In the health care field, women occupy only 15% of C-suite executive positions, and for women of color that percentage is even smaller. The importance of gender and racial diversity in health care leadership is clearer than ever, and organizations dedicated to equity in executive roles are building successful visions for the future. In this conversation, Roxie Wells, M.D., senior vice president chief physician executive and strategy officer with Novant Health Coastal Market, discusses her long journey to and through the health care C-suite, and the importance of mentoring young women leaders through the glass ceiling and beyond. 

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Tom Haederle

It's well known that women make 80% of the health care decisions in the United States. Yet they occupy only 15% of executive C-suite positions. And for women of color, that ratio is even smaller. The importance of gender diversity in health care leadership is clearer than ever. And the glass ceiling, while still there, can be broken.

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Tom Haederle

Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle with AHA Communications. March is Women's History Month, a good time to celebrate ambitious, talented and successful women who serve in executive positions in health care. One such trailblazer is Dr. Roxie Wells, senior vice president, chief physician executive and strategy officer with Novant Health Coastal Region in North Carolina.

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Tom Haederle

She is also a past member of the AHA Board of Trustees. In this podcast, hosted by Ogechi Emechebe, senior communication specialist with AHA's Institute for Diversity in Health Equity, Dr. Wells talks about her long journey from her childhood in rural Alabama and how mentors, inspiration and hard work brought her to where she is today.

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Ogechi Emechebe

Thank you so much for joining me today. Before we get started, just tell me how you're doing so far.

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Roxie Wells, M.D.

I am doing well. It's beautiful here in Wilmington, North Carolina. The sun is shining. It's a beautiful city. I couldn't ask for more. So I'm doing extremely well. How about you?

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Ogechi Emechebe

I'm doing great. Thank you. So I'm glad to hear you're having really sunny weather. It's a little bit rainy over here, but we'll make it. We're really excited to have you today because the conversation is going to discuss the importance of gender diversity and health care leadership, specifically women in C-suite positions. So currently, about 15% of health care system CEOs are women.

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Ogechi Emechebe

And you are a family medicine physician and also the senior vice president, physician executive and strategy officer at Novant Health Coastal Market. Can you walk us through your journey into health care and what inspired you to enter the field?

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Roxie Wells, M.D.

Sure, I'm happy to do so. You know, years ago, I grew up in a rural community in Alabama. My mom served as a midwife for a large percentage of the African-American moms who were delivering in my town. She was actually trained...Back in the day, you could be trained as an apprentice by the family physician in towns and rural communities.

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Roxie Wells, M.D.

And so she was trained by the family physician there. And I remember from being a very small child, seeing her leave and go to attend these deliveries. And as I got older, I recognized what she was doing and the importance of it. And then as I aged even more, even some of my peers were babies that she had delivered while I was small.

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Roxie Wells, M.D.

And so it just kind of made me really think about health care as a career choice. Although I did not understand at the time that I could actually become a physician because there weren't physicians of color in my town, and I don't recall having women physicians in my town. It wasn't until I moved to a larger city in Alabama and then here in North Carolina that I really saw women physicians in action and women physicians of color in this career and that's sort of how I got into health care and how I became a physician, was just really recognizing that it was truly an option for me.

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Roxie Wells, M.D.

It was something I've always wanted to do. I just didn't necessarily have the path to it. And so once I was able to be mentored by individuals at my university or individuals in my circle, I decided it is something I could do. And so I attended medical school at East Carolina University in Greenville, North Carolina. After I left there, I did my residency actually down here in Wilmington at Coastal Family Medicine and then went to practice at a rural community with the hopes that my being in that rural community would be another way for young people to see me and know what their possibilities could be.

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Ogechi Emechebe

That's really great. So you said that you really didn't see women who looked like you or women in general until you got to Alabama and North Carolina. Then you started connecting with women who mentored you and prepared you to come into this position currently. So can you describe more about that mentorship and how did they prepare you and guide you to make sure that you are not only just breaking barriers, but you have a seat at the table?

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Roxie Wells, M.D.

Well, you know, some of those women weren't necessarily physicians, but they were leaders in their fields, in their own right. And so they sort of transferred that leadership to me and they, I think, saw something in me that kind of piqued their interest in the things that we see when we look at leaders are people who are potential leaders and something about me stood out for them and they just started to mentor me and introduce me to people who were in the medical field and who were in the institutions of higher learning that could connect me.

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Roxie Wells, M.D.

You know, a mentor at my HBCU Fayetteville State University here in Fayetteville, North Carolina, was one of the first African-American women to graduate with a Ph.D. from UNC-Chapel Hill. I mean, really, what better mentor could you have than Valeria Fleming, who had a Ph.D. in biomolecular science and who served as a mentor and as a teacher for me.

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Roxie Wells, M.D.

I remember her calling me one day, and that's before we had cell phones. I didn't make it to class one day, and she called me and she said, Miss Wells, did you miss my class today? And I said, "well, yes, ma'am." And she said, "were you dead?" Well, no. She said, "well, that won't happen again, will it?" And I said, absolutely not.

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Roxie Wells, M.D.

And it's that type of intentionality that actually helped propel me to become a physician. And to really think about leadership the way I think about it today.

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Ogechi Emechebe

That's such an excellent story. I love that example about your professor holding you accountable. I liked that.

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Roxie Wells, M.D.

She held me accountable and recently we just lost her about a week or two ago. But she held student accountable her entire career. She was tall and statuesque and just brilliant and smart and just exuded everything that you would want to be. And so she just kind of drew you in and you wanted to make her proud and you wanted to do the right thing.

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Roxie Wells, M.D.

And she just mentored tons of young women and men, really through sciences and health care.

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Ogechi Emechebe

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Ogechi Emechebe

as CEOs to grow. So this group offers a safe space for black women to learn, share their experiences, and also be really safe in an environment where they may not be able to share these experiences in a universal setting. So up to date, there are almost 30 members. I know you were instrumental behind the formation of the group. Can you tell us more about how this came about?

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Roxie Wells, M.D.

Sure. Happy to do so. You know, I sat on the AHA Board of Trustees for three years and really started to ask the question, are there black women, other black women CEOs in this country? And if so, where are they and who are they? And really just set out to really find them. I basically wanted to look for a community where I felt safe and felt comfortable sharing vulnerabilities that I felt.

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Roxie Wells, M.D.

Being able to ask questions, being able to really have unencumbered discussions about equal pay or any type of biases that that I may have noticed or that other women may have noticed. And really just asked AHA leadership about opening or forming this group. And when we first set out to really see who was out there, I think we started with about 17 women.

00;08;56;19 - 00;09;35;16

Roxie Wells, M.D.

And I'm going to tell you, we received photos and bios from them and the team at AHA sent them over to me for me to look at them. And when I first opened that email and started to look at those pictures, it became really emotional for me because I'm looking at a group of beautiful, powerful, thoughtful women in their own right who have risen through the ranks in various ways, some directly, some through circuitous routes, and that they are just performing very well in our field.

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Roxie Wells, M.D.

And it was just an emotional experience for me. And so when we all came together for the first time at the AHA Annual Meeting about two years ago, we met for about an hour and a half and the emotion in the room was palpable. And that just made me realize the importance of forming that group. And we've continued to meet.

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Roxie Wells, M.D.

We meet for business meetings four times a year, and in between we have social happy hours virtually. Two of our business meetings are in person, one at the Annual Meeting and one at the summer Leadership Meeting, and then the others are virtual. And we want to really look at ways to think about how we might improve quality of care for women of color.

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Roxie Wells, M.D.

Think about how we may ask or teach people or lead people to stronger personal advocacy for themselves. Really think about personal well-being. Think about connecting with other women who may have some of the same challenges that you're having in your work roles or what have you. So it has been just a phenomenal opportunity to get to know amazing women who have storied careers in their own right and to really just celebrate all of the wonderful things that they're doing and then really to offer them a place of solace if it's needed.

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Ogechi Emechebe

I really like that. So you said that this group has been very impactful and it's giving these women a space to just, you know, be vulnerable and share their - pretty much challenges and experiences in this field. Can you share some tips or advice that you have given them or some challenges that they're facing as black women in these roles

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Ogechi Emechebe

and how do you all ensure that you can persevere through some of the barriers that you navigate?

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Roxie Wells, M.D.

You know, let's make no mistake about it. They pour into me as much as I share with them. There's certainly a spirit of reciprocity in this group. You know, we discuss things from, I've had discussions about equal pay. Maybe the woman was a president of a hospital in a health system. How do you have the conversation with your system CEO about equal pay? Other things might include workforce issues and you're trying to figure out how to navigate the difficulty that we all are facing from workforce issues and making sure that our leadership teams are doing the things that they're supposed to do.

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Roxie Wells, M.D.

When you have to have crucial conversations with individuals, whether that's a crucial conversation upstream to your system CEO or those people you report to, or whether they're crucial conversations to people who report to you. How to work through that and how to have those conversations in a way that really gets you to the place that you want to be with those individuals.

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Roxie Wells, M.D.

So our conversations and discussions really, I mean, they range from personal: We've had members who have had personal issues, personal health scares and just talking about talking through that and what that looks like. So it really has become a community of women that not only share work and career concerns or challenges or experiences, but also talk about those personal things, well-being.

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Roxie Wells, M.D.

How do you take care of yourself? What are the things that you do to really fuel yourself that's outside of your work life? How do you stay connected to your family? Understanding that many of us feel that there are extra hurdles that we sometimes have to jump to perform at the level that people would expect us to perform, although that may be higher than others.

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Roxie Wells, M.D.

How do we stay true to self? How do we maintain those family and personal relationships? And how do we keep them separate from our work career goals and aspirations? And so we talk about things like that. And so it has been a wonderful experience. Our happy hours are really just to come together and laugh and celebrate each other. You know, everybody's on LinkedIn and you see all the great work that everybody's doing.

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Roxie Wells, M.D.

And to be able to celebrate that, to be able to celebrate when one of our members are listed as the top 20 of something by Modern Health care or whomever. You know, we just want to celebrate those things and let those women know that you are phenomenal. We believe in the work that you're doing and we're here to support you.

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Ogechi Emechebe

I really like that. It's key on being supportive of each other. So do you see a vision for the roundtable expanding beyond AHA? Essentially, do you see a vision for this being the blueprint for other systems or organizations to follow where they can offer a space for women or women of color to network with each other and amplify their voices, to not only develop a pipeline of diverse women leaders, but just to ensure that they feel supported and heard and that they can have just someone to lean on when they need it.

00;15;22;03 - 00;16;09;00

Roxie Wells, M.D.

I absolutely do. I think that it can certainly be cascaded throughout our field from the national level at AHA to the state associations, to different health systems or what have you. I mean we here at Novant, we have business groups of all types that fit this and we do have one for women of color. And absolutely, I think it's a great tool that can be mimicked throughout our field that would be helpful for women in general, and particularly women of color who who want to ascend to leadership roles. From an AHA perspective,

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Roxie Wells, M.D.

right now, it's mostly CEOs or presidents or administrators. But I would love to see in the future other leadership roles actually become a part of the group at AHA. I'd love to see the expansion there, but we chose to start with the CEO, administrator, president, executive vice president role so that we could actually pull it together, make it succinct and really grow from that standpoint.

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Roxie Wells, M.D.

Understanding that a smaller group giving thought to how we expand this would be best. And so I certainly hope in the future that we will expand beyond that CEO, president or administrator role and go to other roles within the C-suite.

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Ogechi Emechebe

So can you tell me, given where you are today and then just looking back on your childhood from when you saw your mom, you know, working in the field, what have you learned along the way that you wish someone prepared you for?

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Roxie Wells, M.D.

You know, that's a great question. I would actually think that ascending to leadership positions isn't as easy as people think it is. And especially for women and especially for women of color. You know, all hiring and mentoring leaders aren't as progressive as they purport to be. And what we do know is that is easier in most cases for people to mentor people like themselves.

00;17;47;14 - 00;18;22;01

Roxie Wells, M.D.

So when I talk about them not being as progressive as they purport to be, it's just easier for people to, again, just mentor people that are like themselves, people that look like them of the same gender or what have you have the same likes or what have you. And so I've found that it's somewhat difficult to break through that glass ceiling because there are still biases that are out there that prohibit movement past certain rungs on the ladder.

00;18;22;08 - 00;19;08;07

Roxie Wells, M.D.

But I do believe that, you know, the goal is to find people who are intentional and who are committed to ensuring that diverse leadership structure. And I've been blessed to have people who have been committed to and intentional about my success, whether they be coaches, whether they be mentors, whether they are friends who have had storied careers. The women in the roundtable have, you know, just pushed me to be a better version of myself. And then not only that, I think it's important to take all of those things that we've been given and lend them to others and to serve as coaches and mentors and friends, to those who are who are interested in becoming

00;19;08;07 - 00;19;10;24

Roxie Wells, M.D.

leaders in health care.

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Ogechi Emechebe

So I really like your quote about finding people that are intentional about your success. And I think that leads into my next question about: do you think there is a role that men can play, if any, to ensure that they create a safe, friendly environment for women to thrive in? Because women can be doing the work to be mentoring each other and making sure that they are creating a support system.

00;19;32;29 - 00;19;43;29

Ogechi Emechebe

But if a lot of these positions are still held by men or trying to break these biases, what role can men play to make sure that they're also creating a safe space for women to thrive and succeed in?

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Roxie Wells, M.D.

I think that's an excellent question, and I do think that there is a role for men to play to ensure that that women succeed in leadership roles in health care. And I've been fortunate again, some of the people that I mentioned before who have been instrumental in my leadership journey have been men, men of color, black men, white men have been very, very instrumental for me.

00;20;08;00 - 00;20;33;18

Roxie Wells, M.D.

But I think that you mentioned earlier that health care CEOs, only about 15% are women, the other 85% are men. But we do know, according to the U.S. Department of Labor, that 80% of health care decisions are made by women. And if that's the case, that it kind of seems a little uneven. So I do think that there are things that they can do.

00;20;33;18 - 00;21;04;24

Roxie Wells, M.D.

First of all, treat women as equals. Secondly, make sure that you are a proponent of equal pay for women, for equal work. Being coaches and mentors. And if a leader doesn't have the bandwidth to be a coach, pay for or sponsor a coach for women in your organization. So sponsorship is important. Being an ally is important and really calling out recognized, unfair, biased treatment.

00;21;05;01 - 00;21;32;29

Roxie Wells, M.D.

Walk the talk, right? Just don't talk about I am fair or what have you. But when you're around peers and you're hearing things that aren't necessarily appropriate, have those conversations. Call those people out. Bring those people back to a place of understanding that equity, equality is is important. Help them to understand the roles that women play in health care.

00;21;33;00 - 00;22;02;10

Roxie Wells, M.D.

We know that 70% of the health care workforce is composed of women. So we need to make sure that we are looking at that when we're talking about equity. Other things might be flexibility, making sure that you understand that the roles of women are often times much different than those of men outside of the workforce. And so what the expectations are for me at home might be different from the expectations from my male counterpart.

00;22;02;13 - 00;22;22;18

Roxie Wells, M.D.

I'm not asking asking for special treatment, but asking for flexibility. Go outside of yourself and go outside of the box and talk to various people in your organizations and see if you can build leadership bandwidth from individuals throughout your organization.

00;22;22;21 - 00;22;39;22

Ogechi Emechebe

That's a great answer. I really like that. I do think that men do play an instrumental role in ensuring that women thrive. So just having that collaborative partnership is key for everyone's success, really. So that is all I have for you, Dr. Wells. Are there any closing thoughts or comments you would like to add?

00;22;39;24 - 00;23;25;25

Roxie Wells, M.D.

Really, just to remind everybody that I was doing a little bit of research before this and looking at the population of the world in general. And it's 50-50. And so really thinking about if we are going to move forward in health care, if we're going to decrease the cost of health care, to include not just from a financial perspective, but from morbidity and mortality, we really need to be inclusive in making sure that the highest levels of leadership in health care are inclusive and quite diverse, because we all have different perspectives, we all come from different backgrounds, and having all of those individuals at the table just makes us better as a field.

00;23;25;29 - 00;23;39;14

Roxie Wells, M.D.

So I would encourage my colleagues across the country to just be intentional and intent upon making sure that there's diversity at the highest levels of leadership and your organizations.

00;23;39;16 - 00;23;46;15

Ogechi Emechebe

I love it. I really appreciate your time, Dr. Wells, and thank you so much for this powerful and informative podcast.

00;23;46;17 - 00;23;54;29

Tom Haederle

Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify or wherever you get your podcasts.