Economic Development and Leadership Q&A Series: Dr. Michael Waldrum

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There are many partners and organizations involved in successful economic development programs and initiatives. In this Q&A Series, the Greenville ENC Alliance is interviewing key stakeholders in the local, regional, and state level that play a role in business attraction, retention, and expansion, workforce development, talent attraction and retention, and community engagement.

Josh Lewis, the Greenville ENC Alliance’s president and CEO, had an opportunity to sit down with Dr. Michael Waldrum, CEO of ECU Health and Dean of the Brody School of Medicine at East Carolina University. Dr. Waldrum is a specialist in critical care medicine and pulmonology and is trained in internal medicine. He has expertise in clinical effectiveness, information system and healthcare management in academic organizations. Josh and Dr. Waldrum discussed how health care relates to economic development as well as workforce development and talent attraction. On a personal level, Dr. Waldrum shared details about his journey to Greenville and his hopes for our community and its future.

(Portions of this interview, as published here, have been edited and condensed for clarity.)


Q: Talk to us a little bit about your career, how you ended up in Greenville. I know you've lived in a couple of different communities so talk to us about your ascension into a CEO position for a large hospital in eastern North Carolina.

A: Well, my path has been one of learning and growing and doing things that I felt matched my core desire to help people and then to do it at scale. That led to a lot of different jobs. Learning how to take care of one person at a time, but also learning about systems and quality improvement, and system change. I never had a defined path and said that I want to be a CEO. It was opportunities that presented themselves. I was told as a young person that the most important thing to do was to get experience and then learn from that experience. And after three to five years in one learning experience, you should learn something new.

So, I did that from an early age.  I started nightshift as an orderly and worked my way into medical school. My mentor said that if you do that, when you get to about age 40, a bunch of doors will open that you didn’t even know existed when you were 25. I followed that pattern, got a lot of great experiences and a lot of different roles, and then became leader of a large academic hospital.

So, my space has always been how to take care of people. Academics are important. For me, it's a value set and learning as well as promoting learning. For me, another core value was populations or areas that need improvement the most. If you're going to have impact, you do it in environments that have the highest need. Long story short, that led to primarily working in healthcare, safety net organizations, and places that need the skills that I can bring. And so, when I was looking at Greenville, it was a desire to become an academic health system and integrate ECU and the hospital. The board and ECU leadership wanted a leader with that kind of experience. And so that was a space that I had. Coming here, it had all those core components that are important to me.

Q: So being a doctor you diagnose patients, you determine what's wrong with them, and develop a treatment plan. I assume you have a similar mindset for systems where you say, okay what's wrong with the system? How can I change it? Which one do you believe is more challenging?

A: It's a different type of challenge. I have a medical degree, an MBA, and I have a Master's in epidemiology. I look at it all as problem solving. I think that one of the things we don't do a good job within education and in life is training people to solve problems. Whether it's a healthcare system or an individual patient, it requires collaboration, so it's a team sport. On diagnosis you must identify the problem, and then you must have a plan to deal with that problem. And in some cases, you may not get the outcome you want. So, if you're trying to save somebody's life, and you can't save it, you must deal with that harsh reality. And sometimes that happens in business also. You can still solve the problem and you can still be successful, but you must change your perception of what the outcome is that you're looking for. I wouldn't say that either is harder or easier. I think the hardest thing for humans is working collaboratively to solve hard problems. That's something I think a lot about. It’s something we feel is important when we're looking at how we solve issues that face eastern North Carolina, or rural America. Sometimes people think because I’m the CEO, that I make those decisions – but it's not like that. It's not a command-and-control structure, even inside the company. That's the same thing with health care, when you're taking care of an individual person, you must understand their needs and desires, their family, or social context.

(Credit: ECU Health)

Q: What do you think is the primary leadership quality that allows you to be successful in what you do?

A: I think you have to mentor and grow teams. Back to collaboration, you have to empower people and grow, plus you need to have the right folks. You must constantly develop self and develop your team. I believe those are fundamental in the work. Back to what I was told by a mentor, that it is windy at the top. Another mentor called it static. You just have to know that it's going to be windy. You don't know if someone will be coming from the east or the west, you just know it's coming. You can't freak out because it's windy. You must be comfortable with the wind, and you have to learn how to put your sails up and sail through it, not fight it.

So, I think that comes down to not having an acute reaction to chronic problems. Most of the issues I deal with have been there for a long time, it didn't just happen. Most of the outcomes that you see, and that people get unhappy with, are a byproduct of something that's been going on a long time. Because of that, you have to have a methodical approach in the team and interventions that change it over time. Having the right leaders, developing the right leaders along with how you solve the problems and create plans, and then having the fortitude to see the plans through and the structures to manage all of that are really the important things to deal with the wind. Otherwise, you're just getting whipped around, and you're just a victim to it. You also have to be comfortable with failure.

Q: As you talked about leadership, some of the things I heard from you included fortitude to be secure in your convictions and to be courageous enough to make those decisions. Another one is perseverance, being able to accept failures, to keep moving and be collaborative to solve problems. And the third one, which was your acute reaction analogy is just about being calm and steady.

A: Yeah, I think also being supported. I'm very fortunate to be secure, supported by the board. And firm and reasonable and steady. People often want to create a perception of reality, that's not necessarily reality. If you're going to solve the hard problem, you have to be comfortable dealing with harsh realities. Sometimes people want to create a reality, that's not the reality on a system problem. It's emotion or it's what they want, or the way they think it works. You can't solve problems when you think it works that way. And I think there's a lot of that in the world today and a lot of that in health care.

You can yell at me but that’s not solving the problem. Or you can run me out of town, but you're still going to be left with that structural reality. And so, that's a big issue for rural health care. We've lost a hospital in eastern North Carolina just recently. But if you look at supply costs, labor costs, demographic issues in rural communities, these are structural realities that are happening everywhere in the country. We need systematic structural change to support our rural communities through those realities. If we're just going to ignore those facts, we'll have a dead patient at the end of the day. That's what being an intensivist teaches you. If you've got something really that's going to kill you, you better know what it is. And you better figure out how you're going to confront that issue and change that or you're going to die. And it's the same thing in systems or business. You may not be able to change but I believe you have got to be willing to confront those issues. I’ve often quoted Good to Great by Jim Collins on brutal confrontation with the facts. You’ve got to be willing to confront those facts if you're going to have a chance.

Q: In talking about health outcomes, rural health care, and the hospital system, in your opinion, how does this relate to the economy? Do you see a correlation between wage outcomes, job outcomes, and community health? How are they correlated?

A: Very. There are two kinds of lenses that are from different perspectives on that one. Health care and delivery of health care, and the people, and doctors and folks that do it are team members. Really important work. If you go into healthcare, you're there to help other people. And the professionals in these jobs create economic benefits. We're one of if not the largest employer and an economic driver. However, you know, frankly, it would be better if we weren't the largest employer and that people's lifestyles and their health didn't need us. Our goal is to help people live healthier lives and have less disease and fewer issues where they don't need us. So, how do you get communities healthier? How do you have populations be healthier? I think that the number one way is to educate, have an educated population. Education is important to driving healthy lives and healthy health outcomes. And having economic opportunity is important. So, if you look at what it takes to have healthy communities, it is education, economic opportunity, and access to health care. I work in all those sectors. I run a healthcare delivery organization. So how do we respond to people with illness but then also try to prevent illness.

The financial incentives inside healthcare are moving rapidly towards incentivizing healthcare delivery organizations to promote healthy lifestyles and wellness. So as a care delivery organization, we are moving down that path aggressively. It's important work, promoting education and supporting our schools to help us have the workforce we need because we hire educated people to provide health care. But we also know that an educated group makes better life decisions that lead to healthy outcomes. And educated people also support economic development. So, companies that may want to move to eastern North Carolina need a workforce that is trained and able to provide the workforce for those businesses. Trying to support groups that are recruiting companies in eastern North Carolina is important for our communities.

Q: What do you think the Greenville ENC Alliance can do to help ECU Health better attract talent and develop talent?

A: Well, I think working with others to create a community people want to belong to and marketing that. We recruit professionals that also have professionals as spouses or friends and so we need other opportunities as well as strong schools. I think creating environments where people want to be part of is the important part.

Q: What's something we could be doing that really sets us apart from some of the other areas that you've lived in?

A: Having been involved with other economic organizations, making sure that we represent ourselves as a united group with a regional perspective is important.

Q: What else as a community can we do to set ourselves apart from some other areas?

A: We need to market the educational opportunities. A lot of times folks looking to move here don't readily understand what they can do to educate their families, which is a big issue for professionals. I think how we bring different cross sector interests together for innovation hubs and creating and leveraging each other and what each bring to the table, and then using that to potentially grow our own or create our own. I think if we took some of these exciting things that are happening and start talking about it as an intersection of different capabilities that that could attract investments in the east. I think most of the economic development is more how do we attract startups and people that are wanting to come in and invest.

Q: Last question, what are you most proud of in your time here at ECU Health?

A: I'm really glad and proud that we created ECU Health. And I'm really proud of our health care workers, and our school on its response to the pandemic. I mean, the largest thing that's affected our societies in our lifetime was the pandemic, and healthcare was in the middle of that. The professionals inside ECU Health just mounted what I would describe as a world class response to that reality. And so, I'm really proud of them.

About ECU Health

ECU Health is a mission-driven, 1708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of more than 14,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 185 primary and specialty clinics located in more than 110 locations. The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children’s Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research. For more information, visit