probably
that you're engaged in, I'm sure automation, generative AI, those types of technologies
are on your mind and how you're gonna, I guess, bring those alongside your people
to solve some of those.
Marcy Doderer 6:30
Absolutely. And I can give you an example that we worked on in the last year. It's
very healthcare specific, but it was leveraging automation in business systems. In
healthcare when you have a government payer as a major source of your revenue stream,
which we do at Arkansas Children's, Arkansas Medicaid is our primary payer, you have
a series of what we call cost reports. It's a year end auditing process of assessing
what it costs us to deliver care for the Medicaid kids that we took care of. And it's
a very involved, detailed, lengthy way of reporting back to the state, what they owe
us for the care we delivered and what it really costs us to deliver that care. It's
been a very manual system. Since the beginning of time, it feels like. But between
our Information Systems team and our Finance team, they've been able to really, almost
fully automate how federal and state level cost report gets populated. That may not
sound very exciting to anyone. But what the reality is our team who works in cost
accounting, they don't want to be data manipulators, which is what they've been by
completely automating the process, their checks and balances of the cost report is
reduced significantly in terms of man hours, allowing them to change their view and
really be the data analyst that they are. And I think every kind of rote, mundane
kind of business function that we could automate, to allow the people to be the thinking,
creative minds that a human can be, every business will benefit from that. AI is a
little interesting, one, I think it's here to stay. And it's actually going to just
boom, it's very scary to some, because I think people feel it may replace people in
their work. But it definitely has a role. And there's, again, there's some rote kind
of work that we do that we think AI can be extraordinarily helpful with, we think
of all the documentation that occurs in a healthcare transaction. When you visit your
own personal physician, she or he is having to document deeply in a medical record
to assess current state and your problem list and what the prediction or prognosis
is for the future. There's a lot of ways AI can help with that and make that easier
on the provider, giving them opportunity to spend more face time with you. But there's
some also, I think, really interesting, unintended consequences of that kind of AI.
And here's another example that we're kind of wrestling with in health care. We can
use automation and a form of AI to help our radiologist read routine and simple radiology
images. The idea was to free up the radiologist, the human, the medical doctor, to
spend their time really focusing on the unusual imaging services that are really acute
and need immediate attention. MRI and CT and brain scans, tumor scans heart issues.
Well, what they're finding though, is the human brain works best when it has some
lulls in its day and by removing all of the routine chest X rays or plain film orthopedic
images, we're forcing radiologists to spend their 8, 10, 12 hours a day looking at
the really intense stuff. And it's overwhelming to a person's brain, it's exhausting.
And so we actually need to come back to some a little bit of a middle ground because
behavioral scientist and brain scientists also know our brains like a little downtime,
not to be just on a break, and not engaging in anything, but to allow the brain to
kind of operate a bit on autopilot. So I think there's some unintended consequences
of trying to automate everything and forcing people to just the highest function,
because we may burn them out even faster than we're doing today.
Brent Williams 10:38
How interesting. That's a very interesting example, you know, and backing up, I would
say, I totally agree with you of the exciting thing I think about the development
of technologies like AI, generative AI, is the ability for humans to no longer have
to do many of those rote tasks and use their creative abilities that only a human
can do. But I think as as, as leaders and managers, and I heard someone say this,
actually, this week, can use the word harmonizing technology and people.
Marcy Doderer 11:13
I like that phrase.
Brent Williams 11:14
Yeah, me too. It really, it really stuck with me. And I think that's sort of what
you're saying with this example. Like, how do we get technology and people working
together in a harmonized way, so that both can be best utilized, and so that the person
can get the most joy out of the work?
Marcy Doderer 11:31
You think about healthcare, particularly in hospital care. When a child is confined
to a hospital room days on end, and they're still aware of enough of their surroundings,
they really look forward to engaging with people. There's some rote tasks that we've
thought about replacing with robots, delivering a patient's food tray, for example,
pretty simple technology, it's out there, it's being used today, a robot can, you
know, the thing can be loaded with the patient trays in the kitchen, it knows how
to move up and down the hallways and up and down the elevators and can stop outside
the room. So a parent or someone could get their tray. But if you remove the opportunity
for the people who usually deliver to the tray to stop and engage with the family,
and really check in on the emotional status of that child, not just the blood pressure,
the temperature, that kind of thing, we might actually dehumanize healthcare and that
we don't want to do that. So I love that concept of harmonizing the technology with
how we're delivering care.
Brent Williams 12:37
Me too. Well, you, you lead an organization in a challenging space in healthcare.
And you know, many of you are probably aware, we're all engaged in healthcare as as
people and consumers, but I'm not sure if, if everyone listening would understand
the real challenges of trying to operate in that system, med. You know, I thought
maybe from your perspective, like what are some of the key challenges that you all
face as you as you operate within this US system?
Marcy Doderer 13:09
Well, healthcare is highly regulated. And those regulations create a burden, an administrative
burden that doesn't always come with a revenue stream for us and every hospital in
the country is faced with that not just pediatric health care. But I do think it's
amplified in pediatric healthcare because our, the floor of our cost structure is,
unfortunately, by design higher. So more costly than in a traditional adult hospital,
for a number of reasons. Start first with people. We need people who are actually
trained in pediatric specialist specialties to take care of kids. Our children have
a different anatomy, different physiology, different medical needs. I mean, their
diagnoses are literally different than in the adult space. And people need to get
trained to take care of kids, not just adults, and that training takes more time.
Therefore, it costs more money, a cost structure goes up. When you think about our
slot supply chain, we source our supplies many times from the same vendors and places
that an adult hospital is but we actually need way more supplies than an adult facility.
So think just in terms of blood pressure cuffs, and I actually wish we're on a podcast
but I wish I could show visual aids because it's pretty impactful. Any day, anytime
in a children's hospital we have micro preemies, so babies born that way less than
a pound. And we might actually have a 500 pound teenager suffering for more morbid
obesity. So we would have a blood pressure cuff that's about the size of a band aid
that can fit on a premature infant. And then we need a blood pressure cuff that can
fit around the arm or the leg of a 500 pound person and every size in between. Well
multiply that by oxygen masks, tiny, tiny oxygen masks, full size oxygen oxygen mask,
multiply that by diapers like a diaper, that's literally the size of a post it note
to a full size, extra extra large depends for an incontinent, bigger person, and everything
in between. So the cost of inventory, the cost of our supply chain is very different
than adult size. From a capital standpoint, the same thing is true from hospital beds.
Bassinets designed for an infant to a bariatric bed designed for a 500 pound person.
And it just goes on and on. And that creates a layer of costs that doesn't happen
in the adult world. And I can say that with ease was actually worked in adult hospitals,
I've had the experience of being in a 700 bed, academic hospital in a large urban
town, those kinds of things make it very different. The people are different, the
supply chain, the things are different, and then the spaces are very different. And
that makes our burden of delivering high quality, low cost patient centered care,
more challenging, I believe, than in just a general adult community hospital.
Brent Williams 16:13
You know, I I had never thought about the variations, you know, physiologically, I
guess in in your patient relative to adult it makes sense clearly when you say it,
but when you hear pediatrics or children or adult, you kind of think one or two. But
wow, what a you're right, you're dealing with a vast variation.
Marcy Doderer 16:34
The last piece I would land on there that I think is such an exciting field in medicine
right now. And more costly than I think the average Arkansan would even understand,
medical technology, medical science, and research and discovery have been creating
novel pediatric drugs, pharmaceuticals, to solve for conditions that were fatal in
the past. Neuro, neuromuscular conditions that children are born with that children
don't live to be, but maybe two or three years old. There are now not just life altering,
but life saving drugs that we are delivering to these children in Arkansas and all
over the country, probably the world. Single doses of those draw those drugs are seven
figures. So a million dollars or more per dose. And that's not just cost on the hospital,
right, we would negotiate that with payers, we work with sources of revenue to ensure
that the drug gets paid for back to the pharmaceutical company. But that's not a sustainable
future for us, except that it is a sustainable future for that one child who now will
live. And for that family who sees hope. And so that that's a fascinating, probably
just in the last five years, piece of our world that's becoming more and more challenging
to maneuver that everyone wants to figure out how we're going to navigate that space,
because we're going to actually save children's lives and going back to the population
decline, we need to save every one of those children's lives.
Brent Williams 18:13
Absolutely. Well, I assume you know, working in pediatrics that that your team is
a very mission driven team, purposeful team. You know, as as I've gotten to know,
we've worked together over the last, let's say, five or six years. I know, you know,
it seems to me like you've had a significant focus on innovation and driving innovation
in the organization or equipping maybe your leaders and teams with innovation. You
know, how did you, what was what drove your recognition of the need for that? And
how have you gone about it?
Marcy Doderer 18:49
It's a great question. And I don't know that I have a perfect answer for you. I I'm
often viewed in my CEO colleague space is a bit contrarian in the world of innovation
in the past, because people in healthcare, love to think we are incredibly innovative.
In the moment in the delivery of care, I would state quite firmly that we are not
often innovative. We're great at incremental improvement. The margin of error of pediatric
healthcare is really small. And not many families would say they want to be the first.
And so in the care delivery system in the hospitals in the clinics as we talk to families,
we are incrementally better, really well. We have great improvement science techniques.
We are very robust in our process improvement and process design. And we need to keep
that going in the moment of care. But it is also true that we have got to come, we
have to be able to create space that allows teams to really think innovatively in
a way that isn't just improving today's solution. It really is completely different.
So we have invested time in trying to seek out champions for innovation to create
free up space, I guess is the best way to say that in one's day to learn about how
to think differently, learn how to be innovative, to give them the tools to really
explore a very different solution, rather than just exploring a better way of doing
what we're already doing today. And I'm hoping that makes sense and isn't inarticulate
on a podcast. So we've, we've partnered with the University of Arkansas, we've partnered
with the University of Arkansas for Medical Sciences to think about how you take clinicians
who are so good at incremental change and break them away from that and give them
a space where they can actually do transformative change. So we do that by building,
the even at the core of our work, a culture that's built on discovery and curiosity.
So when I interview people I'm looking for what was the last thing you learned that
was new? How did you learn something new, whether it was work related or not, trying
to assess for a team members interest in their curiosity level, in their interest,
discovering something new and doing things differently and I think, if we do that
senior leadership, or we do that with frontline leaders, or frontline staff, we can
create a culture that is naturally geared towards discovery and insightful ways of
looking at things that will promote innovation in a very different space.
Brent Williams 21:30
That totally makes sense to me, the way you explained it. Really trying to give your
team space that allows them to think outside of your lump and, and transform them
together. So totally makes sense to me. And we've been pleased to be a part of that.
Maybe, maybe transitioning to leadership. You know, I mean, when I when I when I think
about interacting with you over the years, clearly we've interacted around innovation,
but I love your style of leadership. And as you as you think about our students, Marcy,
you know, the Sam M. Walton College of Business is really producing the next leaders
of the organizations throughout the state and region. You know, what, what advice
would you start to give them? Maybe let's start with leadership. And like, how do
you develop and how did you develop your own framework of leadership?
Marcy Doderer 22:25
I think I was drawn to leadership really, really early in my life, which may not be
a typical path. But, if you were to rewind the clock all the way to high school, I
always lifted my hand to, you know, be nominated for an officer in a high school club.
And
Brent Williams 22:41
Were you in the first row of the classroom?
Marcy Doderer 22:43
Many times. Sadly. My mom would tell you that, you know, as a five year old, I was
the one going, I want to say why, I want to determine the why. And I think that was
what drove me. I really had this innate curiosity to always want to understand why
and then realize, you know, what, I could define that why maybe better than others.
So that drove me into leadership. One of the things that kept me in leadership really
has been this passion I have for developing others and helping people see, you can
be a leader from any seat you sit in. And I think that's an important lesson for students.
Not everyone wants to be a CEO, not everyone can be a CEO. I mean, it's a pretty steep
pinnacle, right? There's only one at the top. And so, you don't have to reach even
the C suite to be an extraordinary leader. And leading is by creating that vision
for a group of people who will follow you to do something better and improve on whatever
whatever it is, whatever business you're in. My own experience in leadership in terms
of success is leading first with authenticity and integrity. I think that was pretty
natural for me, but it was rein- reinforced by mentors I've had through my career.
And I think sadly, women sometimes get steered a little differently that they they
a persona around them that they think the world is expecting and they leave a bit
of their personal life or their personal approach to the side. And I would never encourage
anyone to do that. Well one lesson I learned really early in my career was kind of
battling a bit of that. Being a little worried about being the only female voice on
an executive team, which I had the experience of, and thinking I needed to frame my
thoughts and my interjections the same way all of my male counterparts were and yet
that isn't the tone of my normal voice, in terms of the cadence of the words or the
way I think or the way I might problem solve. And when I got comfortable with self
that wasn't an outside world telling me to do that it was internal, and just decided
to be myself that it was almost as if the team around me was like, well, thank goodness,
Marcy is now here, you because they knew me in that way individually. And then I'd
get to the big table, and be a bit cowed by that. And I think finding your own voice
and leading with that level of authenticity, the teams around you will welcome that.
Yeah, it won't be perfect, but nothing is. I would also suggest you be a student of
your work. I have had that conversation with team members. People often comment, how
do you remember that stuff? How do you know those numbers so well? I've been a student
my whole life. I'm 55 years old and 10 years into this CEO job and I still study our
work every day. I mean, I spent time yesterday really looking deeply at some statistics
around food insecurity, just so I could understand it differently because of a conversation
that's coming up. And there's a lot of noise in our world telling us to know certain
things or to be certain ways or to be pulled in different directions. And if students
or young leaders, new grads in their first roles, can learn how to put a lot of the
noise aside and be a student of what it is you wish to do, what you are doing today
and what it is she wished to do in the future, you will know your work better than
anyone else. And with that will come growth in your career.
Brent Williams 26:22
Well Marcy. I love the viewpoint on authenticity. Each one of us are individuals,
we're unique, we bring something unique. And that's actually what can make an organization
and a team really special is when everyone brings those experiences and their unique
self to bear and and then that mixes together and creates a pretty unique history.
Marcy Doderer 26:45
I went it was reinforced for me just recently, I was out rounding, I do this a lot
to get out of my office and go spend time on one of the patient care units. And I
was on one of our medical units a few days ago, and there was a new member on the
team and I stopped and I she looked a little frightened that I walked up to her I
had a business suit on and you know, didn't wasn't wearing scrubs. And I said hi I'm
Marcy, I said I can tell by the color your scrubs you're one of our student interns
this summer because our team members are color coded in scrubs, which really helps
me know what they do. And she kind of had a little frightened look on her face and
one of her teammates and I think was her preceptor Kelly walks up and puts her arm
around her. She's like, don't worry. That's just Marcy. She's one of us. You'll get
to know her as you work here. I was like thank you, Kelly. I appreciate that. And
then I visibly saw the shoulders relax on the student intern. And she told me her
name. And I welcomed her at Arkansas Children's. But Kelly, the team member was comfortable
doing that for a CEO because she knows me. And that comes with leading with authenticity.
Brent Williams 27:57
Absolutely. Well, Marcy, I want to say thank you to you and to Arkansas Children's
for the way that you serve our state and should be the future of our state.
Marcy Doderer 28:09
Thank you so much. I have the best job in the state of Arkansas. And Arkansas Children's
has such a bright future as one of the preeminent health care systems in our state.
And I think the children of Arkansas will be better for the work we will do as Arkansas
Children's but more importantly the work Arkansas Children's will do in partnership
with people like you and the University of Arkansas partnership with business and
other community advocates who are out there wanting to make sure every child can reach
their fullest potential. So thanks for your time.
Brent Williams 28:41
Absolutely. Well, I know one thing we share and that is a passion for the future of
this state. So thank you for joining us today.
Marcy Doderer 28:48
Absolutely. Have a great day.
Brent Williams 28:49
You too.
On behalf of the Walton College, thank you for joining us for this captivating conversation. To stay connected and never miss an episode, simply search for Be Epic on your preferred podcast service.
Brent D. Williams is the Dean of the Sam M. Walton College of Business at the University of Arkansas.
With a deep commitment to fostering excellence in business education and thought leadership,
Dr. Williams brings a wealth of experience to his role, shaping the future of the
college and its impact on students and the business community.
