“I was a full scholarship student at Dartmouth. My father was disabled when I was twelve years old. We had four kids. He was very clear that a requirement for going to college meant a full scholarship, and Dartmouth gave me a full scholarship. I mean, in a time that I don’t think a lot of students had full scholarships. I always wondered about how we would get back. Like any alumni, I gave to the campaigns in a modest way, but I felt like I would like to make sure that people that came from a situation that I came from would have the same opportunities. My whole family is really interested in kind of, if you have merit, can we give you the opportunities so you can actually achieve what you want to achieve? And it felt like this was absolutely a full circle that as leading the health system, which is a critically important part of the community up here, it allowed me to actually give back to the community that had been just a wonderful place for me to learn to be not only an adult, but also a leader. You’re fortunate if in life you can actually complete that circle. So I’m living a dream up here.” 

“[Dartmouth is the] most rural academic medical center in the country. So we sit on 100 acres here, and you actually can’t see us from the highway. But you drive down one of two roads and all of a sudden it emerges kind of like the Emerald City out of the woods, number one. Number two, very few people appreciate that the positive impact on a community that has an academic medical center, meaning a lot of people that have decided to retire in the Upper Valley come here because of health care. You don’t appreciate it until you get older, but health care is really important and access to health care is really important, high-quality health care. And I appreciate that. We are both a safety net. People come to us with their problems. We’re an economic driver. Between Dartmouth Health and Dartmouth College, we employ the vast majority of the people in the Upper Valley. You are there at the beginning and end of many of their families lives and you become actually a known figure in the community. So everywhere else where I’ve been, I’ve had this level of anonymity that I could go into a grocery store with my jeans ripped on and a t-shirt and nobody would know who I was. Not up here. And we do solve world problems in aisle three of the local food store called the Co-op. I mean, that is the sense of community. I was at a town meeting last night talking about affordable housing for three hours sitting with 150 of my best friends. But you’re recognizable; with that recognition also becomes a level of responsibility to think more broadly about what’s going on within the walls of the institution and think about the broader community. So we’re into affordable housing and what do we do about childcare for the community and what do we do about transportation across the region.”  

“I do talk to a lot of medical students about how we as physicians are kind of a patchwork quilt of the experiences we’ve had with our patients. And patients and situations affect us and they make us who we are. You’re a little bit unformed, really, as a medical student and as an intern. And you start to form who you are as a physician as you kind of move through both the education and the process of achieving mastery in your specialty. And you become a physician, you’re not born one, you’re not trained to be one, you become one because of the experiences you have.  

I remember when I was an intern, this woman from Orangeburg, South Carolina, had a really horrible respiratory infection and was in one of our medical intensive care units. I was an intern. I remember doing her intake and talking to her. She was a really simple, but just genuine, wonderful woman. I can see her now with her white hair that was pulled back in a bun. And it’s interesting that every day I would come and talk to her and I’d hold her hand and we’d talk about how she was doing. But her infection was rapidly progressing, and she had to be intubated on a ventilator. But I would come by her bed and she would squeeze my hand, but she knew that I was there. I do remember she actually became unresponsive. This is what happens a lot of times when people are horribly sick. They felt that there was no hope of her actually ever getting off the ventilator and surviving. The process is to remove somebody from the ventilator in the most supportive way possible. And she didn’t feel any pain. But it’s interesting. I think we sometimes teach people in medicine to be tough. So the minute the team made the decision, everybody marched out of the room. But I stayed there. I stayed there until her heartbeat stopped, holding her hand. It reminded me that we actually need to be present. I mean, you need to record the passing of somebody. There was no family there. You can’t let that go. And you can’t just kind of say, ‘Well, business as usual.’ I think you do a disservice.  

I have this concept of how feelings and consciousness, it’s like a square in a round sphere. And every time something happens, that square turns and the edges rub against the sphere. They’re not bad feelings. They’re just feelings you need to acknowledge. It is moments like that you kind of say, ‘Oh, that hurts,’ but you need to appreciate it. And I would then teach residents in the operating room when a patient died—despite our best efforts not to just turn away and say, ‘Well, my job is done,’ and turn off the monitor—to appreciate what had happened and that person’s life. Just make sure that it becomes part of your patchwork of your quilt, because it makes you a better physician. Those are the things that I’m not sure you can read in a book. You need a mentor that’s going to say, ‘Experience this. Don’t try to stuff it. Just experience it and appreciate it.’ … If you don’t acknowledge it, the edges start to rub off and you become a sphere, rotating in a sphere, and you don’t feel anything anymore.” 

“What we encourage our leaders to do is actually do huddles before and after every shift. So the before one is kind of: ‘What’s going on? What are the issues? How can we help each other?’ The after is: ‘What are people leaving with?’ Because if they have any concerns or issues, you don’t want them to go home with that. You want them to actually leave at their work and you want to create an opportunity for them to talk about that, if we can create solutions right there. What you want is that employee to go home not worried about, ‘I didn’t do everything I wanted to do for that patient. I feel like I didn’t do my job.’ I don’t want anybody to walk home with that feeling. So we’re training leaders to do these kind of, they’re really important, beginning and end of shift huddles, and they don’t have to take that long. They could take fifteen minutes, but it’s just checking in to make sure that people aren’t leaving with some burden . . . it’s far better if they actually unload it at work.”  

“As I have kind of matured as a leader, I realize that not every decision needs to be made right away. And sometimes there’s real benefit to letting a problem roll around your brain. I’m a big believer in sleep, by the way—that your brain does organize your thinking while you’re sleeping. Sleep is super important, and if you don’t get enough sleep, I used to think, ‘Oh, I’m an anesthesiologist, I can live on five hours sleep a night.’ It’s not true. Your cerebral spinal fluid actually cleans your cells when you’re asleep, and it organizes a lot of the things that you’re thinking about. So ‘sleeping on it’ is actually a very good tactic. And you’ll find that your brain is kind of organized a little bit differently when you wake up. And sometimes a solution that you didn’t actually see before is immediately apparent, first of all. Second of all, there is timing and opportunity about when you want to bring up a tough conversation, and sometimes we get into trouble when we try to force it. We kind of have our own timeline of, ‘I’ve got to have this conversation by X time.’ I spend a lot of time actually looking for opportunities. Even when I’m in a disagreement with somebody, I have this mantra: Don’t get mad. Because when you get angry, you stop listening, and you’re missing an opportunity to actually change the direction of the debate. And so you need to always be kind of that positive listening for that opportunity. I’ve become a lot more deft in when I introduce difficult topics . . . I’ve started to really be very thoughtful about how I bring up difficult topics, and that’s both when I mentor people, when I’m working with my executive team, when I’m working with a physician group—there is some benefit in understanding the importance of timing and opportunity.”  

“In 2011, I was invited to go to this retreat. . . . When I attended this leadership retreat, it was really more self-reflective. I was the only person in health care there. The focus of the retreat was: Now that you’re at an influential time in your career, how are you going to use that influence in the most positive way? And how are you actually thinking about your future in a way that you’re not bringing your present and your past forward to hold you back? How do you kind of think into a different future? And I thought, ‘That is really a different way of looking at this.’ One thing that impressed me is this group of women. Within two hours, everybody was sharing personal information that they probably didn’t share with their partner. That was very personal. Personal and professional-personal. I was like, ‘Wow, there’s a real need for this.’ So actually, at the end of the retreat, you had to kind of make a statement that was called a ‘legacy statement,’ but just basically put a stake in the ground in what you were going to do. And I said, ‘I’m a public figure. I need to push the conversation forward about: How do we create a healthcare system that actually works for patients and providers? Because our current system probably doesn’t work.’ That’s a very complicated problem. But I used it in my speaking platform because I spoke a lot nationally. Make sure that we didn’t forget that that’s why we’re all here, is to make this system work better for everybody we serve. But I realized that there were probably a lot of other women in health care that felt the same way. And I said, ‘Well, how could I bring them together?’ And I applied for a grant at the Robert Wood Johnson Foundation, and they gave us $95,000. And we convened the first group in 2013, which was called Women of Impact. And it was funny. There were twenty-three of us, and they laughed because they said we were all friends of Joanne’s, friends of Joanne’s relatives, friends of Joanne’s friends, or we met Joanne in a cab. But I brought this group of women together. We have now been together almost ten years, and we’ve got over 150 women. We don’t want to necessarily be a big group, but we want to create a space where we’re going to elevate women leaders, because we realize that in order to really change health care, we don’t have enough women leaders. And frankly, if we’re going on a current trajectory, it’ll take 100 years till we have parity in the C -suite. So we need to accelerate that.”  

“I really love the aspect of my job that gives you kind of personal connection to people. Like, I did some night nurse rounding for Nurses Month, and I did that on Monday night. And it’s much better to have meaningful conversations with six people over an hour and a half than it is to give ice cream sandwiches to 150 people. It’s just appreciating that time with that person and not rushing on to the next kind of unit that you have to give snacks to. I think we could do with a lot more of that. Less ‘rush, rush,’ and more being kind of present and appreciative of individuals.” 

“I actually went and had an eye exam [with] this young optometrist who just had her first child, [had] been out on maternity leave and was back. She loved her job and was so appreciative of the support and infrastructure. We talked a lot about childcare, which gave me a lot of really good feedback about how we could improve our childcare access. And I’m going to write her a note thanking her afterwards, just appreciating the fact that she was so efficient but also so present, and also shared with me how much she liked her job. So it’s that human connection that I think gives everybody—you get more than you give, but it’s the glue that keeps us all together.” 

“We need to have a level of kindness, and I think sometimes people don’t know how do we get that into the workplace.”  

“I think the responsibilities of healthcare providers has kind of bled into our private lives. It’s probably all of our phones. We’re immediately available, and there’s a cost of that, I think—that people don’t actually get to decompress. I think the most resilient people are people that actually, they’re wired to decompress and to laugh. I’m like, I’m the big compartmentalizer. I can put stuff in a box and put it on a shelf and then take it down, but I can leave it on that shelf. Some people can’t do that. So we’re all wired a little bit differently. That is actually a pretty good skill for a resilient person to have.”  

“What’s fascinating is 50 percent of women change their jobs within eighteen months. Which tells you that once women figure out where they really want to have impact or influence, the second question is, ‘Are you in the job that’s going to allow you to do that?’ And a lot of women say, ‘No I’m not.’ And they actually pivot and find the job that will allow them to have the greatest impact. And you find that they’re actually personally and professionally a lot more satisfied.”

“That’s why we’re all here, is to make this system work better for everybody we serve.”  
 

“Women often do what’s put in front of them instead of doing things with and for a purpose. And what we do is say, ‘What is the purpose? What is the impact that you want to have?’ Then making decisions in service of that.”  

“So we know that you need to spend 20 percent of your job time on something you really love. You only have to spend twenty. If you spend less, it doesn’t have the greatest impact. If you spend more, you don’t get any greater engagement. Twenty seems to be that kind of sweet spot. So when I actually round and when I talk to my executive team, I actually spend some time asking them, ‘What do they love and how much time are they doing?’ That is the way to actually create that stickiness.” 

Rebecca: “Dr. Conroy, if I could ask you, what do you love the most about your work, and do you spend 20 percent of time on it?” 

Dr. Joanne M. Conroy: “Well, Women of Impact. And actually mentoring women, supporting women. I love doing that.”  

“I know there’s an underpinning of it: that [health care is] a business and there are processes and it’s a system, but they’re people that are in that system, and just making sure that the people are as supported and connected as they can be. Maybe you could take that analogy of the loose thread. I mean, when you start to lose the threads, you could argue that our healthcare workforce problems across the US are just, we’ve started to lose the threads in our quilts. And how do you actually stitch those back together?”  

“Health care is a great profession. People say health care is hard. (Yeah, it’s hard.) We’re working hard to make it better. But if we don’t do it, who will? That’s what I say to my team. We’re the people best prepared to navigate through what are kind of some stormy waters right now in health care. But if we don’t do it, who will? So, let’s buckle up and kind of get to work and lead the teams through this.”  

“Be aware that with leadership and responsibility comes accountability. Just appreciate that.”  

“It’s all about relationships. It’s not necessarily about having the right answer. It’s actually being able to come to that solution with an army of people around you and leading them with a solution that have a lot of fingerprints on it. So it’s not being right, necessarily. It is actually moving everybody in that appropriate direction. Yeah, there are a lot of young physician leaders that think they have to have the right answer that’s necessary but not sufficient.”