CATHERINE JACOBSON: WHY COMMUNICATION IS HER BIGGEST JOB

Catherine Jacobson serves as president and CEO of Froedtert Health, a regional health care system based in Milwaukee, Wisconsin. Jacobson joined Froedtert Health in 2010 as executive vice president of finance and strategy, chief financial officer and chief strategy officer. She was promoted to president in 2011, and in 2012, she assumed the role of CEO. Prior to joining Froedtert Health, Jacobson spent 22 years at Rush University Medical Center in Chicago in various leadership roles.  

What is the most important thing you've done to enable organizational agility at Froedtert?  

What we try to do is make sure that our strategy, our direction, and our vision are, very, very well communicated throughout the organization. I really see that as one of my biggest jobs. It's making sure that everyone from my direct executive team all the way through the organization hears from me and articulated by me what we're trying to accomplish.  

We are a very aligned, incentive/metric-driven organization, so everything we do cascades from our strategic plan. It's translated into a robust annual plan with goals and metrics that everyone has to meet. And so, the organization is structurally aligned, but within that we want you to move -- everyone knows what we're trying to accomplish and what their role is in terms of accomplishing that, and then the idea is get moving -- get things done within that framework. That's what we've done to make sure that the organization can move at the speed at which we need to move.  

We’ve created an innovation company that is focused on bringing initiatives into the organization that help start making people think  about transformative change. Our structure and communication occur in a way that allows people to get their jobs done, but we probably need to start introducing a little bit more time for creativity and innovation. That's a tough balance when you're trying to get work done while  moving really fast in a competitive industry, but at the same time trying to allow some time for creativity to come up with new ideas.  

When you look to the future, what's the foremost thing the organization must be prepared for in order to accomplish your vision to be the region's premier health system?

We have to be very, very fast-moving in an extremely competitive market, both from a performance perspective, but also getting the work done to be able to grow, to be able to change, to transform health care. That's a critical need now for success in the future.

What in your opinion is the number-one critical challenge faced by business leaders today?  

It might be old hat to some industries, but what's facing health care right smack in the face is disruptive change. Whether it's Amazon or Netflix or Uber -- people talk about the disruption in retail, but it's really happening all over the place. In just about every industry that is consumer-facing right now, we're seeing these massive disruptions in terms of either new product development or just things people never even thought they wanted or needed, and suddenly now are seen as essential. And we are a consumer-facing industry -- we're a service industry providing healthcare. All of that is on top of us right now.  

Other industries have been through it, some are still reeling from it and in the process of adjusting. I think all business leaders need to be aware of the  movement that's out there and really try to lead your organization by recognizing that if you haven't changed things -- that if you're doing business the way you've done it for a number of decades, that just isn't going to fly anymore.  

Are you noticing a discernible change in terms of the expectations of patients, or consumers of health care services?  

Yes, without question, and I think the hard part right now is that no one has come up with the code yet to crack the system. The system is pretty ingrained right now -- you go to your doctor, you go to your hospital, the insurance company is like the middle-man. The issue is that people have expectations built from experiences from other industries, it could be retail or Uber, for example, so the expectations of patients change. Dissatisfaction with the way things have been done in health care starts to grow. I think the only reason that the incumbent system still exists the way it is, is that no one has quite cracked the code to scale yet. There are a lot of pilots going on and some movement in that direction but the wholesale disruptor hasn't been found yet. It has to work, it has to have a sustainable business model.  

So, for example, we're making sure that we have more Saturday and late hours because people can't always take off work to go see the doctor. You can schedule online, because not everyone wants to pick up the phone and do that now. You can pay your bill online, things like that are the basic little things that I think everybody knows that they have to do. But what if you never have to go to your doctor's office? What if you just see somebody on a video visit? There are fantastic transformations coming out of medical care that can enable a lot more care in the home. I think that we really are on the cusp of seeing how all of that is going to tip the system on its side.  

Have you observed the strategies of leaders evolve over the course of your career and if so in what ways?  

I really have. I'm 30-plus years now into my career. I started at a public accounting firm, so when you talk about traditional, hierarchical leadership structures, that's exactly what was going on in the mid-'80s. I think there was some realization at the time that you should be nice to your staff -- that you shouldn't be rude if you were a partner, they were starting to realize that we needed to communicate better. But I would say also there was really no recognition of the value of diversity in the workplace. I think there was more of a "Gosh, we have to attend to this" type of conversation, certainly not the realization of how valuable it would be to have women partners at the table. There was no conversation about that at all.  

What I see today is that clearly leaders have evolved in a way to understand that all staff are valuable to you. You need to mentor them, develop them, you want to keep them with the organization, you need to involve them in their work, not just tell them what to do.  

In terms of diversity, there is true intellectual recognition of the value there. I think people are starting to see that when you bring diversity of thinking into your management group, your leadership team, your boardroom, that you make better decisions.  

I clearly remember maybe 15 years ago working with a board that was all male, all white, pretty much retired, over the age of 65, in a room trying to make decisions about an organization. They had no concept of what was going on in the workplace at that point. Now seeing the active engagement of people from across the community, the value in that conversation is being recognized. The biggest change I've seen is that the hierarchy and paternalistic view of leadership, which was still very intact in mid-1980s when I came in, has shifted significantly. Leaders recognize that you have to do things a different way.  

Let's talk about one characteristic -- if you could only name one -- that is a deal-breaker in terms of what leaders need to possess.  

It's humility. Self-awareness that you are not the smartest person in the room.  

And is there one behavior that you've consistently observed to be a derailer for leaders?  

When the leader starts thinking that the job is about them.  

Do you think companies are succeeding in terms of diversity and inclusion and are there any glaring areas where they're just missing the mark?  

There's a great recognition that there is value in diversity and inclusion. I definitely see people moving towards measuring -- so, for example, for us, we look at our community, we look at the make-up of the population in the community and we make sure our board makeup reflects that. We make a conscious effort to recruit people in that way to our board, to our management team, and so on. So, I think there is absolutely effort, there is measurement, there's assessment, so that's all moving forward.  

What I don't see yet is recognition that you have to go deeper than that and create opportunity at an earlier level of development. Bringing diverse employees into the workplace in a professional setting so that they have the ability to succeed. And you have to develop those opportunities because this is still very much -- particularly the higher up you go -- a game of who you know in terms of getting the opportunities opened up to you for jobs. If you don't invest in creating those opportunities at an early level of development, people will never get there.  

So, that's number one. Number two where many companies are missing the mark is inclusion. It's one thing to recruit someone of a diverse background into your organization. It's another thing to include them. Even with my own experience in say, the 1990s, when I got to be in more of a C-suite type organization, how many times -- and it still happens today -- that I am the only female in the room. I've gotten so comfortable with it now that it doesn't bother me anymore, but at first that's very intimidating. And I used  to be a lot of times one of the youngest people in the room -- and if you don't have people reach out to you to really start involving you in the conversation, or say hello, or welcome you, you just don't feel included and might therefore give up. And I think that's the same whether you're female, a person of color, no matter your sexual orientation, all those different types of things-- if you're not made to feel comfortable in your environment, whether it's just coming to work every day or it's in the boardroom or the C-suite, that can be a derailer. I don't think everyone recognizes that it's not just hiring somebody to sit in a seat.

What do you think about the argument that women are more effective leaders in some ways because they tend to have higher EQs (emotional intelligence)?  

I've worked for both male and female leaders. I don't know that it's an issue of gender and EQ per se; I've worked with some pretty obtuse women leaders and some very emotionally connected guys. So, I'm not really sure that that's the issue.  

What I would say is that I think that women tend to just get the work done.  

Again, it's almost the humility factor, and this has been written about a lot, that women don't seem to have the need to pound their chests and say they're great all the time -- and maybe they don’t to a fault. They -- we -- just concentrate on getting the work done. Women don't spend a lot of time self-promoting.  

Don't be humble here — what do you consider to be your greatest strength as a leader?  

You know I would say I've built my reputation probably the most on being trustworthy. If I tell you that we're going to do something, we try our darnedest to do it. And my mantra is “base your decisions on doing the right thing”. I think also I've been recognized as being a team player -- it's more about everyone's contribution to the game, not one individual's.  

What's your advice to a leader facing a crisis that threatens to tarnish the brand of the organization?  

You have to own the problem. Sometimes you get inappropriately pulled into an issue that's not what it seems and then you have to come out and correct the misconception. And sometimes your organization did make a misstep, and the number-one thing to do first is to own the problem, admit where you made the misstep, and then immediately get in there and fix it. If that means apologizing to people, you have to do that. I think the worst thing you can do is try to bury something your organization didn't do a good job on. It will come back and bite you every time.  

I imagine that when you were studying to become a CPA, you probably didn't have your current role as the CEO of a health care system in mind. What would you say are the traits that you possess that really got you to where you are today?  

I always say that how I got here was 50 percent hard work and 50 percent luck. I am one of those women who just gets her work done. I'm results-focused, very reliable -- if you tell me to get something done it gets done. I think that got noticed along the way -- people know they can rely on me.  

And I'm a problem-solver. I found at about my mid-career point that people were coming to me with their issues and asking for guidance on how to effectively move through things. I became a strong team player because during my formative years I got to work in a staff role, and it was all about getting the organization into a better place, it wasn't about anything personal. So those are some of my strengths.  

Did you face any headwinds in your career trajectory because you were the only woman in the room?  

I think for everybody and at least for me personally, it's either real (and at one point in my life it was real) or somebody else's perception of my need to balance my career with my family.  

Let’s face it: when women get to child-bearing age, everyone starts to look at them and wonder what they're going to do. Are you going to stay on your career path, are you going to go part-time, are you going to back out of the workforce? And I do think that impacts your ability to have opportunities given to you. So, some of that is real. In my own life I did have to find that balance because I wanted to spend time with my family and I did go part-time for about four-and-a-half years.  

But at the same time, I think there is also a perception that some people expect you to do that and, so they may not offer you the opportunities at that time. And sometimes you have to prove which direction you're going during the time that you're raising your family, and once the employer gets some confidence that you're staying in the workforce, then some of those opportunities come back around. But I think that gets in the way of the opportunities that a woman might have.  

The other thing that I had to learn is communication style. Men might get away with raising their voices in a room; women can't. And I think that you have to figure that out. So, I learned a lot over the years about how to moderate my communication style.  

Has there been anyone in your professional life who, looking back, really had a big impact -- maybe offered you an opportunity for a stretch assignment that really made all the difference for you?  

Both the last two CEOs I worked for were that for me. Dr. Larry Goodman [CEO, Rush University Medical Center] gave me a chance to be the CFO when the organization was not in a good place financially. He took a risk on me to do that.  

Bill Petasnick, when he hired me to come to Froedtert, gave me a chance to be a CEO. Those two were the ones who were instrumental in lifting me to that place.  

But -- and I think this another strength -- I learned pluses and minuses from every single leader I've ever worked for. If you really observe them, sometimes working for someone you think is a bad boss is actually much more effective in honing your leadership style than someone who is a good boss because you recognize very clearly what you don't like, and you make sure that you're not doing that. I worked for a female boss once whose style I really didn't appreciate, but then I realized that I had some of that in my own leadership style and I had to change.

Have you ever taken what felt like a big professional risk?  

I think I've built my career on taking risks.  

That offer at Rush to become CFO -- that was a risk. They were not in a good place financially -- the previous CFO had resigned over it. So that was a big deal to step into that job.  

I think the first time I learned that risk matters was when I left public accounting to work for a client that had lost a lot of money, but they were backed by a bigger client. I got a chance to go in and be a problem solver and got a lot of responsibility really fast. That was a job that a lot of people had turned down because it was a high-risk company at the time, but I went ahead and took it anyway.  

Did you believe that you could pull it off?  

I did. But I was young, I didn't have a family, I wasn't supporting anybody. My public accounting firm did tell me that they would take me back if it didn't work out. And I knew enough people at the parent company that I thought I would be okay. And again, you know, I was 25. I figured I could go get a job someplace else if I had to.  

What's a typical day look like for you?  

I don't have a typical day, which is actually what I love about this job.  

If you look at it over a week, about 20 percent of my time is in standing meetings -- management meetings, another 20 percent is meeting one-on-one with different members of the team. On any given week another 20 percent is spent on speaking in the community, or in the organization, nationally, locally. Next week that will take up nearly half my time. And probably a good 20 percent of my day every day is taken up just keeping up with what I say is correspondence -- it used to be paper but now it's email. That can start early and go late into the day, but I would say that that's a significant amount of time. And then if I'm really lucky I get a little bit of time to put my head down and plan for the next month -- from what's coming up and prepping for meetings to reviewing one of our strategic initiatives and setting the course.  

What is the professional accomplishment of which you are the proudest?  

Froedtert Health. I'm very proud of what we've done here in the last five years.  

Somebody told me this once: Inherit well. And I did. When I took over five years ago I inherited a very strong organization both from a performance and a financial perspective, uniquely positioned in the market. So, I inherited well and was able to take all those strengths and knit them together to make them even better. Today we are a stronger performer in quality and patient experience, and we've grown significantly. We're stronger financially and have held up all the high standards I inherited -- most preferred brand, high patient satisfaction, all of those different types of things.  

What I have found is that when you're a CEO it takes longer to put your mark on an organization because if you're following a successful leader, which I did, you kind of continue to execute their long-range plan for a while, and at about year three it starts to become yours. After five years -- I'll give Bill Petasnick the credit for the first two because we were just following his path -- I'm exceptionally proud about what we've done here.  

I know you're involved in a couple of organizations that support the development of women in leadership. What can employers do to support women's leadership development?  

Health care is a challenge because it's predominantly female. That doesn't mean we're predominant in leadership, though. Quite frankly around my cabinet table we are up to four women, so just about a third of our senior leaders -- senior VPs or above -- are women. As we become more mature in our diversity efforts we are creating different business resource groups with diverse cohorts of individuals. Bringing in the experiences of these employees will help the organization address our strategic priorities through a a wider lens., We haven’t developed a cohort focused on  women. That is something we need to address, maybe targeting the lack of diversity in leadership.

As I said, women are the predominant gender in our workforce, but that doesn’t mean that many succeed above a certain level. So, if we create a women’s leadership program here at some point it would probably be something more at the executive development level because we have a lot of female leaders, it's just making that jump to the executive level. Frankly, all of health care suffers from that. For being as well-represented as we are in the workforce, women are underrepresented in leadership.  

What advice would you give to someone going into a leadership position for the first time?  

Do the job you're in before you worry about your next job. A lot of times what I find with young leaders is that they are on their ladder -- they're already thinking about positioning their next move. Do the job you're in really well and you will be noticed. And if you’re not noticed, then you start to raise your hand and make sure that people know you're available for other opportunities. But make sure that you're mastering the job that you're being paid to do before you worry about the next one. That's going to take some time. A lot of young leaders are impatient -- they only want to stay in a job for a year. But I think it takes a good three years, depending on the scope of the job, before you settle into understanding leadership, understanding your scope, and all those types of things before you're really ready to go on to the next level. If anything, we've recognized that when you move people up too fast they miss some fundamental experiences along the way.  

Do you have a book recommendation?  

Not a specific title, but I love history and, so I like biographies of leaders, especially of historical women leaders, because they weren't allowed to be formal leaders, but still they managed to lead. I don't read a lot of business books unless they're about a specific strategy.  

Describe yourself in one adjective.  

Trustworthy.  

When you were 10-years-old, what did you think you wanted to be when you grew up?

A teacher.  

This last question some people think is weird and other people like, but if you had the power of time travel, what would you go back and whisper into your 22-year-old self's ear?  

Have more fun. Work hard, do your job, everything's going to work out, have a little more leisure time, especially before the kids come -- enjoy your freedom!