Talking Pediatrics Trailblazers: Dr. Emily Chapman

Dr. Kade Goepferd: This is Talking Pediatrics, a clinical podcast by Children’s Minnesota, home to the Kid Experts, where the complex is our every day. Each episode, we bring you intriguing stories and relevant pediatric health care information as we partner with you in the care of your patients. Our guests, data, ideas and practical tips will surprise, challenge, and perhaps change, how you care for kids.

Welcome to Talking Pediatrics. I’m your host, Dr. Kade Goepferd. Today we are having another Talking Pediatrics Trailblazer episode. And joining us today is Children’s Minnesota’s new president and CEO Dr. Emily Chapman. Notably, Dr. Chapman is the first woman to be president and CEO in our organization’s 100-year history. Dr. Chapman brings a wealth of experience and deep commitment to the health of children in our community. Interestingly, her career began as a child life specialist before she pursued her medical degree from Dartmouth Medical School and completed her residency at the University of Minnesota. She then began her pediatric career as a primary care pediatrician at Wayzata Children’s Clinic where she would go on to become owner and president.

Almost 20 years ago, she joined Children’s Minnesota as the associate director of Medical Education, providing support and oversight of medical student and resident training. From this role, she would go on to become the medical director of the hospitalist program at Children’s Minnesota for six years and continue her care of kids and families as a practicing pediatric hospitalist. In 2017, she became the chief medical officer and senior vice president of medical affairs for Children’s with oversight of the professional staff, employed clinicians, quality, safety, education and research. In her almost 20 years at Children’s Minnesota. Dr. Chapman has been instrumental in expanding our clinical services, strengthening our care teams, and fostering a culture of speaking up, continuous improvement as well as reducing health care harm across the system. She championed the move to label inequity and disrespect as preventable harm, leading to increased accountability for health disparities and has been an impactful public advocate for the well-being of children and families. Dr. Chapman, it has been such an honor to work with you for the past 20 years at Children’s and I could not be more excited to support your leadership as our new president and CEO.

Dr. Emily Chapman: Well, thank you, but the honor is entirely mine. I have loved working alongside you all of this time.

Dr. Kade Goepferd: It was interesting when I read that you’ve been here for 20 years. I thought I’ve been here for 20 years too. We just, it’s funny how that works, have both been here together. So my first question is both as your colleague and as your friend, how has this been going? We’re about two months into your role now. What has it been like for you?

Dr. Emily Chapman: Well, it really has been as I expected, I expected this to be hard and I took quite a long time thinking through whether it was something that I was ready to take on and in preparing for it, I thought through the various scenarios that might meet me, and I’ve seen most of them in the first few weeks in this role. I will say I knew that a new CEO stepping into this role would not only need to get oriented in the typical 90 days sort of sense of launching yourself in a role, but also would be challenged to ensure that we had stability and continuity at a time when our organization is taking on all sorts of new investments and opportunities. That said, when I listed out in my mind what those things might be that would challenge me in the first several weeks I thought of measles, I thought of cyber attacks, I thought of challenges to the programming that we provide, whether it be for gender diverse kids or anything else. I thought of the programming that we provide to kids who need us most. At this time, I did not anticipate a school shooting and the impact not only on our clinical services and how we needed to respond, but how we needed to respond as a member of this community whose children were under attack in a very transparent way in that day. I am proud to be leading. I am respectful of the role that I’ve taken on and what it has and will continue to ask of me.

Dr. Kade Goepferd: You shared a pretty sobering thing that surprised you in your first few weeks as CEO with the Annunciation shooting. I did have a question about what has surprised you and I’m wondering if in addition to sort of unexpected events in our world and in the community, what has surprised you about being CEO? What were you not expecting?

Dr. Emily Chapman: I think one thing I may not have been expecting is how much this work touches me every day. I think I’ve had roles in the past where I’ve gotten familiar with what I need to do. There is a sort of economy of effort that I can apply to it. In this role, I’ve been struck by how much it asks of me personally. Each interaction that I’m having requires a different level of presence and contemplation and intention. I love that about it and I’m recognizing that I need to care for myself as I do that to ensure I can show up for the organization the way I want to.

Dr. Kade Goepferd: I think that’s really important and I think often when, particularly those of us who are clinicians or physicians, when we move into more administrative roles where it’s less direct patient facing, I think sometimes there’s a worry that we’re going to lose those touching moments that really connect us to the care, but also not being directly face-to-face with patients and taking on what they bring in the room with us. We’re still taking on quite a bit every day. You probably more than most. So I think it’s really good insight to recognize needing to set some boundaries around that for yourself and your well-being.

Dr. Emily Chapman: And it’s not just the difficult things, and I say difficult in quotes because sometimes the things you think are difficult are less taxing. It’s also the beautiful moments and the way that they strike you and sit with you and that too taps into that same core energy. So pacing myself intentionally, investing in sleep and health is an important part of this. It’s hard to prioritize. Absolutely. There is so much that I feel needs to get done right now and I’m recognizing that if I don’t respect that need to reinvest in myself that I’m not going to be able to be successful.

Dr. Kade Goepferd: When I was introducing you, I mentioned that it was notable that you were our first female president and CEO in the organization’s history, and obviously you have immense talent and unique professional and interpersonal skills that have led you here. What feels important to you about the distinction of being the first female president and CEO of this organization and what do you think is notable about that?

Dr. Emily Chapman: Well, I want to clarify that while I am the first woman to hold the title of president and CEO at Children’s Minnesota, I do stand on the shoulders of so many groundbreaking women who helped this organization start and thrive early on. I just want to call out that Eleanor Sackett Reed was a longtime leader of the St. Paul campus as a director and administrator from 1947 all the way to 1970. So there’s a challenge for me in terms of tenure and when the Minneapolis Hospital first started, a woman named Patricia Clark served as the hospital administration. And then I’d also like to mention Dr. Susan Ellis Crutchfield, an African-American woman who chaired the board of our Minneapolis Hospital. I think medicine, and pediatrics in particular, owes its strength to women. So much of the care that is delivered is done by women and has been over the years. So much of the community support originated with women who saw the need and stepped in coming in as the president and CEO. I feel that the benefit I have is that I might in some way be able to identify with and align with that force that has built this organization and grab hold of it and run with it in a way that another may not be able to.

Dr. Kade Goepferd: I’m wondering when I started here 20 years ago when we were both entering this organization, all of the physician leadership was male. There was a female chief nursing officer, the rest of the team was male. And that’s really changed since then. And as you mentioned, the field of pediatrics, I think at the time I started, over 60% of our professional staff were women. What has changed to shape the current demographic of our executive leadership team that is much more diverse, not only in terms of gender but also in terms of race. What do you think has been the driving factor for an executive leadership team and just leadership across the organization in general that is more representative?

Dr. Emily Chapman: I want to be respectful to the historical leaders in the organization, but my instinct is we got smarter. We recognize the well-established fact that a diversity of thought and lived experience brought to bear against any challenge improves the outcome in managing to that challenge. And that’s true whether you’re looking at trying to build a financially sound organization, whether you’re trying to innovate, whether you’re trying to build the trust of a community that surrounds you, that is also diverse. So when we made the commitment to be every family’s essential partner in raising healthier children, I think we took on the imperative that we needed to be an organization that connected well and was accessible to every family. And taking a look at ourselves, it became apparent that we had so little connection to the extent of the diversity in our community and we had such a narrow thought process in approaching making. And so I think it was very intentional to say we have whole swaths of our state that have perspectives that we have not opened ourselves up to and that we aren’t prioritizing and we need to change that. And in medicine in particular, we all know that when there is concordance between the caregiver and the family in some identifiable trait, that helps the family connect and that helps the family trust and follow through with recommendations for their health. And it’s demonstrated in a whole host of health outcomes, everything from infant mortality to length of stay and complex heart disease. So we can’t, as an organization that is taking care of this beautifully diverse state, sit back and allow ourselves to fall short in this dimension. And I credit my predecessor Marc Gorelick for stating that and leaning into that and putting us in a position where we have a tremendously diverse Foundation board, governance board, executive leadership team and leaders throughout the organization. Are we where we want to be yet? No, we’re not. Obviously, we continue to have to work on the ways in which our own perspective, whatever it is, results in bias and opening ourselves up and asking actively, challenge me on my biases.

Give me your perspective on this, shape our thought process and shape our thinking together because otherwise I might as well stay at home. The reason we’re an organization of 6,000 people is because it takes 6,000 perspectives to make the right call.

Dr. Kade Goepferd: It’s beautiful. And I want to lean into that a little bit more in terms of our bias of what a leader looks like. What makes a leader? I think when I joined the organization, there was a very specific prototype of what a leader looked like, how many years of experience you had to have, what sort of roles you had to have. And I think that’s largely changed in part because of what you’re calling out, which is that it takes a lot of different perspectives and a lot of different minds and people who can look at a problem, look at a clinical population, look at a department, look at our care teams with fresh eyes, and many folks don’t know this, but you have been one of my personal mentors since I started at Children’s Minnesota and you were, in fact, the person who gave me my first leadership role when you invited me to be the site director for medical student education. I think that you have a real talent for cultivating leadership in others and maybe in others that would otherwise be overlooked.

I remember when you approached me about taking that site director position, I said to you, “well, why me?” I mean, don’t you want to ask my colleagues who’ve been in practice for 10 years, 15 years, 20 years, like they would probably want to do this job? And you said, I know, but I want you to do this job. I see something in you that I think would be a good fit for this role. So I would love to hear you talk about that part of your skillset and how you think it is that you’ve been so successful in developing such a strong portfolio of leaders over the last two decades because you’ve influenced not just me, but many of our current leaders, our clinical leaders, our clinical vice presidents. You’ve had a hand in developing their leadership, and so I’d love to hear you talk a little bit about how you approach that.

Dr. Emily Chapman: I love that you call out that there is an assumption, a bias that leadership looks a certain way. I have battled that for sure. And in this observation, I’m not specifically talking about gender, I’m talking about personal style.

I think there is an assumption by some that leaders must be tough, maybe hard, decisive, action oriented. We also then think of them as being certain, definitive. I’m not that way. I come to a conclusion by being open, by tapping into other perspectives. And I am also when I’m ready to be, when I need to be decisive. Sometimes people think if you bring the soft skills, oh, she’s great at connecting with people, but can she really do the leadership job? That always makes me laugh. What makes you think that leadership isn’t all about connecting with people?

There is so little that I personally am going to do. All I can do is help the people around me achieve what they’re capable of achieving. So my job is to see in them sometimes before they see it, what they’re capable of achieving either in their career as we talked about or in problem solving on a particular issue, and help them believe that they’re capable of that, let them fail and encourage them to try again and see what they’re going to do. I’ve often said that one of the most difficult things for me about leadership is that I tend to absolutely thoroughly enjoy just about everyone I meet in life. And sometimes that makes it difficult to make decisions that impact other people.

However, it also allows me to see potential and apply people against a challenge to get a result that might not otherwise be possible. We need to remember that this is truly a people powered organization, and that’s not just at the frontline where typical unquote “care” is delivered. That’s when we are trying to solve a budget challenge, when we’re trying to respond to an executive order, when we’re trying to figure out how to improve our supply chain efficiency. All of them start with connecting to and leveraging what people are capable of. And so a good leader must stand in that as a foundation lest they not be able to in their moment of decisiveness, make the right call.

Dr. Kade Goepferd: I really respect the way that you approach leadership and what you just said about developing people and helping them see that they may be up for challenges that they might not otherwise imagine in themselves. You also said something about seeing potential in people that they might not otherwise see in their selves and getting them to believe that they can do something. And I’ve always said that one of the things that I love about you is that you could sell an umbrella to someone in the desert because you would convince them that it’s the only way to keep the sun from overheating, right? Which is true. And I wonder, you have this approach to leadership that you’ve called servant leadership, and what I heard you just describe is more of a reflective, helping people see what they may be up for and you’re not doing the problem solving, you’re helping others do the problem solving. Where do you think that comes from? What informs that for you and why did you come to believe that was such an effective way to lead?

Dr. Emily Chapman: I might rephrase the servant leadership. That is a phrase that I’ve used for a long time. I’m leaning a little bit more into, it’s a radically human style of leadership because it is not in service to the other people necessarily. It’s harnessing humanity against the objectives of the organization. And for us, the organization is literally the health of children who surround us.

And if that isn’t a human endeavor, I don’t know what is. My journey to leadership is in entirely non-traditional, at least in how I thought about my path. You had mentioned that I started my medical career as a child life specialist, and that wasn’t in order to go to medical school. That was because when I was in college, I was so attracted to psychology and the interaction between people and I have always been in love with children. And that dynamic, the parent child dynamic Society supporting children had been fascinating to me moving into a child life specialist role. What I loved about that was it took that subject matter and it turned it into a team of people who executed against very specific objectives to try to help a child and their family. My interest in medicine was really because I recognized literally I could only have certain conversations with the family as a child life specialist. And understanding the pathophysiology and the treatment plan from a medical perspective is such an important thing for a parent and a child who’s of age to do so, to be able to master.

And I wanted my conversations to include those things and that took me to medical school. And so I do think that everything that I have done as a pediatrician, as a pediatric hospitalist, as a teacher, and now as a leader, has been drawing upon the importance of communication and connection to get to an outcome. So each time that the idea of leadership came up, it came up not because I had an aspiration for a leadership position, but because there was something that either pulled me to it, like my saying, dang, I want to have a different conversation with these families. Well then I need to go to medical school. Or someone who kind of pushed me from behind and said, you know what? You’ve got traits and skills and passion that we need in a particular position or space in our organization. It was never an intentional development. The characteristic of my leadership was not an intentional development. It worked the other way around. I was intentional about human connection and the power of it in this world, and the leadership fell out of that.

Dr. Kade Goepferd: My next question is directly about that human connection. It is a really hard time to be a doctor right now, and I think it is even a harder time to be a pediatrician as we are facing just rampant misinformation in politics and in the media about health and what causes health and how we approach health. How do we handle this moment at Children’s and continue to build trust with patients and families knowing that our ultimate goal is, as you said, the health of children. I mean that’s really important. How do we take your lessons around human connection into that space?

Dr. Emily Chapman: It’s intensely challenging. I think as you mentioned, particularly for pediatricians, it’s challenging on a moral level. We have dedicated our lives to the science that has taught us how to keep children alive and the life expectancies that we have today and our ability to cure diseases and the rates that we are dependent upon that. And if you’re a pediatrician or a pediatric specialist, that tends to be not only your job but your identity. So this is very challenging to our identity. I get down and out about that. And then something reminds me of probably two things. One, we as a country, as a species, have been here before. We have had advances and fall back and advance again and fall back again. And that concept that speakers here at Children’s Minnesota have helped us see how history echoes has helped me put in perspective that this is my lifetime. This is what’s happening during my lifetime, just as those who went before me and all kinds of crusades had their own context in which they were trying to move something forward, and that perspective helps. And then secondly is the idea that, well, darn it, I’m not going to be able to change all of these things, so I have to act within them. I’m reminded that I think we dramatically overestimate our control and we dramatically underestimate our power. Our power in this moment may be to mitigate how far we fall back in this time where we in science have failed to maintain trust with our community one way or another because voices have distracted our community or because we weren’t accessible or because we had patterns of abuses that resulted in mistrust. But one or another we got here and this is our watch. And it may be that what a win looks like on our watch is mitigating the harm that might come. We trust in the cycle that progress always takes of advances and falling back in advances of falling back and know that the journey doesn’t begin or end with us. But this is our assignment now.

Dr. Kade Goepferd: That is literally one of the most beautiful things I’ve ever heard. As you know, I find myself daily in that cycle, and I think remembering that this is our lifetime. There are people who came before us who had their struggles in their lifetime, and this is our lifetime. And remembering that the power that we have right now sometimes is to completely change a trajectory and sometimes is to mitigate harm. Thank you for that.

Dr. Emily Chapman: There is an expression that I absolutely love. I carry it with me all the time, which is, just because you wear it well doesn’t mean it isn’t heavy. And I went through a particular time in my life where I showed up looking well, and I had something very heavy that I was carrying, and nobody knew that. And so I remind myself every day when I walk around here of two things. One is that there are people carrying heavy things that I don’t know about at every turn. So I’m going to be careful not to judge. I’m going to be careful not to assume when there’s a reaction. We often, in a very myopic, almost selfish way, think it’s related to us. It’s not. They’ve got a whole life. And that helps me listen better to people and relate better to people. But then I also recognize that just because I’m carrying heavy things doesn’t mean that I can’t carry them well. And I have a role right now that requires that I help people see yes and yes, there is all of this hitting us. Yes, so much of it feels inconceivably wrong, and we’re strong. We have power, and any progress is incumbent upon our continuing to believe in ourselves.

Dr. Kade Goepferd: Thank you for that, and I am really excited to see where you lead us over the next 5, 10, 10, 20 years as our president and CEO. And I appreciate you taking the time to sit down with me today and talk about your journey into leadership and the things that shape, and the things that are helping to continue to shape the way that you think about your role today. So Dr. Chapman, thank you so much. Appreciate the time and appreciate what you’re bringing to Children’s Minnesota.

Dr. Emily Chapman: And Dr. Goepferd, thank you for shaping me over all of these years because you have and I am stronger for it.

Dr. Kade Goepferd: Thank you for listening to Talking Pediatrics. Come back next time for a new episode with our caregivers and experts in pediatric health. Our showrunner is Cora Nelson. Episodes are produced, engineered and edited by Jake Beaver. Our marketing representatives are Amie Juba and Krithika Devanathan. For information and additional episodes, check us out on your favorite podcast platform or go to childrensmn.org/talkingpediatrics.