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Rural health care in the age of CVS and Walmart: An interview with Marshfield Clinic CEO Susan Turney

Health Evolution | November 26, 2019

When Susan Turney was in kindergarten a teacher told her that girls cannot be doctors. Not only did Turney prove her wrong by becoming a physician but she also went on to be a veteran CEO, serving as the head of MGMA and presently at Marshfield Clinic.

After beginning her medical career as a practicing internist at Marshfield, Turney stepped into chief executive posts at the Wisconsin Medical Society and then MGMA before returning to Marshfield as its CEO.

Health Evolution Editor-in-Chief Tom Sullivan spoke with Turney about the threat retail clinics, CVS and Walmart pose to rural providers, her career journey, the best and worst leadership advice she ever received, as well as the biggest career risk she has ever taken and how it paid off in the long run.

Health Evolution: Having been a CEO at multiple organizations, what fuels your work? What’s your professional passion and how does it shape your role as top management?

Turney: As I advanced in my career I always went back to my roots. It’s always stuck with me that we can’t forget our rural communities. The thing that worries me a lot is that rural hospitals are closing. At MGMA I worked with groups of every size and that gave me a deep perspective of the health care landscape and helped solidify in my mind the difference I could make for communities where my heart has always been.

Health Evolution: And is that what inspired your return to Marshfield? 

Turney: Rural health care is different. We’re in many communities where we’re the only provider. People would have to travel hundreds of miles if we weren’t there. I have a deep respect for the people in rural areas so it was an easy decision for me to come back as CEO of Marshfield to serve our community — it really is a core passion.

Health Evolution: What’s the biggest threat to rural health care? Retail clinics? CVS-Aetna? Walmart? 

Turney: The short answer is yes. National chains are going to go where the people are. We aren’t in metro areas where there’s a CVS on every corner. Walmart is in every community and other national brands have a large presence in our communities. But when you have 2,000 customers walk through your doors every day, buying groceries, over the counter medications, prescriptions, you really have an opportunity to manage the health of that community — we want to be in health as much as health care. So, in some ways, the competition has changed but we have the providers and are well-established in our communities, in the fabric of our communities. We can’t do business as usual. We have to change and we are.

Health Evolution: What is the best piece of leadership advice you received? The worst?

Turney: The best is to lead with your heart. I know it sounds nice and might not make business sense but when you focus on the communities it is a recipe for success that benefits the patients and staff and empowers the people around you. The worst piece of advice I got was in kindergarten when my teacher told me girls couldn’t be doctors — I actually ended up taking care of my kindergarten teacher at the end of her life.

Health Evolution: Reflecting on having broken through the glass ceiling, how has that shaped you as a leader?

Turney: I always lead with the philosophy of doing what I think is right and acting with integrity. We’re creating a culture of yes — empowering our staff to do their job, use common sense. It’s not always easy but I’m proud that we’ve been able to build that culture. And then there’s the economic impact. Many communities would be devastated if our clinic was lost because people rely on us for health care but also for the impact we have on the community.

[Watch: Susan Turney and others share personal stories and career experiences at the Health Evolution Summit 2019.]

Health Evolution: What is the biggest risk you’ve ever taken and how did it payoff? 

Turney: There are a lot of risky things you do as CEO. You have to be bold and aggressive. I really like patient care and enjoyed the intimacy of the relationship I had with my patients. The hardest decision was to leave that day-to-day practice of medicine. I practiced for over 20 years — that was a departure of what I’d known for more than 2 decades — but there’s payoff, the experience at MGMA and the Society enabled me to come back to Marshfield as CEO.

Health Evolution: Let’s look ahead just a bit. When building a strategy for three to five years into the future, what are your top priorities? 

Turney: There’s the ‘what’s possible’ and then all the changes happening in our world today among payers and plans and delivery models and disruption. But in the short-term future, the top priority is becoming a fully integrated health system. We’re growing in the acute care space — we’ve been an ambulatory provider — so we’ve recently been building the infrastructure for an integrated system. How can we realize the promise of a fully integrated health system? More efficient, better coordinated care that will give us the ability to impact the cost of care.

Resource stewardship is another priority. Having been ambulatory, we know we have to manage resources to operate as efficiently as possible. Now that we have the system, we have more clinical care and a health plan.

Another priority is patient experience and it’s not just about patients and their perspective. It’s really the entire experience of those who seek care, provide care, partner with public health — it’s really about making it easier for people to navigate the system, expanding access to care and having the whole experience be friendly. That sounds sort of simple but it’s true. Care is daunting. We’re extremely proud of our services but know we can do better.

Health Evolution: When you say you can do better, what are you striving for? 

Turney: A simple way for me to look at is having patients and caregivers get care how, where and when they want it. A lot of our efforts have been focused on that. We have a center that does community health advancement, substance abuse, chronic disease, mental health, social determinants of health, to expand outside of our four walls. We know if we don’t do things differently, our competitors will and they’re not just our competitors of the past. It’s all the other disruptors, the national payer strategies, national pharmaceutical strategies. We have to be vigilant and very smart about how we change.

About the Author

Health Evolution, Staff Writer