Healthcare Equity with Geoffrey M. Roche

angela_r_howard (00:01.915)

HFRE, welcome to the podcast. It's good to have you on.

geoffrey_m__roche (00:04.37)

Thank you so much, Angela, for having me.

angela_r_howard (00:07.267)

Yes. And go ahead and tell the audience who you are. Give us a little background, a little bit of story, because I know we've talked about your background and your family and your mom in particular, and being a great inspiration to some of the work you do today. But also what you do and the impact you're looking to make on the world.

geoffrey_m__roche (00:26.55)

Sure. Yeah, so again, thanks for having me here. And it's truly a privilege to talk about social responsibility at work and really how it's been an important aspect of not only who I am, but the work that I've always been privileged to be a part of. So I'm the son of a nurse and I always tell people I'm incredibly proud of not only the work that my mother has always done, but as a young child was always really just amazed she would come home, she was a labor and delivery

school and high school, different colleagues and colleagues, students of mine, and friends of mine would share how my mother would deliver some of their siblings and stuff like that. And so I learned a lot about service and a lot about my mother's passion and commitment to really helping others was a major threat to my entire childhood. And I always say I talk a lot about my mom. My father, who I lost a few years ago,

was a Union carpenter. And so very, very different. Knew I was never going to go that way. Knew I was never really good with my hands from a technical end. My brother had that opportunity. I didn't. But my father always was the type that would always talk to us about really that determination and passion to do whatever you do, do it well. And so between both of my parents, that aspect was threaded in me at a very young age. And I knew I didn't

geoffrey_m__roche (01:56.55)

college senior had the opportunity to do an entire semester where I interned with a healthcare system. And there's that experience that opened my eyes that I could be in an administrative role where I could focus on leadership, which was always an important part of who I am. Always have loved studying leadership, practicing leadership, and leveraging leadership to impact not only the world but also others. And so that's really what led me into healthcare.

geoffrey_m__roche (02:26.91)

What do I want to impact there's you know, there's several things that I want to impact and for those that you know follow me on LinkedIn, you'll see I go by the name Heart Leader and You know, there's a reason there I'm a firm believer that if we have more leaders who lead with our heart We can not only better connect with others and form meaningful Relationships that are built on trust and on the foundation that we're here to serve one another

geoffrey_m__roche (02:56.71)

a society where it's critical. And so, you know, I want to impact not only the country, but the world, that if we lead with our heart, we can truly create a very different model of the workplace, and create a very different model of building community. And so I desire to build community in whatever facet of situation I'm ever in.

angela_r_howard (03:24.267)

I love that. We talked earlier about the intersection between some of your work with healthcare and healthcare equity and also the system of the workplace and how this idea of building community or serving the community in both aspects, right? So whether you're serving your, your, your community and the healthcare system or at the workplace, we're kind of talking about the same process.

angela_r_howard (03:54.187)

to that and saying like, what does that mean? And like, what's the state of it and what's the problem we're trying to solve? So I would love to hear more from you on that.

geoffrey_m__roche (04:01.89)

Yeah. So, you know, I mean, when I look at an issue like health equity, in my experience, what it has meant is that we have to be honest within our health care system that some systemic, long-known issues have significantly impacted various individuals and communities, not just in the United States, but across the country. And so within our health care system, whether it's whether it's, you know, you take

mortality, which to this day, to think that the United States has one of the worst outcomes for black moms, African American moms, who simply have a child, but because of their genetics, because of our healthcare system not being as advanced as it should be to meet their needs, the fact that in our healthcare system, I mean, if you look at examples after examples,

geoffrey_m__roche (05:01.95)

William dealt with some maternal issues when she was pregnant, she raised those concerns and doctors doubted her, and she almost lost the baby that she carried for that period. Well, that speaks to health equity because ultimately what we're speaking to here is that the same mom who could happen to be white, white privileged, potentially would have a much, much, not only, is almost guaranteed nine times out of ten statistically do not have

the issue for there. One is we haven't created an equitable system. Two, we haven't created the right providers coached them prepared them, and educated and trained them to understand what it's like to meet the needs of different populations of patients. And for me, as a healthcare leader, to think in 2023, we are still not there, is quite frustrating.

have a system that, in my view, has just been systemically designed to do exactly what it's doing, and we haven't made the changes to systemically update it. And so we have to do that because literally, lives are at stake. And we know that because of some of these issues, you know, we have cardiologists and we have endocrinologists and we have a whole host of specialists who've

geoffrey_m__roche (06:32.09)

populations and what it's like to create treatment protocols that meet the needs of those distinct patients because they've been systemically just designed to meet the needs of one distinct patient. And so we have to be honest about these types of situations if we're ever going to move the needle in issues of health equity.

angela_r_howard (06:51.887)

Yeah, and I want to take a step back on even the word equity because there's a lot of confusion around it and what it means. And so the example that you mentioned, and what I like to provide some perspective on to define equity is, you know, equity is about equal outcomes, equal outcomes.

angela_r_howard (07:21.667)

for everybody and when we have systemic barriers or structures in place that do not serve everybody, we don't end up with the same outcomes. We have disparate outcomes. So some people are benefiting or getting those successful outcomes and some aren't. And there's something in the system that's creating that. And so, I've worked with healthcare clients before around culture. And every time that we talk about culture,

we serve and equity is always a part of that conversation. But what I find and I don't know if you experience the same thing because you're I guess more in the day to day when it comes to this when it comes to health care and health equity outcomes is there is a perception of you know equity-like nothing's wrong with the system right like we're just doing our

angela_r_howard (08:21.867)

folks in the healthcare system. So how can you move and progress forward if we're also working under unsustainable conditions? So I would love to hear that angle as well and how that interacts.

geoffrey_m__roche (08:34.55)

Yeah. Well, you know, there's a lot to unpack there and you are 100% right in that there's still so many people who say, oh, come on, you know, this really, this is just a, you know, a made out thing. But the reality of it is, is if you go story by story, fact by fact, data by data, we see it all the time. And some phenomenal voices in our healthcare system have been leading and speaking to this authentically.

geoffrey_m__roche (09:05.31)

who leads some incredible population health and health equity work at Common Spirit Health. And Dr. Jackson shares publicly her own story of how she almost similar to Serena had a situation in one of her pregnancies that was similar. And Dr. Jackson is a black woman, who happens to be a physician. And again, was doubted by other medical professionals and she's a physician. And so, yes, there's still a lot of naysayers

when it comes to this, but let me say that when you look at our healthcare system, we've made some strides, not going sit here and say that. We have some systems doing phenomenal work, just like anything, some do better than others. But we have to systemically be willing to call the shots for what the shots are. The facts are the facts, and we have to be willing to look at how we move that needle. And one way to move that needle is to truly authentically engage the communities that can help us understand

before. And I will always say that in our healthcare system, while I appreciate all doctors, all providers, and all clinicians, one of the ways that we can do a better job is to truly engage the communities we serve and let them tell us what we need to do differently. And when we do that, we see true change, true meaningful results. Now to your second point, how do you do that at a time when you're dealing with the workforce crisis? And let me just

geoffrey_m__roche (10:35.15)

you're still on the front lines at a very, very difficult time. But we also have to address the culture, because we knew this workforce crisis was real before the pandemic. It's only been further exacerbated during the pandemic. But the fact of the matter is the data and their reality was demonstrated before the pandemic. So the reason now we're all sitting here raising the flag and saying, oh my gosh, we're in crisis. And you still have people who don't want to call it a crisis, first of all, but it is a crisis.

have enough nurses today and it's only going to get worse by 2025. We don't have enough doctors, nurse practitioners, and physician assistants today only going to get worse by 2025. And we're still not even speaking about the leadership crisis we have in healthcare, where a majority of our C-suite is about to have a significant explosion at the retirement level and we don't have succession planning. And so we're at a really difficult spot when we talk about

in health care. And so there's a couple of things I think that are critical. A, we've got to have stronger authentic academic partnerships. We can't just view it as a degree to completion, come and get, you know, come and serve, get trained, etc. We have to view it as how do we create authentic partnerships that start even earlier than college, high school, middle school, and K through 12, we've got to engage the youth to understand that health care is a special place to serve. One of the ways

If you create a system that's more equitable and you give people opportunities in the education system, to your point, which you alluded to earlier, we know education is also not equitable. So how do we sit here and expect to diversify the workforce? If we have a system just like healthcare, that's been designed in an inequitable manner. And so we've got to fix that too. We've got to have a system that allows everyone the opportunity to be educated. And if they want to become a doctor,

a barrier. If they want to become a nurse, there's not a barrier. If they want to become a respiratory therapist, there's not barrier. And there are too many barriers. And so, you know, there's a lot of things like that that we have to fix or we're only going to continue to be in the situation that we're in today.

angela_r_howard (12:51.927)

So I always would hear this connection between the different systems that we operate in. So, you know, I always think about education, healthcare, the workplace, the economy, and transportation. These are all systems that are like interconnected fibers. And equity is always a factor that is a dependency to enter the next system, to your point.

geoffrey_m__roche (12:53.05)

Thank you.

angela_r_howard (13:21.867)

here into the workplace. Is there anybody connecting those dots? Like, how can one think about this as a broader system and work between these systems to make this?

geoffrey_m__roche (13:37.33)

Yeah, so in my day job, my organization, Core Education, certainly is the type of organization that's without question doing aspects of connecting the dots. Because we, so we work across the country as an operating partner to over a dozen small to mid-sized colleges and universities. And one of the things we do is work on the partnership space of bringing together healthcare and other industries to not only foster that meaningful collaboration

with the healthcare industry, but focus on that workforce space. Look at what it is to have pathways, and what it is to create authentic, meaningful solutions that can drive the future of work. So organizations are doing that, but as you know, higher ed, like healthcare, are two industries that have historically not been known for a whole lot of transformation.

geoffrey_m__roche (14:36.55)

in both, but when push comes to shove, they are not designed for authentic innovation and transformation. And you see it now, you know, in healthcare is facing some of the biggest challenges they've ever faced, and you know, even the larger systems that have innovation hubs are not doing anything with them because now the budget's not there. Well, you can't ever think you're gonna fix something if you take that idea of, you know, there's no budget, because the reality of it is,

very few margins to go around to innovate anyway. You've got to always be thinking anew and using whatever you can to be different and just try it out. And I think part of it is higher ed and healthcare are also just super regulated and I get that and they should be because we're dealing with people's lives and quality, patient safety and we're also dealing with education which needs to also be regulated because there's a lot of data there.

geoffrey_m__roche (15:36.37)

risks and try things differently in both industries. And again, that's been my experience having served and worked in both. But I think we have to do very differently today we have to recognize that the times are very different and they're only going to get even more different. If there's one element of this that I always talk about that I think is important is that we have more generations in the workplace today than ever. But instead of celebrating it and finding what

every one of those generations can bring a solution, we wanna dismiss them. We wanna talk about the fact, I'm a millennial. We wanna say, oh, millennials aren't gonna be here. Long they're gonna be moving on one year and then they're on. That's not the discussion at hand. The discussion and Steve Cadigan has written a great book. If you don't know Steve, Steve is the first human resource officer at LinkedIn. Great guy. And I don't know if you've read Workquake, but I haven't finished it, but I'm loving Workquake.

in the book why aren't we just recognizing that the future is not going to be people sitting at the same organization for so long, especially when the culture is terrible? They will move on. Why are we still saying we don't want to invest in them because we're afraid they're going to move on from an education perspective? Guess what? They're going to move on either way. Invest in them. Get what you can get out of them. Have them be the best employee. Have them contribute most effectively. And maybe if you have the right culture, they won't move on.

You know, I think we have a lot of work to do to create a future of work that to your point is not only socially responsible. And I will say part of that is in both healthcare and higher ed, we need to go back to the basics. Both institutions at the core are anchor institutions. They're anchors in their community. That means you have a duty and a responsibility to take care of your community. Education has a duty, healthcare has a duty.

geoffrey_m__roche (17:36.61)

at these organizations have to reflect on whether they're contributing to that aspect. I would sit here and say that I don't feel many or a majority of them could honestly authentically say that's the case. And if they do, happy to have that debate, but the fact of the matter is we've got to get back to truly being an anchor institution partner in the communities that we serve.

angela_r_howard (18:01.527)

Yeah, and this goes into leadership, which I think is an important facet. And actually, it's the one thing that I feel crosses over all of these systems. So that was, you know, kind of what I was getting at with, you know, what is, what is the, what is the solution and leadership regardless of if it's in the healthcare sector or it's within the workplace, within a healthcare sector or anywhere else or within the community. You know, I talk about something called the leadership mentality, which is to

angela_r_howard (18:31.647)

And I think we just have it wrong. I think we've just developed this construct of leadership, especially in this country, that is not focused on serving. It's on self-serving. And that's detrimental to things like equity and social impact. So tell me a little bit more about your philosophy around how leadership could be this lever for change.

geoffrey_m__roche (18:52.27)

Yeah. So, you know, like you, I agree with you wholeheartedly. And I always tell people that I'm blessed and fortunate that I had so many amazing leaders earlier in my career. As I have matured further in my career, I have not necessarily been seen as a great leader. And it's helped me not only navigate those uncharted territories at times,

be that beacon to help others who are facing that. And I'll tell you just a little example of what became my leadership mentality. When I was early on in my healthcare career, I was extremely blessed to serve with a CEO, a nurse CEO who also happened to be a woman CEO, at a system where she faced a lot of challenges as not only a nurse CEO but also a woman CEO. And I was fortunate

not only be mentored by her but to be taken under her wings and shepherded through not only the learning process of what it was like to become a hospital CEO but more importantly, what it was like to lead others. And what I saw in my former CEO was this authentic commitment to never forget where she came from. Was a nurse, would put on nurse scrubs, would go work those

When it was a surge she was on the floor when times were tough. She was there speaking to them and She didn't ever lose that and that's what people saw in the community to people saw a CEO Who didn't sit in an ivory tower? Wasn't making decisions from afar but was making decisions with the community that she served and so from a leadership mentality Having that experience was without question transformational for me

to see an authentic leader. I had the opportunity to see a leader who loved to serve. And so for me, I can remember if there's been one thread that's always stuck with me through all my experiences and journeys and leadership. It has been that I view leadership as a true blessing. I do not view it as a job. I view it as a vocation.

geoffrey_m__roche (21:22.47)

of others, but you've got to constantly maintain the trust of others. And I think we often forget that. I have worked with leaders throughout my career and even to this very day I don't truly understand what a blessing leadership truly is. And every day for me, I look at it from the vantage point of, I'm in a position of leadership to change lives. I'm in a position of

geoffrey_m__roche (21:52.37)

willing and able to acknowledge that. And I have to have humility at all times to make sure that not only does my team, our team, but more importantly, everyone who sees us sees someone who's modeling the way. And the other aspect I would say to my mentality has been, I also view leadership as that that role to question things, to get into good trouble, because a leader is not going to be afraid of that. And there are colleagues of mine to this day who say, oh my gosh, you

Well, the reality of it is that I learned from my CEO, you know what you do the right thing when people aren't watching but you continue to do the right thing when they're listening and they're watching and I have learned that Authentic leaders who truly care are not going to be afraid to shy away from from challenging the status quo Even if it means they're challenging their boss

geoffrey_m__roche (22:52.27)

Nothing more important than a leader could do. And I had a recent example where members of my team said, wow, I'm surprised you did that. And I said I did it for you. And they said, well, clearly you did because you put a lot on the line. And they said we can't thank you enough. And I said I don't need to be thanked. That's my job. That's my job. I'm accountable to them and for them. Yes, I may be the leader. The buck does stop here. But I think too often, we as leaders want to just pass the buck.

to own it and so I've been fortunate to have leaders that said no you own it. Leadership is about owning and so you know that's a little bit of my mentality but to your point the last point I do want to make that I think is important is I always tell people the first letter of leadership is L for a reason it's about listening and learning and so to me every day is another opportunity for me to listen and another opportunity for me to learn and I have always said to any team that I lead

geoffrey_m__roche (23:52.83)

I am not here to be viewed as a boss. I am not here to be viewed as a manager. I can't stand both of those words. I'm here to be walking with you on this journey. I'm here to help and I'm here as a resource. And if I'm ever in the way, you have the right to respectfully request that I get out of the way. Because ultimately, if I'm here to walk alongside you, I'm here to be your partner. I'm not here to be anything different than to be your partner.

angela_r_howard (24:23.247)

I love that. And I think it just, it gets back to your, you know, heart leadership that you mentioned, which is so important for this conversation around equity because it is a mentality that is important to drive outcomes for people rather than this kind of again, the self-serving mentality that I think, I think we've developed over time has become a paradigm for leadership and it's seeped into the construct of how we define leadership.

So I'm so happy you're a part of the movement to change that conversation. And I think it's really important to this conversation around creating equity because it takes humility. It takes a sense of serving to bring communities together to listen to them, to step into their shoes, both from a health outcomes and equity perspective, but also equity, creating that within organizations with your people. And we could talk about this all-day

to dig into, which is usually the case when I want to talk to my guests. But I want to thank you for taking the time with us today. Thank you for sharing your perspective. And I just really love your perspective on how these different systems connect. And that's really what this podcast is about. This is about the workplace. But the social responsibility element of this is

angela_r_howard (25:53.327)

about. And so thank you for sharing your knowledge. If people wanted to reach out, if they wanted to work with you or work alongside you, how could they find you?

geoffrey_m__roche (26:03.354)

Yeah, the best would be on LinkedIn if they just look for my name, Jeffrey M. Roach. Happy to connect and happy to talk at any time with anybody.

angela_r_howard (26:11.827)

Wonderful. We'll make sure to put all that in the show notes. And when we market this episode, Jeffrey, thank you so much. Truly. It was a pleasure to have you on the podcast.

geoffrey_m__roche (26:20.37)

Thank you for having me and thank you for all the work that you do.