Over its 23 year history, the Commonwealth Fund Fellowship, along with California Endowment Scholars program and Joseph Henry Oral Health Fellowship, has a proven track record of creating physician/other health professional leaders; the Alumni Spotlight interviews showcase the expertise and dedication to care for vulnerable populations as a testament of that success. Interviews have been edited for length and clarity.
Roderick King, MD, MPH (CFF '98)
Senior Vice President, Chief Diversity, Equity and Inclusion Officer, University of Maryland Medical System, Baltimore, MD
Adjunct Professor, Department of Pediatrics, University of Maryland School of Medicine
Adjunct Professor, Department of Health Policy and Management, University of Maryland School of Public Health
Q. Please describe your current role in your organization and your journey to that role.
A. I am currently the Senior Vice-President and Chief Equity, Diversity, and Inclusion Officer for the University of Maryland Medical System. Prior to this, I was the Senior Associate Dean for Diversity, Inclusion, and Community Engagement, as well as Director of the MD/MPH program at the University of Miami Miller School of Medicine. Outside of my academic role, I also held the role of Chief Executive Officer for the Florida Public Health Institute (aka Florida Institute for Health Innovation).
Q. How did your Fellowship training prepare you to do the job that you have?
A. The training I received really prepared me for this current role. Obviously, you can't learn everything in a one-year graduate school program, but it set the foundation for some fundamental skills, and I've been building on those ever since. Public health research and research methodology, understanding epidemiology, leadership development, and other essential skills needed to lead change.
At the same time, the Fellowship really helped to accelerate and expand your network of health care and public health leaders. This really catalyzed my career development because, essentially, almost every job I got since the Fellowship came out of networks that I acquired in 1997-1998. Of course, over the 25 years since I left the fellowship, I built on them, but it was those fundamental relationships that got me to those key positions.
A perfect example is when I become the CEO of the Florida Public Health Institute. The reason I became the CEO was that the prior CEO, Dr. Claude Earl Fox, was the Administrator of the Health Resources and Services Administration (HRSA) when I was a Fellow. He had spoken at the Fellowship’s second or third annual meeting, and he gave me my first job in 1999. I didn't stay in federal service, but when I left in 2005 and went back to Harvard, and then decided to move to South Florida, Dr. Fox had launched the Florida Public Health Institute with support of Donna Shalala (former President of the University of Miami and former Secretary of Health and Human Services during the Clinton Administration). He remembered me and said, "Hey, look, I need someone to take over the Institute." And voila, that's how I became the CEO. That’s one small example of how building on those early relationships really laid the groundwork for almost all of my career opportunities going forward.
Q. What is the best piece of leadership advice that you've received?
A. The two best pieces of advice I got from the Fellowship came from Joan and Ron Heifitz. Joan always said, "Remember to take care of yourself." This whole idea of self-care is vitally as important as advancing a policy initiative or moving forward a political appointee. It's a marathon, not a sprint, and very often I will forget that I need to take care of myself, take a pause, ground myself spiritually, ground myself in terms of physical activity to stay healthy. Self-care is so, so important.
The other great piece of leadership advice I received was from Ron Heifetz when I was a Fellow, about learning to identify the adaptive work. You'll find that it is easy to get distracted whenever you come in as a leader. Team members get distracted with the new and shiny things, or with things they've always done. But what you really have to do is peel back the layers and ask yourself, "Okay, what's the real work that needs to happen here to change attitudes, beliefs, and behaviors, to move the organization forward?" And that advice I've held onto and applied it in every job I’ve ever held. It keeps coming up over and over again, because most organizations – I won't say all leaders, but a lot of leaders avoid the adaptive work. They tend to do the easy thing, the low-hanging fruit – that’s good if you want to achieve a couple of quick successes, but in the end, the leader is there to identify the adaptive work and move the organization in a direction that it wouldn't normally move on its own.
Q. Could you please describe your leadership style and talk about a difficult decision you had to make as a leader?
A. I would describe my leadership style as collaborative. If the leader's job is to identify the adaptive work that needs to happen, in order to do that, you need other leaders on your team to work alongside you. So, I reach out to folks who could be partners in helping me identify how to drive the work forward, how to support the change management, how to deal with the financial issues, how to deal with personnel issues, etc. It's very much a collaborative style, which, again, came out of the Fellowship.
In terms of a tough decision I had to make – when a leader comes into a role, you often spend the initial six months to a year just listening and learning about the system and the programs and activities. But it gives you a sense of where the work needs to go. Where are some of the challenges? What are things team members are NOT talking about? And what are the things you have to stop doing? And so, one of the bigger challenges – which I've run into several times, but most recently had to address here – was changing the direction of our Equity, Diversity, and Inclusion (EDI) training for our corporate executive team, reassessing where it was going, transitioning to a new consultant to help us on that path, and then restarting that work all over again, which is now doing extremely well. One of the most critical pieces of driving EDI work is that you've got to get the leadership all on the same page. "Leadership" meaning not just the CEO, but the C-Suite leaders (e.g. CFO, General Counsel, Chief Operating Officer, Chief Nursing Officer, Chief Medical Officer, etc.). This training was critical, because I needed to get them all on the same page to drive the work through the whole system. Having to make that transition from an old consultant to a new one to really align the strategic direction of the organization, I think, was a tough but important decision.
Another challenging issue I’ve faced several times is wanting to drive a particular activity or an issue related to health disparities when the timing is not right politically or the resources aren’t there initially. You see an issue that you know needs to be addressed and you have to put it on the side burner until, as John McDonough used to say, "that window of opportunity opens up," and then you can try to push it forward. That’s what I faced in South Florida when I was trying to advance climate change and health – not a place, politically speaking, that embraced the idea at all. We tried to advance it, but we had to put it on the side until, hopefully, the political climate changed a little. Sometimes you have to make a hard decision when something’s the right thing to do, but it's not necessarily the best time, or the support isn’t there, and you just have to wait.
Q. What are the biggest barriers that you see for leaders advancing health equity?
A. Among the biggest barriers for leaders driving health equity, one is being able to understand and use data to decide where to focus efforts to improve health inequalities.
I have a sticky note on my desk with three skills written on it that a leader needs to have. The first is leading organizational and institutional change, which is essentially change management. The second is understanding and navigating political dynamics. When you step into a job, there's always politics, and you have to learn and navigate those dynamics. For me, that’s within the whole University of Maryland School, within the state, within the broader health care environment. To be able to navigate those political dynamics is so, so important. And I find a lot of leaders lack this ability and simply ignore or retreat from these dynamics. I mean, they're excellent with finance, excellent with managing – you know, the achieving of key benchmarks, but they're sometimes clueless around the politics and the relational aspects of getting the work done. And then the third, which I broadly call, "leveraging and wielding power" – each of us brings to the table a certain amount of influence and power. Some of it comes from our network, some of it comes from our knowledge – like if you're a clinician or a researcher – and some of it may be from prior roles. But learning that you come to the decision-making table with this power, and then leveraging it to move things forward, this is how you can effectuate change.
A lot of times, leaders either underestimate the power that they have or don't even know that they have it. Opportunities may go by where they could have moved things in a certain direction, but they felt like, "Well, I don't have any influence on that." It’s a subtle skill, but as you get further along in your career, it becomes more and more visible what that power is, and it’s then that the skill to be able to leverage and wield it becomes even more important. And we have former Fellows now with a huge amount of influence. Their sphere of influence is massive compared to when we were in the Fellowship. It's important that as we continue to grow, we understand how big that sphere is and how to partner with each other.
Q. When you're in a situation where stakeholders don't share your values regarding health equity or social justice, how have you been able to move the needle to seek the outcomes that you're after?
A. Well, I'll be honest. I've gotten to the point where I don't really care if they share my values. What I need them to do is “turn the page”, as Joan would say. I need them to work with me to move the work forward whether their values align with mine or not. And that means aligning the health equity work with what's in it for them.
So, if, for example, you're on the finance side, you're worried about overspending and the minimal profit margin for the hospital this year. I don't come to you to talk about infant mortality and the number of deaths; what I will do is look at that disparity data, and then I'll translate it into what will be important for you, which is finance. And then I'll make the case to you, for example, this way: "Look, if you get behind this with me, this will actually save us X amount of dollars over the next five to 10 years, and fiscally put us in a much better place than where we are now, where we're not doing anything about it." So, I’ve found that to get people to move with you, you need to create a narrative in a language that they understand and so they can see what's in it for them.
I think we're getting a little better with making that case around equity. But, you know, earlier, in the 90s and 2000s, the pitch was always around: "It's the right thing to do," and: "people are dying"—primarily making the case that it’s a moral imperative. That's a very important way to frame it. But in the end, when you're trying to get people to do something different—and they’re not caring for patients but they’re the bean-counter or the frontline registration person—and they don't get it, then you have to make the case around equity by “connecting the dots” to what it is that they do. Get them to see what their stake is in the work.
Q. How would you say that your personal narrative and your past experiences have influenced your career progression?
A. My personal experiences caring for elderly parents and caring for kids with educational needs really reshaped my goals of what I thought I would be. To be honest, it was a real tension for me between my ambitions and balancing the needs of my family. If you see a role that you want to do and that you see your colleagues doing – you may be well equipped to do it, but you're not able to based on your own life circumstances – that creates a tension. It makes it hard to hold yourself back until the timing is right for your family. So that shaped what roles that I did, because I ended up taking roles that allowed me flexibility to attend to the needs of my family. But it also was a personal challenge – an internal struggle to wait until I addressed the priorities of my family before my professional goals.
Earlier in my life, my dad was a physician in inner-city New York, with my mom. They had a small medical practice in underserved Brooklyn, NY. That grounding, working with my parents, helping people not just with health care but educational things, etc., really gave me a solid foundation regarding what it takes to help improve the well-being of communities of color. My whole career has been building on those experiences that I had as a child with my parents.
Fast forward to last year. My father passed away last February. And it was a time when I had just done a virtual interview for my current job, SVP, Chief Equity Diversity and Inclusion Officer. I was about to start my second-round interviews, but my father passed away. I took some time to reflect on his life and my mom's life and their work in terms of being on that front line of supporting communities through their office. And it brought me back to what I felt I was being called to – being in an institution like a health system to be on that front line, improving the quality of care for communities of color. And so, it was on the heels of the bereavement of my dad that I came here for my second interview. And once I got a chance to meet the people here and see their passion and commitment, it reconnected me to my father's work. And that really was the deciding factor for me: "Okay, this is the right place for me to be."
Q. How do mentors play a role in your present life? And how have those mentoring relationships developed over time?
A. Mentors have played a critical role all along my career. I don't think I've ever made any major career decision without talking to at least two, maybe three mentors along the way. Even this job. But also, mentors have played a really big role in helping me identify opportunities that I didn't necessarily see – suggesting that I sit on a board or that I consider being part of some committee. I have at least half a dozen, maybe a dozen mentors in all different areas, fields, and sectors who have played a very important part in helping me stay connected to the work, make decisions on career opportunities, and think about how to balance work and life. So many people have been really helpful – not necessarily giving me the answers but giving me a space to think through it with them. It's always been my decision, but it's never been a decision I've made by myself.
Interview date: September 2022
