This episode of MGMA's Women in Healthcare podcast features Roshy Didehban, Chief Administrative Officer of Mayo Clinic in Arizona.
Since joining Mayo Clinic in 2002, Didehban has served in multiple roles including chair of Practice Administration and secretary of the Mayo Clinic Clinical Practice Committee as well as administrative leader for the Arizona Clinical Practice Committee, Outpatient Practice Subcommittee and Operations Coordinating Group. Didehban’s current focus includes providing leadership and strategy, defining and implementing Mayo Clinic’s operational plan, and expanding Mayo’s leadership in Arizona as well as the Southwest.
MGMA’s Adrienne Lloyd, MHA, FACHE and Didehban discussed lessons in leadership, failure, perseverance and driving transformation in healthcare. Didehban shares insights from her career journey along with Mayo Clinic's efforts to lead the change in an industry ripe for innovation.
Editor’s note: The following Q&A has been edited for length and clarity.
Please share with us about why you chose healthcare and healthcare leadership. What do you love most about what you do and what you're working on?
Thinking back to what first energized me about healthcare, I go all the way back to high school. I really do think of working in healthcare as a calling, and it's a calling to serve others. In my high school years, I volunteered at a children's HIV clinic at Cook County Hospital in Chicago … which can be a very challenging place. I observed all the challenges [including] access to healthcare, the fragmentation of healthcare and the cost of healthcare. But I also got to see this power of hope, the power of healing and the power of compassion. Working with those children really inspired me and that fire of wanting to serve others and wanting to serve a greater purpose is something that continues my motivation today.
Let's talk about failure, perseverance and overall growth. What do you feel about failure is so important for growth and moving forward?
I think many of us would agree that fear of failure has, in many ways, caused us to avoid risk, opportunities, and especially avoid taking on assignments where success is not clearly defined and not laid out well. So I have seen in my career these amazing leaders that avoid taking on that hard ambiguous assignment that's going to help them grow dramatically as leaders because of the fear of failure and because they don't know exactly how to accomplish a goal. I believe that as leaders, and especially in healthcare, we have to be willing to take on the unsolvable problems and really have the potential to fail at trying them. If we don't push ourselves, we're not going to be able to achieve that transformed healthcare system where we can better care for our patients, our communities and each other. We have to be willing to solve the unsolvable and that's why I think failure is really critical to growth. You have to fail, because that's what makes you stronger.
As leaders, we often were trained as well to be very prescriptive with our teams. When you start out as a leader in your new role, to some degree, you're trying to learn the details and trying to figure out which team member has the skills and capability to take the right actions, so you are in the weeds more. Then as you move up and into bigger roles, one of the things that is a challenge, for me, is crafting that vision and giving your team some rough parameters so they don't waste time but also giving them the freedom to actually create what that journey looks like.
In healthcare, we save lives every day. That is part of why we're in healthcare – we want to provide new solutions to patients, we want to help them achieve good health, and really help them navigate through some of the most vulnerable times in their lives. So healthcare has a lot of focus on perfectionism, but I think sometimes we forget that there are a lot of business processes around that perfectionism that you can take on risk – you can try new things and do different things without impacting the care of those patients, which is are very focused on our very mission.
I process improvement background. If you really map out a process, usually 10-20% of the actual process is really impacting the direct patient care quality. We of course want to make that as perfect as possible with all the rest of the stuff so that we can really make a significant impact, save time and make it just more enjoyable.
I truly believe that to have the most successful career as a leader, you have to be willing to fail. I do think we all need to be more comfortable with failure. I think about key leadership attributes that require a willingness to fail, risk tolerance, curiosity, innovation and change entrepreneurship – all of those capabilities that we believe are really critical to leaders require us to be comfortable with failure. My very first experience with failure was really early in my career. I was one of those early leaders in my career in first job after my administrative fellowship. My physician partner pulled me aside one day and said, “Roshy, you're failing.” It was the first time in my life anyone had ever told me I was failing. What he said to me was, “You're failing to engage your team, you're failing to create followership, you're failing to recognize accomplishments of those that you're working with and how they're serving our patients and our communities.” It was really hard to hear that. So the first thing I often tell individuals I'm working with is any time someone takes the risk to give you feedback, the first thing out of your mouth no matter what is, “thank you.” The reason is because they're taking a risk. They care so much about you and your development, that they're willing to take the risk that you're going to be defensive or argumentative.
There's three things that I think are really important when you're thinking about how to get through a failure or how to get through when you hit that failure point. Number one: you have to pick your attitude – are you going to be a pessimist and say, “I’m not going to do it” or are you going to be an optimist and say, “I can choose to see that there's an opportunity here for me to be better"? The second one is you have to pick your perspective. You can have self-pity or you can choose to overcome. I love the quote that “your attitude determines your altitude.” The attitude and the perspective you bring to the problem allows you to have that perseverance to get through it. Then the last thing I often say is pick your purpose. Why are you doing what you do every day? Why do you come into work? Why do you work with the people you work with? And if you can figure out what that greater purpose is, that purpose can actually get you through any kind of conflict, hurdle or failure because you're aiming for a bigger goal.
So we've talked about failure, but what about perseverance? How do you define perseverance and why is it important?
We've talked a lot in other environments about resilience. I have struggled a little bit with resilience because resilience to me feels like people are attacking me and I have to be strong and stand up. Whereas perseverance is something that I don't just have to defend against, I actually am owning it, leaning forward and continuing to try. So, I do think there's such a power in perseverance – it's being steadfast, it's being determined and it's persisting in the face of those challenges. It's having clarity on what is the goal you're ultimately trying to achieve and then giving yourself the space and capacity to just say, “I'm determined. I'm going to get to that point and I'll pivot along the way and that's okay, but I am actively going to continue to make it to that goal.” I do think that difference between resilience and perseverance is an important one just to sit with and really think about, “what is the difference there and why is it really perseverance that allows you to continue to grow and develop?”
What are one or two ways that you've really cultivated mindful practices to help you navigate your leadership roles and just in life?
The first thought that comes to my mind is actually what we just talked about – being your authentic self. I think part of being your authentic self is recognizing what it takes for you to be your best self at work every day. So as leaders and in life, the eyes are often on us – how we show up, how we engage and how we communicate. What I recognized early in my career is that when I was not in my best place, when I was not my best self and when I showed up as a leader I didn't want to be, I was short with people. I was condescending, I was stressed and I had those behaviors that was not the ultimate leader I wanted to be. The lesson I had to learn was, “what does it take for Roshy to show up every day as her best self,” and that is different for every person.
The second thing, I think is critically important, is gratitude. Working in healthcare, our teams deliver miracles every single day and our teams transform lives every single day. I think cultivating a practice of both being grateful for the incredible things that are happening around us and having that sense of awe about what we get to deliver every day creates joy. I think it allows you to have a different perspective when challenges arise because you're coming from that perspective of gratitude as your starting point.
Is there something right now that you are working on at Mayo that you're really excited about and what impact are you working to create coming through that?
In 2019, Mayo Clinic really made a commitment that we wanted to lead the transformation of healthcare, which is a really bold statement for an organization to say, especially as we know how complicated healthcare is. It's really fragmented, it's not affordable and it's hard to access. We have major workforce challenges. It's not personal enough. You look at how many healthcare organizations are not in a sustainable position to continue to invest in healthcare. So, we talked about failure and perseverance – imagine how much failure and perseverance it's going to take to transform healthcare.
What's one piece of advice or lesson that you've learned that you wish you would have known sooner, or you would share with others, as they kind of move through their challenges and are working to drive success for themselves and their teams?
Early in my career, I was so focused on everything has to get done today and it has to get done well. I have to check the box on everything. You once mentioned having to leave work because you took on so much stress. That happened to me early in my career, where I literally had to leave in the middle of the day and go hide under my covers because I was so completely drained. The lesson I learned was you always have to follow through. That's a leadership competency we all need to do. When someone asks you for something, you have to be able to say, “I totally understand why you want that. Looking at my priorities, is it okay if I get back to you by next Friday or can I get back to you by the end of the month,” and setting appropriate timelines and boundaries in a way that really allows you to feel successful and feel like you can balance. I think sometimes we start our careers and we just want to accomplish [things], and we don't take the time to say, “What's the greater purpose here? Why am I doing this each day?” I think having that personal purpose can really help you in the decisions you make and how you navigate your career.
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