Fostering a ‘sense of belonging’ to improve culture, care: Q&A with David Miller, M.D., M.P.H.

March 23, 2021  //  FOUND IN: Strategy & Leadership,

At the beginning of 2021, David Miller, M.D., M.P.H., took over as president of the U-M Health System. In the months since, he has helped guide the organization through the ongoing COVID-19 pandemic, while keeping the focus on collaboration, teamwork, and improving access and quality of care.

Headlines recently caught up with Miller to discuss his new role, his strategic priorities and where he sees the organization going in the future.

Here’s what he had to say:

Q: You received your medical degree from Washington University in St. Louis and earned a fellowship in Los Angles but you returned here, where you completed your residency training in urology. What is it about U-M and the Ann Arbor area that called you back?

DM: As a resident in the Department of Urology, it was clear to me that UMHS is truly a place where patients want to receive care, colleagues want to work, and students and residents (at all stages) want to learn. I wanted nothing more than to contribute to and be a part of this legacy.

Q: You may have had one of your first experiences in leadership at U-M as chief resident back in 2004. How would you describe your leadership style today?

DM: I believe an important part of a leader’s job is to foster collaboration. We all work and feel better when we feel a sense of belonging and know that we are contributing to a greater goal. At Michigan Medicine, everyone has a critical role in advancing health for Michigan and the world, and I believe it’s important for us to recognize and appreciate each individual’s unique contributions.

I also believe that a large component of leadership is the ability to listen and learn from all of our team members, from my direct reports to our front-line staff. By having open and collaborative conversations, we can raise concerns, solve problems and improve our culture and the care we provide to our patients. 

Q: What is your approach to guide the health system through the pandemic, as it continues on and is still creating many uncertainties for us?

DM: This pandemic has been an incredible challenge for all of us. Decision making can be extremely complex and difficult, so I try frame our actions within the principles that have guided us throughout the pandemic: putting patient and employee safety first, maintaining access for both COVID-19 and non-COVID-19 patients, committing to serve our Michigan communities, and minimizing impact for our teams.

In the context of the current resurgence, we will again have to make refinements — or micro-adjustments — in our work every day to meet these principles. We are prepared for the current circumstances, but we will need to emphasize continued flexibility, collaboration, innovation and support for our teams. We must also continue our efforts related to wearing masks, social distancing, hand hygiene, and vaccine education and administration. We don’t know what the future holds, so our priority for the pandemic is preparedness.

Q: In your past leadership roles at the health system, you have focused on strategy. What do you see as your top longer-term strategic priorities to be successful for this position?

DM: I believe we can make a lot of progress on our goals if we focus on three strategic priorities. The first priority is to enhance access to care for our patients and that means providing more seamless transitions between inpatient, ambulatory, virtual care services and care at home. It also means expanding our statewide network and partnerships with community hospitals, and to provide more options and improve our offerings of equitable health care for diverse populations.

The second priority is safety and quality. We must continue the teamwork necessary to reduce hospital-acquired conditions, like pressure injuries, falls and sepsis. Resources, such as our BCBS collaborative partnership, provide clinical data that help us improve treatment and care for specific conditions like cardiovascular disease and cancer. This focus on quality and safety also helps us address health disparities in minority and vulnerable patient populations.

Third, we need to constantly think about the patient experience. Our ongoing work on high reliability will help us improve communication and relationship skills, which will ultimately enhance the patient experience. We need lifelong learning among all of our faculty, staff and learners to further improve this experience for our patients and their families.

Q: What advice would you give to a young aspiring leader?

DM: I think it is critically important to seek feedback and guidance from mentors, peers and other leaders who have diverse perspectives. We learn the most when we are exposed to new and different thinking, because it challenges us to broaden our own frame of reference and mindset. In my experience, solving complex problems or managing challenging situations is generally more productive and effective with a group of diverse people.

I also recognize the importance of leadership visibility and engagement. During the height of the COVID-19 surge last spring, I rounded on our inpatient units almost daily to communicate and offer support to our teams, and to understand the realities of care delivery for front-line providers. Personal relationships build trust and accountability, and the lessons from these unscripted interactions provide invaluable opportunities for improvement.

I would also emphasize the importance of humility in decision making and in being responsive to feedback. Finally, it is important to recognize that complex organizational decisions will not always be viewed favorably. While it is essential to have empathy, it is also important to maintain the courage to move forward with honest optimism and clarity around long-term goals that may not be uniformly popular in the moment.

Q: This past year has been challenging for all of us. You have mentioned how impressed you have been with the resilience you have seen in our faculty, staff and learners. What and/or who has helped you through the trying times this past year?

DM: It is difficult to fully describe the determination, teamwork and resilience demonstrated by the Michigan Medicine community throughout the COVID-19 pandemic. As a leader in the organization, I feel immense gratitude and admiration for our entire community for their extraordinary courage and commitment. 

Throughout the pandemic, I have been buoyed by the remarkable work of our teams, and by the authentic expressions of gratitude, encouragement, caring and empathy that have been shared by our patients and colleagues. I have also turned daily to my family and close friends for conversations and uncomplicated moments (e.g., outdoor walks) that provide support, joy and gratitude. Finally, I find that regular exercise is a source of daily rejuvenation.

Q: Outside of work, how do you like to spend your free time to recharge?

DM: As I mentioned, exercise — mainly jogging — provides me with a daily opportunity to relax and think clearly about both current issues and future opportunities. I also look forward to spending Friday evenings with my family around our backyard fire pit, watching and cheering for U-M athletics, and reading a book on the weekend with a cup of coffee and our golden retriever, Wilson, at my side.