Submitted: 25 July 2014
One interview session in two parts: 27 September 2013
Total approximate duration: 3 hours 15 minutes
Interviewer: Tacey A. Rosolowski, Ph.D. (email)
For supplementary materials:
Please contact, the Historical Resources Center, Research Medical Library:
Javier Garza, MSIS, firstname.lastname@example.org
About the Interview Subject:
Donna K. Sollenberger (b. 14 January 1949, Tuscola, Illinois) currently serves as Executive Vice President and Chief Executive Officer of the University of Texas Medical Branch Health System in Galveston Texas. However, in 1991, she came to MD Anderson to serve as Division Administrator for the Division of Surgery and Anesthesiology. She remained in that role until 1993, when she became MD Anderson’s interim Vice President for Hospitals and Clinics, a position that became permanent the next year and that she held until 1997. She was the first woman to hold the position of vice president.
Major Topics Covered:
Personal and educational background
Division of Surgery and Anesthesiology; developing collaborative/efficient operations
Vice President for Hospitals and Clinics; roles, initiatives, perspective on institution
Leadership: development of skills; stories of leadership challenges
Institutional reorganization in the 1990s
Financial challenges and managed care in the 1990s
Developing a “customer focused” culture
The Aim for Excellence Program
Women in healthcare leadership
Regarding the Transcript and Audio Files
In accordance with oral history best practices, this transcript was intentionally created to preserve the conversational language of the interview sessions. (Language has not been edited to conform to written prose).
The interview subject was given the opportunity to review the transcript. Any requested editorial changes are indicated in brackets [ ], and the audio file has not correspondingly altered.
Redactions to the transcript and audio files may have been made in response to the interview subject’s request or to eliminate personal health information in compliance with HIPAA.
Table of Contents
Interview Session One: 27 September 2013
Stimulated By Challenging Situations; Building a Career as a Woman
Chapter 01 / Professional Path
An Institution on the Rise Provides New Opportunities
Chapter 02 / Joining MD Anderson/Coming to Texas
The Division of Surgery and Anesthesiology in 1991: Advocating for the Value of a Division
Chapter 03 / The Administrator
The Eighties Crisis: the Push to Expand MD Anderson and Create Patient-Centered Experiences
Chapter 04 / The Administrator
An Encouraging and Supportive Father
Chapter 05 / Personal Background
Serving as the VP of Hospitals and Clinics: Budget Stresses and Impact on Employees
Chapter 06 / The Finances and Business of MD Anderson
Confronting Managed Care
Chapter 07 / The Finances and Business of MD Anderson
Responding to Managed Care: Moving Toward multi-disciplinary Patient-Centered Care
Chapter 08 / The Finances and Business of MD Anderson
Turning MD Anderson Around Through the Aim For Excellence Program
Chapter 09 / Building the Institution
Changes When John Mendelsohn Arrives
Chapter 10 / The Administrator
The First Woman Vice President at MD Anderson
Chapter 11 / Diversity Issues
MD Anderson Now and in the Future
Chapter 12 / Institutional Mission and Values
Interview Session One: 27 September 2013 (am) (listen/read)
Interview Identifier (listen/read)
Chapter 01 (Professional Path)
Stimulated By Challenging Situations; Building a Career as a Woman (listen/read)
In this segment, Ms. Sollenberger provides an overview of her education and professional path prior to arriving at MD Anderson. She sketches her next moves: working for the Illinois Department of Transportation, getting a Master’s in English; and working for the Illinois Conservation Department until political changes in the state forced her to look for a new job. She took a job as Chief Administrative Officer for the Department of Surgery at the Southern Illinois University School of Medicine. (She remarks that at the age of twenty-six, she ran the clinics and everyone except the physicians reported to her.) She loved the challenge of the job as so much was evolving in medicine. Next Ms. Sollenberger talks about the lessons she learned from this experience: know yourself well enough to hire to your weaknesses and be proactive in helping your organization even if you don’t know everything.
Ms. Sollenberger tells a story to show the importance of being proactive about developing a leadership career. She tells how, at a meeting, she volunteered to rewrite a practice plan even though she didn’t really know what this would entail. She underscores the importance of moving outside of a comfort zone to take on activities that will get you noticed, make you grow, and make you invaluable.
Ms. Sollenberger next talks about building her management and negotiation skills when the University of Springfield began to set in personal computing networks. She worked with the Department of Surgery and Information Technology to overcome resistance and built her skills for brokering successful outcomes.
Ms. Sollenberger summarizes her strengths and weaknesses as a leader. She talks about how important it is that a leader identify her weaknesses and get education to in those areas, as she did in finance and accounting. She needed to know enough to understand the numbers that accountants and finance professionals would present to her. She notes that she tried to go back to school for her Ph.D. in English, but could not add this work to her heavy schedule.
Ms. Sollenberger explains how the surgeons she worked with communicated the expectation that all employees work long hours that were not family friendly. She notes that she was fortunate because her husband, Kent Sollenberger, was an artist and could stay home with the children (Shannon, Blake, and Bradley) when she went out to work. She also notes that she left administration to teach for four years to have a lesser work load while her daughter was young. She also recalls that Dr. Folse asked about her plans to have a family while she was interviewing with him and notes the prevailing assumption at the time: if you had children, you would not return to work.
Chapter 02 (Joining MD Anderson/Coming to Texas)
An Institution on the Rise Provides New Opportunities (listen/read)
Ms. Sollenberger recalls that during a meeting a vascular surgeon in the Department of Surgery at Springfield dismissed her work and “her Irish got up.” She saw an advertisement for a job at MD Anderson and began thinking about doing her work on a bigger stage. Ms. Sollenberger reviews why MD Anderson presented greater opportunity for her: it owned the hospital and clinics; it had a large philanthropic campaign for expansion and was emerging as a critical force in cancer research. She next lists skills that she brought to the job and recalls the key point in her interview –a response that got her the job.
Ms. Sollenberger recalls that her father was a big influence on her life and shares a bit of his wisdom about finding a way forward in challenging situations.
Ms. Sollenberger explains that after interviewing a second time, the position was deleted because of an institutional reorganization. However, two months later, Dr. Charles Balch called her with an offer because the original institutional structure had been retained. Ms. Sollenberger recalls that she insisted on speaking with Dr. LeMaistre to confirm that the institutional structure would be preserved (preserving her position). Dr. LeMaistre provided the confirmation she needed and she accepted the job. Ms. Sollenberger talks about the advantages of being in Houston and the chills she gets when she sees the Texas Medical Center.
Chapter 03 (The Administrator)
The Division of Surgery and Anesthesiology in 1991: Advocating for the Value of a Division (listen/read)
Ms. Sollenberger provides an overview of the administrative and political situation in the Division of Surgery and Anesthesiology when she arrived to serve as administrator in 1991. Dr. Charles Balch was Division Head and he faced resistance from Department heads who resented reporting to a Division Head instead of a Physician-in-Chief. Ms. Sollenberger explain that her role was to focus the Divisions agenda and to support Dr. Balch as he demonstrated the value of Division leadership to the individual departments. One approach was to bring the department heads into the strategic planning meetings for the Division: Ms. Sollenberger observes that this involved breaking down barriers between departments and increasing the very low levels of transparency about their inner workings. Ms. Sollenberger explains that she wanted circulate each department’s financial statements and recruitment plans to set the background for discussions of how to set priorities and coordinate efforts. She confirms that this strategy created a new atmosphere in the Division: people felt more included, they saw positive change in how decisions were made, more links between clinical and research initiatives, and more planning and dialogue. Next Ms. Sollenberger explains the strategic plan for the Division. The main aims: to integrate basic science and translational work into clinical care to create programmatic synergy; build educational programs; create efficiency in the clinics.
Chapter 04 (The Administrator)
The Eighties Crisis: the Push to Expand MD Anderson and Create Patient-Centered Experiences (listen/read)
Ms. Sollenberger describes the economic environment in the late eighties, when under Dr. Charles LeMaistre, MD Anderson was growing at the same time that concerns were evolving about the cost of indigent care in Harris county (which provided to resources specifically for cancer care). This was also the period when fears of managed care were growing and the impact of prohibitions against patient self-referral were becoming clear. Ms. Sollenberger notes hearing the news that Houston was going to have 50% more hospital beds than were needed at the same time that MD Anderson was building three new buildings, including the new Alkek Hospital.
Next Ms. Sollenberger lists the positive developments she contributed to in the Division of Surgery: building trust, advocacy for project funding, stronger and more collaborative budgeting processes. She worked on refining the process of billing for surgery so the institution could receive maximum reimbursement. Ms. Sollenberger notes that, at that time, operations were largely designed around the convenience of physicians. She notes that Dr. LeMaistre has observed that “your other job was having cancer” and recalls a member of a prominent family saying that they would not go back to MD Anderson because it was “like a cattle call and they’re not nice.” Ms. Sollenberger sat in clinics to determine when the waiting areas were packed then talked to schedulers and department chairs to refine the scheduling process.
Ms. Sollenberger lists members of the Division of Surgery who really embraced collaboration in the division.
Chapter 05 (Personal Background)
An Encouraging and Supportive Father (listen/read)
Ms. Sollenberger talks about the ways her father, Norman Fitzpatrick, encouraged her to believe in her own skills, particularly by taking her to try out for boy’s softball, then creating a girls’ league when she couldn’t join the boys. She speaks briefly about her mother and younger sister, Jan.
Chapter 06 (The Finances and Business of MD Anderson)
Serving as the VP of Hospitals and Clinics: Budget Stresses and Impact on Employees (listen/read)
Ms. Sollenberger explains that she became the Interim VP of Hospitals and Clinics in 1993 when the former Head of Hospitals abruptly resigned and Dr. LeMaistre asked her to take on the role.
Ms. Sollenberger explains the Dr. Charles Balch was a great advocate of her career. She observes that Dr. Balch’s wife was not given administrative support during her medical career and left the profession.
Ms. Sollenberger explains that MD Anderson was expected to have a $60 million budget shortfall and lists some of the immediate measures taken to ease the budget stress. She next lists the discussion points take up by the leadership team that Dr. LeMaistre convened to deal with the problem, discussions leading to the decision to reduce the workforce. She describes this process and the low morale created at the institution as faculty and staff lost colleagues and coworkers.
Ms. Sollenberger next explains what she would have done differently. She talks about the negative impact of making decisions at the leadership level, noting how important it is to involve people “in the front lines” in planning changes.
Ms. Sollenberger stresses how import it is for leadership not go into hiding after making difficult decisions, but to communicate directly with individuals.
Ms. Sollenberger describes a lesson she learned from Dr. Charles LeMaistre about interacting with employees. She recalls how astonished she was to discover that he knew employees’ names and families. She explains that this was “a great teaching moment for a young executive.”
Chapter 07 (The Finances and Business of MD Anderson)
Confronting Managed Care (listen/read)
Ms. Sollenberger begins with an overview of the challenges that managed care presented to MD Anderson in the late eighties: reimbursement rates would fall, there would be serious restrictions on the patients MD Anderson could see, and managed care did not support a good system for taking care of patients. There was concern that if MD Anderson did not drop rates, it would not be included in managed care networks. There was also fear that the Federal government would take away MD Anderson’s exemption status: Ms. Sollenberger explains that exemptions were given to a limited number of cancer centers and lifted all limits to care for patients while they were in the hospital. Ms. Sollenberger also notes that there was concern about the increasing numbers of patients without insurance and the absence of self-referral in Texas at the time.
Ms. Sollenberger next talks about the strategies used to deal with these challenges. She first talks about her conversations with Dr. David Hohn, VP of Patient Care, about plans to work with the Harris County Hospital System to put in screening and diagnosis systems and the develop in-patient oncology services at the Lyndon Baynes Johnson Hospital. This would be a solution to the problem of indigent care, providing a community standard of cancer care for common cancers at early stages or for late-stage palliative care. She talks about the negotiations with community physicians over which services they would provide versus those MD Anderson would provide.
Ms. Sollenberger then discusses the process of changing state legislation to allow patients to self-refer to MD Anderson.
Chapter 08 (The Finances and Business of MD Anderson)
Responding to Managed Care: Moving Toward Multi-disciplinary Patient-Centered Care (listen/read)
Ms. Sollenberger recalls the first discussions about clinics set up on a multi-disciplinary format. In November of 1994 she met with Mary Ann Newman and Dr. David Hohn. Ms. Newman stated that MD Anderson was missing an opportunity of it wasn’t set up like multi-disciplinary clinics. Ms. Sollenberger recalls that plans were laid out on the pool table at Dr. Hohn’s home. A primary concern was reducing the distances that patients had to travel to different appointments. She explains an informal study that revealed some patients walked 3 miles for appointments.
Next Ms. Sollenberger talks about planning the multi-disciplinary clinics, named care centers, which would span inpatient and outpatient services.
Ms. Sollenberger explains how she built support for patient-centered care. In a humorous moment, she notes that she and others realized they should “ask the patients” what they wanted, beginning with volunteers who had been patients and individuals from the Anderson Network. Their comments “really opened the leadership’s eyes,” she says.
Ms. Sollenberger explains that this new approach led to a much broader consideration of what was needed to create good care. Patients asked about access to exercise, acupuncture and other complementary medical techniques to help them relax. She talks about the Wellness Center that was established in the Duncan Cancer Prevention Building.
Ms. Sollenberger lists other patient requests and their responses that shifted the “physician-care centric” approach.
Chapter 09 (Building the Institution)
Turning MD Anderson Around Through the Aim For Excellence Program (listen/read)
Ms. Sollenberger explains the Aim for Excellence Program adopted in about 1995 in response to the accrediting body for managed-care participation. This was an early program for quality control in health care: Ms. Sollenberger describes the mission and some of the people involved in setting up the program at MD Anderson. [brief pause]
Ms. Sollenberger lists the indicators the Aim For Excellence Team looked for in determining quality, using the guideline that “systems are at fault, not people.” The team worked for process improvement based on the growing idea in the industry that eliminating duplication and increasing clarity reduces chances for errors. Ms. Sollenberger observes Lean Design was incorporated into the quality movement because of this perspective.
Ms. Sollenberger describes how the Care Centers were geared to effectiveness in providing multi-disciplinary care and that this was something patients didn’t find elsewhere. She describes the changes and retraining that faculty and staff had to accept in order to move to this system (this included requirements that some staff members reapply for their jobs). She also explains how the team communicated the changes to employees, noting that a “matrixed environment” makes it difficult for some individuals to function. After a couple of years, the institution’s margins improved, with the best profits coming from international business. Her team set up an international office to cultivate this business.
Ms. Sollenberger lists the people who led MD Anderson’s turnaround after a financial crisis. She also talks about what would have happened if the institution had failed.
Chapter 10 (The Administrator)
Changes When John Mendelsohn Arrives (listen/read)
Ms. Sollenberger comments on the institution’s view of John Mendelsohn: a trusted and loved leader, the “dad” and energetic third president. She recalls in-house candidates for the position of president and also her interview with Dr. Mendelsohn, who spent time getting to know the organization, faculty, and staff when he first arrived. She contrasts Dr. Charles LeMaistre’s focus on patient-centered excellence with Dr. Mendelsohn’s work on building research excellence. She comments on her departure from MD Anderson to take the position of Chief Operating Officer at City of Hope Hospital: she had ambitions to become a president or CEO and felt she had reached the highest position possible at MD Anderson.
Chapter 11 (Diversity Issues)
The First Woman Vice President at MD Anderson (listen/read)
Ms. Sollenberger notes that she became a role model for many when she was hired as a VP at MD Anderson –the first woman to serve such a role. She felt both fortunate and humbled by the magnitude of the responsibility she took on, noting “My dad would have been proud.” She also contrasts her professional life with her mother’s. Ms. Sollenberger goes on to talk about why it is so important for women to serve leadership roles in health care, citing the fact that the field still has a predominantly female workforce and these employees relate more easily to female leader. She also feels she can approach problems in ways that would be difficult for a man. she feels that women bring more compassion, a more nurturing spirit, and more openness to leadership roles.
Ms. Sollenberger talks about the influence her parents had on her life and success, cautioning her “Don’t get above your raising” and to always remember it “takes everybody to do the job right. Ms. Sollenberger also mentions the weight that comes with being the first woman in any role.
Chapter 12 (Institutional Mission and Values)
MD Anderson Now and in the Future (listen/read)
Ms. Sollenberger provides her perspective on MD Anderson now, after serving at other institutions for many years.
[The recorder is paused.]
Ms. Sollenberger observes that MD Anderson is about all the people who are devoted, caring, compassionate and emotionally and professionally invested in patients and their families. In the last minutes of the interview, Ms. Sollenberger comments on how political issues can arise with leadership changes: these must settle down so the institution is not demoralized. Ms. Sollenberger talks about the importance of communication in healthcare, especially one-on-one communication. In closing, Ms. Sollenberger describes MD Anderson as a wonderful, essential organization for the U.S. and for Texas.
Original Interview Profile
Interview Profile #42: Donna K. Sollenberger
Submitted by: Tacey A. Rosolowski, Ph.D.
Date revised: 25 July 2014
This interview with Donna K. Sollenberger (b. 14 January 1949, Tuscola, Illinois) takes place on 27 September 2013 (about 3 hours 15 minutes in duration). Ms. Sollenberger currently serves as Executive Vice President and Chief Executive Officer of the University of Texas Medical Branch Health System in Galveston Texas. However, in 1991, she came to MD Anderson to serve as Division Administrator for the Division of Surgery and Anesthesiology. She remained in that role until 1993, when she became MD Anderson’s interim Vice President for Hospitals and Clinics, a position that became permanent the next year and that she held until 1997. She was the first woman to hold the position of vice president. The interview takes place in a conference room in the Administration Building on the campus of the UT Medical Branch in Galveston, Texas. Tacey A. Rosolowski, Ph.D. is the interviewer.
Ms. Sollenberger attended the University of Kansas in Lawrence, Kansas from 1967 to 1970 before transferring to the University of Illinois at Springfield, where she received her B.A. in English and Chemistry in 1971 and her M.A. in English in 1974. Over the course of her administrative career, Ms. Sollenberger has been influential in strengthening organizations that are undergoing considerable stress. After serving as Executive Vice President and Chief Operating Officer at City of Hope in California, that institution awarded her the Spirit of Life Award (1999). She next served as President and Chief Executive Officer of the University of Wisconsin Hospital and Clinics: in 2006 she received the Best of Madison Business Award for Children’s Hospital Leadership. In 2007 she was named one of the Top 25 Women in Healthcare by Modern Healthcare Magazine.
In this interview, Ms. Sollenberger provides a detailed look at the challenges that MD Anderson confronted in the nineties because of institutional reorganization and the growth of managed care and other factors. She first talks about how the Division of Surgery and Anesthesiology created more collaborative and efficient operations under Dr. Charles Balch. Discussing her role as Vice President for Hospitals and Clinics, she talks explains the institutions financial crisis and response. She spends particular time discussing how MD Anderson created a “customer focused” culture through improvements to patient care, patient services, and creation of the multi-disciplinary disease site centers. In addition to sketching the institution’s history during this critical time, Ms. Sollenberger also provides many anecdotes about leadership in healthcare. Her interview includes comments on the challenges women face in healthcare leadership as well as what they bring to organizations.