The Leadership Rx for Women Physicians
The Leadership Rx for Women Physicians
Revolutionizing Healthcare: Fostering Collaboration and Community in Medicine _ Interview with Dr. Martha Rodriguez
This episode is back to my interview series of inspiring women physician leaders.
Dr. Martha Rodriguez is one such leader I have known for several years.
At the time of this recording several months ago, Dr. Rodriguez owned and operated her private practice at a state-of-the-art facility she coined, MMR Healthcare. Her field of specialty is geriatric care and making patients' golden years shine. MMR Healthcare has been PCMH recognized since 2014. In 2012, she co-founded one of the highest performing Accountable Care Organizations in the country and served as its Chairman of the Board until the end of 2016. With coordination of care at the frontlines of every patient visit, she works to ignite the path towards healthcare excellence.
Her other passion is leadership. She was the medical director of several skilled, assisted, and independent living facilities for many years.
She holds several other leadership positions including Palm Beach County Medical Society President and Co-Chair of the Palm Beach Medical Society Leadership Academy.
Outside of medicine, Dr. Rodriguez loves to spend time with her family and go to the beach. Her greatest pastime is playing with her first granddaughter.
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🌐 Website: www.theleadershiprx.com
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Hi everyone and welcome to another episode of the Leadership Prescription Podcast for Women Physicians. My little attempt to increase the number of women physicians in this world. My name is Asha Padmanabhan and I'm a Board Certified Anesthesiologist. A Master Certified Physician Coach and a Leader and I love to bring you this podcast where we talk about all things leadership and from time to time I bring you inspiring women physicians who I consider great leaders and who All of my listeners can learn tons of stuff from. So today I'm thrilled to present, to bring to you Dr. Martha Rodriguez and Dr. Martha Rodriguez is someone who I find very inspiring. She is a, an Internist and well established primary care physician in Boynton Beach, Florida, and she has built up a fabulous practice all by herself. Her accomplishments are many. I'm just going to highlight a few. She owns and runs. her own private practice and which is called MMR Healthcare and her specialty is geriatric care and she really focuses on making her patients golden years shine. She also co founded one of the highest performing accountable care organizations in the country and was Chairman of the Board until the end of 2016. She also is very passionate about leadership and this is where we connected. She is the Medical Director of several skilled assisted and independent living facilities for many years. And she's also co chair of the Palm Beach Medical Society Leadership Academy and currently enrolled in the American College of Physicians. Leadership Academy. She's been on the board of directors of the Palm Beach County Medical Society for several years and is now the president elect and also chairs the Women's Council for the Medical Society. Apart from that, she's involved in the teaching of pharmacy students and for fun, she loves to spend time on the beach with her family, especially her podcast. Because I think you guys are going to learn tons of stuff from her. So Dr. Martha Rodriguez, welcome, and I am so thrilled you're here. So I'm going to start off. Thank you, Dr. Padmanabhan. Asha, we know each other to be, let's go with first names, if you're okay.
Dr. Rodriguez:Thank you. Thank you for the honor of having me. You
Dr. Asha:are welcome. So, Martha, I would love to start with your journey in medicine in leadership. I've heard this offline, and I think it's so inspiring for people to hear where you started. And then we'll focus on your private practice, how you
Dr. Rodriguez:started.
Dr. Asha:Okay. So what I would love to do, Martha, is to take our listeners through your journey, uh, in medicine, how it started, how you first started in leadership, what challenges you face, and then we'll focus on how you built and how you started and built this primary care practice to such a successful level. The finances of it, the challenges of it, everything that you went through.
Dr. Rodriguez:So, the first thing I'd like to say is that we must recognize, as physicians, as women, as human beings, that life is a team sport, and until you realize that, and you humbly work. Realize that unless you have the right teammates with you, you will get nowhere. Whether it's in your home, whether it's in the CREB cycle with the other elements, whether it's in anesthesia with the nurses and the anywhere. Once you realize that, which it took me a long time, by the way, because in medical school, we are trained to be autonomous. So the first clue that I will say to anyone is to humbly realize that we are not anything but a member of a team. Very true.
Now,
Dr. Asha:how did you come to that realization?
Dr. Rodriguez:So I came to that realization because I was, I've always been very passionate about chronic care, longitudinal care. I never really, actually, that's not true. When I went to, when I was in training, my brother was diagnosed with ulcerative colitis when he was 19 years old. So my whole life I wanted to be a gastroenterologist. My senior year of residency, when I was seven months pregnant, I got stuck with a needle of a patient while putting in triple luminin and I just left in a car and just went to Florida and found a job and realized that really what I wanted to do is longitudinal care and understand people, share people's lives and grow with them. So from day one, I realized. That there was nothing I could do if I didn't engage the patient. So, it is very important to realize what your challenges are, what your barriers are. And what you're up against before you confront anything.
Dr. Asha:Yeah. And we've talked a little bit about this offline is the challenges you faced when first going into practice. Could you share a little bit about that?
Dr. Rodriguez:Yeah. So I started my practice in 1997 and, I was coming out of, so I came to Florida in 93. And I came to Florida as a hired physician by offices that held, HMO contracts. And I was asked to, not provide the right care for people so that they could make money. Which, by the way, that's, that doesn't happen nowadays. But at that time, the way HMOs worked, which they don't work like that. I want to make it very clear. They don't work like that anymore. one day I was asked not to order mammograms on patients, not to order stool cards on patients. So, I left and I went and opened my own practice with a very bitter taste about managed care and about value care. And for about 10 years, I would say about 10 years. I had about four employees. I, I went through a lot, a lot of challenges, including one day one accountant told me you owe 38, 000 in payroll taxes, and you have to come up with that. so I went through all of that. And then one day I realized this is not working. I cannot see a patient because they're sick and get paid. I should get paid because I keep a patient healthy, which is the way I have always envisioned healthcare to be. So, very, very sharply, I realized, hey, you could make money and get paid for doing the right thing. And that's when my turning point came, came around, when I realized that private practice should be based. I'm keeping people healthy, not getting paid for seeing patients when they're sick.
Dr. Asha:Very interesting because this is how that's kind of the change, right? Because we go in and treat patients when they're sick or patients come to our us for care when they're sick. So turn it around and say, let me keep them healthy. I mean, I'm sure lots of physicians want to do that, but. Haven't found a way. So how is it that you found the way and what is it that you do?
Dr. Rodriguez:So the way I found the way is, so fortunately, It just happened to be that, insurance companies, the government even, is looking for ways to find, solutions to keep people healthy and save up front and long term. So you might invest a little bit up front and then save long term. So the way I've done it, the way I do it, the way I think everyone should do it, is to look at contracts that pay you for proving That you do the right thing, that you control diabetics, that you control high blood pressure, that you don't have to have people have congestive heart failure. I don't want to have a patient with an ejection fraction of 40%. I have an ultrasound that I hold in my phone and when I do a wellness visit, I look at their heart every year. And I tell, if I see a change, I act on it. That's how medicine should work. And you get paid for doing that, and you get paid very well. So my biggest message, I guess, is for people to understand that there is so many opportunities. This is the right time for people to go into private practice and realize that If you prove that you can do this, it is a golden opportunity. I'm telling you, can you imagine if you want, would you rather I find out that you have congestive heart failure or When I do your physical, I look at your ejection fraction every year and see if there's any change. What happened? Did you have a cold? Did you have something affect your muscles? Did you have an obstruction all of a sudden? Something. Or do I wait until you have congestive heart failure and get paid because you have congestive heart failure? So the way I've succeeded, to put it simply, It's prevent something before it happens and invest money to do that.
Dr. Asha:Let's talk about that. You said invest money to do that. And then how did you get the patients to buy in? So what did you invest in and how did you get your patients to buy into this model where they are, have to be more proactive, right? Is what
Dr. Rodriguez:I'm hearing. So, so one of the biggest things that, So, what Value Based Healthcare allows you to do, it allows you to have a team, okay? So, in my office, for instance, if you're a diabetic and you come to my office, and let's say your hemoglobin A1c is 8, I call in the room before you leave, I call the dietician, I call the pharmacist, and I call the coach. And someone calls you every day, if you have to. We call, we have the, companies that do continuous glucose monitors, donate monitors to us. So that we can prove that we can change and we can control your sugar. The number one reason why we succeed at that is because we educate the patient. We make the patient aware that all of this that we're doing, nothing can get anywhere if you don't do your part. So, yeah, it's a team approach, we engage the patients, we educate the patients a lot. We have, classes every week in the office for the community. Even if they're not our patients, we don't care. We have classes for diet, for exercise, for everything. We even cook for patients. once a week. so, yeah, team approach. Yeah. So
Dr. Asha:what were the, so you said something really interesting, which will lead into what, where I'm going with this, as you said, people should go into primary care or independent practice now. And here I'm seeing, at least in this part of the world, and I'm sure other parts of the U. S. as well, A lot of physicians, internal medicine, family practice are becoming hospitalists and leaving their private practices. And you're encouraging people to go back into private practice. How, what, what is the advice you'd give them on how to get started? What they should do to build that successful practice where you went from a solo practitioner with your, just your staff to what is it now? What is your practice now?
Dr. Rodriguez:So the thing is that it requires a shift, a shift in mentality. From the day we start in medical school, we learn to run a code. We learn to tell students what to do. We learn to tell residents what to do. Autonomy is what makes us succeed through what we do. The difference between that And what would make you successful in private practice is that you realize that you cannot do that. You cannot do that. So my first step would be to get in the community. Get in the community of people that have crossed those bridges. If you have gone through the Washington Bridge, Actually, everything is like this. This is why we have CPAS, we have EPAS. It's so hard for me to understand that we don't apply that in medicine. Like, if I already went through all of that, community, ask me, tell me how I did that. How do I get that contract? Can I get that contract? Can you make a phone call? I believe... If you come out of residency and you partner with someone, you don't have to be an employee, you have to partner, which is very different, okay? Asha, you're a leader. I want to learn from you. You coach me on how to be better, okay? Martha, I, you did private practice, how do I do that? That community process of telling, asking, telling, asking people, how did you do this? Who do I call? Can you make a phone call for me? I will say the day you graduate or even before you graduate, you shadow someone like me and you say make those connections for me. There's, there's no competition. There's collaboration. There's no competition. There's collaboration. So I will say the first step is the community process. This is why I'm so passionate about community concept. And now, you know, in medicine, historically, and this is a fact, we. All think independently. We all think we're in competition and we're not, you know, we should be in collaboration, which is what you're doing. And that's why I, I'm so proud to be here because in reality, by ourselves, we can do nothing. And, you know, it's so funny because, you know, even in, physics, they have done studies. One horse can run very fast. Two horses. So, all these things can run five times as much because they're together, you know? But we need to apply that. Yeah,
Dr. Asha:I love that. I love that collaboration aspect because I think you're right. In medicine, we are taught to be autonomous, but I think that also the other part that comes in is a lot of, many of us are afraid to ask. Because we are embarrassed or we feel like we show our ignorance. And I just want to tell people, listen to what you just said is don't be afraid to ask for help and don't be afraid to ask for guidance because that's how you grow. And just as you said. We can help each other out. Someone, if someone comes to you and says, how did you do this? You are willing to help. And that I think is the beauty of what you're doing. And now your, your practices, you said, how many physicians do you have in your practice?
Dr. Rodriguez:Just to add to that a little bit, to piggyback on that, the biggest challenge in life is to know what you don't know. Yes. And you'll never know what you don't know unless you're exposed to other people who have been there and done that. Mm-hmm. Okay. So humble yourself and be, be open-minded. You know, I don't know that I, I How did you do that? The biggest step to progress and go, up in a ladder is to find out what you don't know. Mm-hmm. Okay. So I think that's, that's very important. Yes.
Dr. Asha:And what is the biggest challenge that you faced while building your practice? As a woman physician,
Dr. Rodriguez:Oh, by far, financial, of course, by far financial until, until it wasn't about being a woman or not being a man or anything. It was about proving that you do the right thing at the right time for the right people. So I, I'm not a big fan of saying women or men, black or white. I'm not a big fan of that. I'm a fan of. the proof is in the pie, you know. we can make diabetics better. We can reduce, CHF readmissions. We can reduce complications. It didn't matter who did it. The evidence speaks for itself. So, my... Key to success is to do the right thing for the right people at the right time. That takes a lot of open-mindedness though, because medicine is a work in progress. You know, today what you put people to sleep with is now what? I used to go for a colonoscopy 10 years ago and go to sleep for six hours. Now you put somebody, asleep for a colonoscopy and they wake up instantly. Mm-hmm. So it's a work in progress, you know, so you have to be very open-minded. It's another thing that physicians don't do, you know, we're very stuck in our ways. You know, we learned that A and B is equal to C. That's not true, you know, everything is a work in progress.
Dr. Asha:Yeah. So, while building your practice, what, how did you learn about the finances, the insurance companies, all the things that you needed to learn to set up an independent practice? Because obviously there's not something that is taught in med school or residency, how to build up your practice. The business of medicine is not taught. So how did you learn?
Dr. Rodriguez:My God, by hitting my head against the wall, literally, literally, really, it's true. I learned by doing it, by doing it and just doing it and It wasn't something you could do if you couldn't get paid. So like I said, if you proof that you can do something, then it's easier to do it. Okay, so I never knew. I didn't know anything about insurance. I didn't know anything about billing. I didn't know anything. But the insurance companies saw that I was saving them money, that I was keeping the people healthy, so they were paying me well, so I was able to hire the right people to be my teammates and then get me through the process. I didn't have to know that. That was not my job. My job was to, my job is to recognize Who I need as part of my team to get me to the next step, whether it's the dietician or the pharmacist or whoever it is. The billing, like I had a billing person today say I need to go home and I have a back issue. So I said to her, She's been with me for 10 years. So, you know, this is a very big thing because right now we can't find staff. So I told her, go into my office and look at my desk. So press a button on the left and see that when I feel like my back is hurting, I lift this, this, the, the, my desk into a different height. You know, she goes, doctor, I never even knew that existed. So again, collaboration. She went into my office. She sat down and she changed the heights on the desk. Simple things like that, that you work together, get you to the next step. There's no magic, Asha. It's one step at a time, open mindedness, and just... Going through it.
Dr. Asha:I think it also what you are, I think you're very humble right now and very self effacing because I remember you telling me about when you set up your EMR and how persistent you were and that really struck a chord because a lot of times people won't do that. So I'd love for you to share that story you told me about when you were setting up your EMR and how you had that person with you for a year and what you did with that. So. So,
Dr. Rodriguez:we, everybody talks about physician burnout, and the number one thing that they list on physician burnout is EHRs, and why EHRs do. Okay, well, if that's the number one, we should be treating diseases, not symptoms, right? EHRs are a symptom, they're not a disease, okay? If we allow the symptom to overcome us, then, then, so what I did? is I had to change EHRs and I had to make everyone engaged and I have 38 employees so I had to bring all of these people engaged on this. So what I did is I partnered with the developers and I said to them, if you help me, I'll help you. So I decided, I picked one person in each department in my office to be a champion. To work with the developers directly and say, look, this is not working. This is too many clicks. This is what we have to change. And actually today we still do that. We use Eclinical and we work completely directly with the developers and the people who... You have to just take charge, you know, you have to just... Take the initiative,
Dr. Asha:take charge, be persistent. And follow through.
Dr. Rodriguez:You cannot be passive. Passive, which is a, I would say if, if I had to say is the biggest disease within physicians is, is the, the thing to say that in my job is to see the patient, take care of the problem, and the rest, somebody has to take care of it. Unfortunately, that's not how it works. You know, we're a part of a puzzle, you know, and the puzzle We are a very important part of the puzzle, but it's still a puzzle, okay, and we have to recognize that. Yes.
Dr. Asha:Yeah. And swinging from that to what we just talked about a little bit is what the leadership characteristics that you showed, which was, you know, being upfront and being persistent and really looking for the solution. As you said, not letting the symptom rule your life. Rather than trying to find the cause. So, I know you're very passionate about leadership, so tell me a little bit about that. How you got passionate about it, what you want to do, and how do you see yourself taking this new step forward, as you become the president of Palm Beach County Medical Society next year?
Dr. Rodriguez:So I was very lucky, Dr. nephrologist in town, one day called me and said, Martha, this is like the perfect thing for you, like, I just graduated from this, but you should be there, not me. You should be there. So I really didn't know anything about it. So I, applied for the Palm Beach Leadership Academy, in which, I'm telling you, I learned incredible things. It opened incredible doors for me, and I realized that we have so much work to do, that there were so many people just taking charge of our lives when we had no saying. So, My, my biggest advice to everyone is to take charge, make sure that you're at the table, not on the menu, you know, I know it's hard. We're all very busy. We're women, we have families, but we have to make some room to be able to be When decisions are being made, how they're being made, who they're being made for, okay? So I believe it's very important for everyone in medicine to realize that you have to be in a community, that you have the opportunity To be able to take some charge and be able to make, be part of decision making that you are not letting other people make decisions for you. So for me, the Leadership Academy was the turning point, honestly, it was like my turning point. I'm very passionate about it. but it's almost like, peeling an onion, you know, like you have to, leadership is not, it's not something that you got up in the morning and you say, first of all, number one, as a physician, you're always a leader, you know, you have an authority, you tell a patient, take a pill, you know, that makes you a leader because they're trusting you, but you can't take that for granted. You can. That's only the very beginning of a very big step that you have to take and politically, economically, socially, there's so many other things that you have to be part of. So I'm very passionate about community, about physicians coming together and making one voice be heard. So the Physician Leadership Academy has been where I've been the most passionate about and the Parmish Medical Society has Although it's been a great society for a hundred years, I think now it's time that everyone gets involved and politically, we are in a turning point. We have to make sure that our voices are heard, but no one is going to listen to you or me. independently, but they will listen to you and I together for sure. So I'm very passionate about getting physicians together, engaged as you know. I feel like women physicians have a very big power. Number one, we're growing. You know, well, where 10 years ago, medical schools had 10 to 1 ratio in females, now it's 10 to 1 ratio in males, so we have to get together, we have to talk together, we have to grow together, and so the society for me is that avenue, and that's why I'm so passionate about it. Yeah,
Dr. Asha:and I have to endorse it as a graduate of the Physician Leadership Academy as well. If you're listening to this podcast and you're in the South Florida area, you can apply to that Leadership Academy if you're in one of the three counties, Miami Dade, Palm Beach, or Broward. And I Totally endorse that. Absolutely great value. That one year was fabulous. So much in it as well. But you're absolutely right. If we allow other people to make decisions that affect our lives and our careers, then we have no one else to blame but
Dr. Rodriguez:ourselves. That's exactly right. So,
Dr. Asha:everyone, I mean, step forward, even if it's in a little, small capacity, small steps. I think everyone should really sit at the table, as you said, and make their voice heard, because that's the only way you're going to be able to make decisions that affect your life, make a difference in those decisions. So what... Go
Dr. Rodriguez:ahead. Sorry, Asha, you know, and we, we did so much, you know, we went through so much to get to where we are. We were never, ever meant to be a nine to five job, you know, we were meant since we made the decision. And I know from when I was a child. I always wanted to do something that changed people's lives. How can you sit back and go 9 to 5 and just go home and not think about what's happening to you, what's happening to the people that are coming after you, that are coming with you? I don't think as a physician we should do that. I don't think apathy is really, it's really acceptable. I think it's, it's, it's so great when we can really say we, we changed our lives. We changed other people's lives.
Dr. Asha:I think it's so important what you said. It's not a nine to five job and I find that very difficult to sometimes understand with people I meet who are physicians and are thinking in terms of. 9 to 5 or this is not what medicine is. I totally agree with you on that. So as just a last, advice for young women physicians who are coming out of residency, stepping into practice, whether that is as a hospitalist or trying to set up their private practice. What is, what are some pearls of wisdom that you would give them?
Dr. Rodriguez:Well, the first probe of wisdom is that Life work balance is very important. It wasn't for me at that time. It wasn't, we did not grow up like that. Now it is, and you have the luxury to do that, but don't overestimate that. Just don't think that because you have a life work balance, you don't have to take charge and change the world around you. So if you're coming out of residency, if you made the decision to not let someone else rule your life for the rest of your life. then take charge. learn from other people who have been there. We are always so open. We will walk you through it. Shadow us. Use us. We are here. We don't have any issues teaching you, showing you all the traces, getting you with insurance companies, getting you contracts, Use us. We're here. So the first thing I was saying It's partner. Partner up in a community that lifts that. As you rise, they lift you. I think, oh my god, that's so important. It's so important because it's so, medicine sometimes can be so isolating, but it doesn't have to be. Not anymore. We're women and women, we can partner, we can lift each other and we Well, I, for instance, I, I will teach anybody that comes to my office. I teach them from A to Z everything. I'll have them sit in every desk. You just get someone that you, you can mentor. You get someone that can get you to the next step. If I walked that already, why do you have to walk through it? If I went through that thing, why do you have to go through it? I'll get you to the next step.
Dr. Asha:I think that's so admirable that you're willing to do that. There's not many people who are willing to spend their time and effort on getting people to the next level, getting younger physicians or colleagues to the next level. So I really applaud you for that and commend you for that. So,
Dr. Rodriguez:well, I live on the, on the basis that you multiply your multipliers and I cannot. I am getting old and I'm going to need people to take care of me and my family. So I want them to be the best they can be. They don't have to be miserable. They don't have to be 9 to 5. They don't have to be complacent. They can do something they want to do and do it well. Yes.
Dr. Asha:Yes. Very valuable lessons. So thank you, Dr. Rodriguez. Thank you, Dr. Martha Rodriguez for this wonderful interview and we will be talking again. So again, this is the Leadership Prescription Podcast and you are listening to Dr. Martha Rodriguez and I, Dr. Asha Padmanabhan, and I will see you on the next episode.