Intro: This episode is part of a special Women In Leadership Podcast series.

Sarah Brownell (Host): So excited to be here today for another Women in Leadership Special Series for Rapid Insights with the Society for Healthcare Strategy and Market Development Podcast. My name is Sarah Brownell. I am the Strategic Growth Director for HDR Architecture. And I'm especially excited about today's interview. We have a tremendous leader here with us today. I'm excited to interview you. I'm excited to learn from you. And I am so excited for listeners to have the chance to learn about your story. I'm going to do a really quick introduction. Julie Freischlag, the CEO for Atrium Health Wake Forest Baptist.

Julie A. Freischlag: So, I am now the CEO of Atrium Health Wake Forest Baptist. I've been that now for seven years. But now, I'm the CAO of Advocate Health. We just partnered with Advocate Health a year ago. So, that's medical centers across Illinois, Wisconsin, Georgia, and here. So, I oversee residency programs in education and the executive vice president of that as well too. And then, I'm the Executive Vice President for Health Affairs for Wake Forest University. So, I report to the president of Wake Forest looking at academics as well.

Host: Wonderful. Thank you for that. And thank you for all this amazing work. So, these interviews are very special to me. I'm a mother of three daughters. I'm a female in the profession. It's very special for me to get the chance to interview someone like you who has done such amazing, incredible things. You have such a great story to share. You have such great insights that we, women and men, all of us should be learning from. So, huge thank you to you for taking the time to do this. You told me a little bit about what your role is now. I want to kind of rewind and maybe can you give us a little bit of, you know, how did you get here? What is your background?

Julie A. Freischlag: I really appreciate you doing this, because actually today I was in the operating room today because I'm a surgeon. I still operate, and I did clinic today with a third year medical student. So now, here's a young person in her late 20s that saw patients with me, but asked me similar questions. You know, "How do you get through this? How do you become this?" She wants to be a pediatrician. And even though there's more women in medical school, there's less women in leadership in medicine and in your business as well too. And how do you get to the other side and how can you be you doing it? I think that's probably the biggest thing.

So, I was born in a small town in Illinois, Decatur, Illinois. And my mother was an elementary school teacher. And she probably was the one that really said, "Get educated because they can't take it away from you." So when I was little, my dad, he was a circulation manager, small newspaper, so we moved to Carbondale, Illinois, which is almost down in Kentucky. And I skipped first grade. I talked a lot, I read my brother's books, and so here I was skipping a grade. And my grandfather, who was a coal miner, basically told me that, "They're going to tell you can't do stuff, you go ahead and do it." He died a year later, probably because of a ruptured aneurysm. So, my mother really pushed education for me and both my brothers.

And so, I went off to college at the University of Illinois to be a teacher. I wanted to be a high school biology teacher, but they closed Education for reasons I don't know. They thought there were going to be too many teachers. To be a nurse, I had to go back up to Chicago. So, I applied to medical school sort of out of default. And I interviewed at Rush Medical School where there was a dean. And this is why one person can make a difference. The dean there, Norma Wagoner, was really looking for a diverse class. And at that time, only 10% of medical students were women. My class was 42%, and the average age was 28. At that time, the average age was 22. And she looked for people with second careers. I was only 21 when I came there. She was instrumental in making that happen. And when I interviewed with a woman histologist, we both had read the same book, Watership Down, about rabbits, and we hit it off. And I got an early decision. And so, off we went to do it. And I thought I was going to be a pediatrician, but I did Surgery first to get it out of the way, and I loved it.

And so, again, a good mentor, Dr. Steven Economou, who said, "Yes, you can do that." And then, I matched at UCLA, only one out of three women in that whole class. And I was only the sixth woman to finish the Surgery program at UCLA back then, so very few women. Top program, pyramidal program, during 10 hours a week, but well worth it to be a surgeon. And then, I liked Vascular Surgery, and I chose that. I was only the sixth woman to get my certificate in Vascular Surgery. So again, just loved being a surgeon, I wanted to take care of patients, even today. You know, I operated on someone and saw patients in clinics. And I really just wanted to be a real good surgeon and that's sort of how I started.

Host: That's amazing. Norma Wagoner, I love that she had set that intention that she wanted to create a diversity and she intentionally did that, because I think that is something that's so important in any industry. I think things don't happen by accident and you have to kind of set that as an intention. So, I love that. You've done so much. You've been the first in the few, in a lot of cases. As you look back, are there moments that stand out to you more than others?

Julie A. Freischlag: Well, I think part of it is I decided I loved Surgery so much that off I went to do that. And I did have mentors that, at UCLA, they had already finished a woman in Surgery, so they had seen that. And the mentor, Ron Busuttil, who I did research with and watched me, really believed in me. And even, lately, when I've seen him in his retirement, I said, "Well, you never told me I was good." He goes, "But you're one of the best people I ever trained. That was a different time then to do it." So, good support with that.

I think the patients were the best. You know, when you think about why do we do this, I worked a lot in the VA system and those patients are so thankful. And they didn't really mind what you looked like. They wanted a doctor. They wanted care. And they really treated you with equal status, whether you were men or women. I did have moments where I walked into a room with a male medical student. And initially, they thought he was the surgeon and I had to say, "No, he's the medical student, I'm your surgeon. I'm going to operate on you." Especially when I was in my 30s, I looked much younger. But they really believed in you and patients believed in you.

And I think part of it was just being who you are, being forthright, knowing, having that confidence that you can do this. There are always days where if the operation didn't go well or you weren't treated well, that you would feel inadequate. You know, the impostor piece saying, "Should I be here or not?" But creating a nice group of colleagues and friends and people that can support you actually help you through that. And I think women are real good at that. There are some women that are this nice sometimes, but you can get a group of women. I have a group of women now that have gone with me throughout my whole career where we've met at meetings and we see each other and the support we give each other is incredible.

Host: That's great. And you know, it's a network, right? And so, you have to give it to get it.

Julie A. Freischlag: And I do that all the time. I mentor many women. Just even yesterday, who I had met at a meeting that wants a new job and talking about what she wants, what can I do to help? And it's amazing. You get a lot out of helping others too. Not only do they get help, but you feel good. Even like the student today, just helping her figure out how she can go forward, how she can be who she wants to be in her style, offering to write a letter for her when she goes off to residency, telling her that, you know, she was really appropriately aggressive about being part of our team. We let her help with the surgery a little bit today, so she was very excited.

Host: So, you talked about your education journey and your journey into Surgery. Can you talk about the shift into today?

Julie A. Freischlag: Yeah, well, partly, I think I always want to be learning something. So, we consider ourselves an academic learning health system here. So after the first 10 years, I was a good surgeon, I was doing research. I studied appendicitis in rabbits. I studied the effect of cigarette smoke on arteries. I did lots of that. And I realized that I really thought I could run things a little bit better. I'm very organized. I can run teams. And I thought I could do it in a way that was a bit better. And if you want things to change, you can influence by being part of the team. But if you really want them to change, you need to be in charge.

So, I decided to be chief of a VA hospital in Wisconsin. So, I went there to be a vascular surgeon. I was chief of vascular, but they needed a chief of the whole Surgery division. So, I did that. And then, I went back to where I trained and ran the whole division of Vascular Surgery, which was quite a challenge because some of them had trained me to do that. And then, I was asked, I had a couple mentors saying, "You really should run a department of Surgery," because I enjoyed all aspects of Surgery versus a division, which is, you know, eight to 10 people. Departments are 30, 40, 60, 80, 100 people. So, I interviewed at quite a few places to be a department chair. I even had one dean tell me that he wasn't going to hire a woman to run Surgery. This was 2002, because he hadn't hired a woman to run any department. So luckily, he didn't hire me, which was great because he wants to work for that person. And instead, I ended up at Hopkins with a great dean who believed in me. Ed Miller said you can do this. And I was there 11 years, really changing the culture. I was the only woman chair there for 11 years out of all of them, looking at culture change. That's when we did the 8-hour work week. Looking at timeouts in the operating room. There were a lot of things changing in Surgery to be accountable, really changing the culture, and that was fun.

And then, after 10 years, or 11 years, I knew I could do that. So, I thought, "Well, maybe I'll run the whole school" because then you can actually influence young people coming through right as they hit medical school and right as they hit college, because you'll get to meet them. So, I started looking at some deans. I wanted to be one at Hopkins, but they chose someone else to do that. And I liked him a lot, but I wanted his job. So, I ended up going out to UC Davis. There was a little change of leadership there that I didn't particularly care for. My chancellor sort of got fired. So, these upper jobs are very political sometimes too, so then I ended up coming here to Wake Forest. And initially, I was just the CEO, but the dean left when I got here because he wanted my job, so I became the dean for a few years. And then, we partnered with Atrium, which I had no idea we would do. And then, we partnered with Advocate, which we had no idea we were doing. And now, we're huge, you know, we're 150,000 employees, eight million patients. And now, I'm the chief academic officer looking at all the residency programs, and that we hired a new dean so we can open up the medical school in Charlotte, because my research dean actually retired. So, Dr. Ebony Boulware, she's our dean now.

So, the other thing we'll get to do is to choose diverse leaders and diverse people to come in to be on your team. I've been here seven years, and our team is very diverse. We have lots of women, people with different backgrounds, people underrepresented in medicine. And the best thing about that, as you know, is that mosaic gives you tons of information and it gives you lots of different thoughts so that you can be creative in how you go forward.

So, part of it was just knowing I wanted to change, knowing that I can run teams really well, and I also get joy out of watching others succeed too. So, if you're someone that just only wants you to do it, that's probably not the job for you. But if your joy is watching others, It's amazing. And a story I'll tell you, I was giving a talk in Tucson this week at University of Arizona, and one of the interns there in emergency medicine, I knew her when she was 16. She was a high school student that came and worked with me at Hopkins, and she worked with me all through college. And then, she went off to medical school and now is a resident. So, many of my publications reflect her as a 16-year-old. So now, she's a physician, she's an intern, she's married, she's in the military, she's incredible. And looking at her knowing that I've known her now for 15 years and watching what she did, it's just incredible.

Host: That's awesome. Yeah. So, I want to talk about challenges. And it's striking to me and I have to comment on this, hearing you talk about your steps and the times you've left and, you know, people telling you no. You say it so easily and it's amazing to hear, to see because you do have this air about, you know, it works out the way it's supposed to. I do want to ask about how you navigate those challenges. How do you navigate the no's and the block, then the having to pivot at knowing when it's time to move on.

Julie A. Freischlag: I think it came from that grandfather. You know, I didn't quite remember him saying that to me. And then, my other grandfather made boilers for the railroad. So, you know, that's probably why I'm a surgeon. They all use their hands. And I had a very feisty grandmother on the other side who was a short little woman who got very outspoken, and probably from there.

I think part of it is when people tell you no, either they don't want to change and they're set in their ways and you probably don't want to work with them at all. Sometimes they can be jealous of you and they say no because they don't want you around, because they would prefer to have people around them that are not as good as them and certainly not better than them. And you can tell that those people really don't accomplish much and people don't enjoy them as much.

I guess I would get sad at beginning when people tell you no. But then, it empowers you to realize that if they don't think they want to support you doing this, then thank goodness you didn't show up and have to live with that, because that would be worse, where you show up and you're with someone that really doesn't think you can do the job. Unlike Ed Miller, who hired me at Hopkins, he knew it was going to be hard. There was culture change. It was tough. I was only the fourth woman chair of Surgery in the country ever. I was the only woman chair there. And he was so helpful to me about empowering me.

And sometimes it's a little rough around the edges where he would tell me, you know, "You got to do this. You got to do that. You got to make it happen." But part of that, I think, if you take those comments and put them inside where you live and breathe and realize that you know you can do it. You can tell in yourself the truth all the time and being honest, because I've made mistakes. I've hired some of the wrong people. I've made mistakes in the operating room. I've made mistakes in judgment. I mean, there's also an owning up to that and always telling the truth. So, I'm always a very transparent person. When I do make a mistake, I go, "Yeah, that wasn't the right answer. That wasn't the right thing." And also, when somebody tells you something, to be very forthright saying, you know, "I hear that's your opinion, but I don't agree." And some people are fearful to tell bosses. I've had lots of new bosses with this job, and you have to just be able to tell them what you think and what you feel.

When you get through one of those episodes where people say no, or they tell you you don't have it in you to do it, and you sort of reboot and go now on this side, you actually are a bit stronger because you go, "Hmm, I'm going to show them. You know, I think I can do it. Maybe not with that person, but I'm going to show them." And so, as you go forward and do it, I looked at three or four chairs of Surgery before I got one, but I ended up at Hopkins, which was probably one of the best ones in the country. And similar to dean jobs, I looked at quite a few. And then, also if you are involved in a situation like I was at UC Davis, where I watched the leadership, you know, sort of change and remove my boss, and I didn't appreciate how it was coming down to do it. I also knew that I couldn't stay there with the way my boss was treated. And also, probably, I wasn't going to have that choice anyway because the president fired the chancellor, the chancellor hired Julie. "Well, let's see how much time you got to do it." And sometimes you just have to say it's just not the person. But I think if you could use it as reigniting versus deflating, even though there's always that little deflate, because you want to be the choice, you want to be the one that says, "Well, okay, I can choose any of these five jobs, and it's going to be up to me, but it's not always up to you."

Host: Yeah, I think that's just amazing. And it's obviously helped, but you know, it's worked out well, where you are now. So, it's great advice. So, knowing that this audience are typically strategists, our members are leaders of strategy within the healthcare organization. I'm really interested from your perspective, if you could share a little bit about what good strategy looks like and how you've seen that kind of play out.

Julie A. Freischlag: Well, I think I'm a pretty good strategist. You know, I actually will put teams together that have different thoughts so that we can talk about opportunities. So on my team, there'll be a marketing person, a lawyer, information officer, a clinician, a nurse. And frequently, when you're talking about a situation and the strategy where you're going forward, some people who don't have content expertise, as they listen, will have some of the best comments for you, because they'll sit there and listen about should we open a clinic, or should we go have a presence in a certain city, or should we advance this research. As they sit there as a marketing person or philanthropy person, they can tell you what they hear in their circles about where that would come out. I think you also can't be wedded to where you've been, you know, because it's changing so quickly, not only how we get paid, how we get treated, everything's going outpatient. You know, when I first got here, that outpatient center was going to be in the main tower. I was like, "No, outpatient surgery has got to be outpatient. It's got to be drive in, drive out. Plus that's where they're going to pay you to do it. And plus patients love it that way." So, not being married to the path, appreciating the path, knowing where you came from the path, but knowing you have to change procedures. You have to change how you do things. You have to think hard.

An example this week, bariatric surgery has been, you know, amazingly successful over 30 years, where people that have weight issues can have surgery to bypass their stomach to lose weight. And it's been great to cure diabetes and help with osteoporosis and all of that. But now, with these new medications coming out, and perhaps some less invasive procedures where you don't have to resew or redo things. I'm not sure we're going to need as many surgeons doing those procedures. So, as we anticipate who we're going to teach and train, we decided not to increase the number we're training, because we're not sure they'll have jobs, and really looking at what's out there, even though it's a great procedure, trying to look where you're going versus where you are.

And so, I think it's hard because if you're a bariatric surgeon and you want to train people and do all this, you're focused on that. So, it takes a strategy person to say, you know, "I want you to be busy and be a great surgeon. But if we train five more, they may not get jobs to do it." So, I think anticipating changes in the market, accepting them, and then figuring out other alternatives to that is important. But having all sorts of people around your table, I think that's what's important. Having patients there to talk to you about what they see, what they do, having students there. When we have search committees looking for positions, we put students or residents or young people there, because they actually have a different piece. Every year, I get a Wake Forest University graduate who just finished college that shadows me for a year. And most of them want to be physicians, so we help them get into med school. But boy, do they have different thoughts about what the world looks like. And unlike our kids who think we're okay, when we're sometimes okay, not, they admire you. I mean, they are so glad to be with you and they will share their point of view with you, which is so incredible to see what does a 22-year-old see versus what do I see and to appreciate and get them to feel comfortable enough to contribute that. So, we put them on committees, we take them to our operating room, we have them be part of our teams so we can hear from them. And it's been invaluable.

Host: That's amazing. And I think it's a great transition. So, you talk about these changes and anticipating what's coming as being a strategy, but I keep thinking about that is a huge organization and the challenges and the struggles that it takes, the conflict that inherently comes with big changes. So, I'd love to hear if you can expand on that a little bit, how you really navigated those struggles and that conflict to get to where you know you need to go.

Julie A. Freischlag: Absolutely. So, these partnerships with Atrium and Advocate have been invaluable. We've gotten resources to build things. We've gotten resources for patients to be in networks where no matter where you are in our 62 hospitals and over a thousand clinics, if you have a disease that perhaps can't be treated in Green Bay or Statesville or whatever, we'll get you to where you want.

But we've had to have name changes, so this was always the Baptist Hospital, Wake Forest Baptist, and now we're Atrium Health, Wake Forest Baptist, and we're doing service lines with the big cancer center down in Charlotte called Levine, and pediatric hospital down there called Levine, but we're the Brenner's Hospital, and we have families here that are Brenners, and the change of names, and does it mean we're going to stay here or not stay here? Winston Salem has suffered over the years with loss, you know, banks have gone to Charlotte, Piedmont Airlines left, Tobacco Company, Hanes, lots of companies here, Sara Lee, and they all were here and then left. And so, their fear is that with all this change, will we still be in Winston? Of course, that was part of the deal to do it, but building the buildings and showing them we're staying here to teach and train has been very important. But making sure they understand that because we're bigger now and have more resources and more backup, we have a solvency that we've never had before and backup that's really important to continue our education. But the change is hard because people remember what it was like. They'll reflect back when they lost things versus when they gained things.

Probably one of the most interesting conversations I've had, Liz Chaney was in town, there was a face to face event here where Jon Meacham interviewed her who's written on the books on the president. And he had a special session just with us leaders about change. And I asked him, I said, "So why are people so reticent to change?" You know, we've gone through COVID, here we are. And it's almost like we want to thrive, but we just can't go. What is this? And he said, "Well, you know, people really truly think when you've gone through a calamity like COVID, that there was a perfect time. They actually think things were perfect in the past, even though there's never been a perfect time. There was 2008 with the economic downfall. There's been issues, you know, back when I was an intern in 1980, they imagine there was perfect, and so they yearn for that, even though it really didn't exist.

So, part of that is to try to show people that perfect's in the future, that it wasn't in the past, that as we go forward, we can make it better as we go forward, versus wishing it was past. It's sort of like aging, you're never going to be younger again, your kids will never be babies, it's not going to happen. So, to take joy in where you're at at the present, I think, that's the piece with telling people, "I hear you, I understand how you're feeling about it. Well, let me tell you where we're going and how much energy this is, and what's going to be in it for you." You know, a new emergency room, more research being done, ability to have a new eye center, things that will really improve patient care. We'll think about that and improve the population growth, which we've had up here. But I think trying to show them the future and trying to remove the pain of the past.

Host: I think that's great, inspiring people and motivating and showing them what can be. I think that's tremendous. And more personable for you, as the first chair at Johns Hopkins, you know, I can imagine the struggles and the challenges that that entailed throughout your journey, you know, being the first and being the few, that's hard, right? How are you able to navigate the politics of that? I mean, being, you know, the first and in so many ways, the negative perception and I'm sure it was there.

Julie A. Freischlag: Well, part of that, I think you surround yourself with really good people. And I'd love coming in and really partnering with the people that are there. And you talked to Willie and Carla here and they were here. Carla's been here 30 years, Willie 15, and partnering with them because they actually know the history, they know what's going on, they know where all the bodies are buried, they know all of that, and they actually can tell the story for you, that you are a partner, like even in clinic today, I'm very close with clinic people, because when I walk in the room, they're a little scared, I'm the CEO, I could fire you, I could make that happen. I do think calling it out, you know, if you hear that someone says something or does something that's not right, you know, letting them know you know, and hearing you with it, "Yeah, I know it's a change and I know it's bad." And also, taking those people off the bus if they can't get on the bus and help you get to where you want, some people will change. You show up and they're not very happy to see you. You give them a chance and they will flip and figure out this is good. Some people don't. And I had to let a few people go at Hopkins, a few people here too, that it just wasn't right to do that to make it. And then, people see that you do make decisions according to people's attitudes and beliefs and how they act.

So, I think doing a few things that shows that you will respect those that have respect for others, you like those that do the right thing. You enjoy people on your team, but you have to support each other. And also, when you walk around and people see you, you want to make sure that they see you in a good light. Now, here I have to park pretty far away now because of the construction, so I walk through. And every day, I see someone. Even this week, a woman stopped me. She's worked here 42 years. And I don't know her, but she knows me because I do videos and know what I look like. And she said, "You know what we call you?" And I said, "What?" She goes, "The undercover boss. You're everywhere. You get things done. But we can talk to you. We see you." So being a person, I think, actually helps. So, the rank and file see you to do that.

I used to think that everyone liked me and I got to choose if I liked you. But what I've learned is not everybody likes you, you know, and I don't have to like you back. You know, if they don't like me, I don't have to like you. It doesn't mean we can't work together. It doesn't mean we can't be respectful. You have to treat me with respect, who I am and what I do. But you don't always have to be liked. And I think that's some places where leaders trip, especially women leaders, you want everyone to like your decision. But Bette Davis, I think said once, "If everybody likes you, you're doing something wrong," right? So, you're going to make decisions that's not going to make everybody happy. And that's your job.

I have a really supportive husband of 31 years who is a business person and has listened. I have a couple of stepkids and four grandkids and a son who's married, and they're very supportive and believe in me. And also, I divide my life. This whole COVID thing, working at home has never worked for me because I grew up as a professional where I work at work. And when I get home, I didn't work. You know, I don't even have an office at home. Sometimes you'd have to take a conference call or something. And with COVID, we tended to be on that computer way too much, so we stopped that. But I really think you need to split. There's work. My husband lets me complain for about five minutes, and then we move on to something else. We go to a game. We watch a movie. We do something that's fun where you really can turn it off. You can't turn it on and off, then you tend to relive it. Now., It doesn't mean there's days where I wake up at three in the morning worried about something, or I get festered about something because people aren't being fair. But overall, I think dividing that and realizing that it's not going to be perfect, that there's going to be things that you miss, things that didn't work, people you don't particularly care for. But trying to get your message out. I do a monthly video here so people hear from me. We put videos of the groundbreaking for the Surgery center, the little care tower, so people can see what we're doing and how we're making that happen, and that's important.

Host: Yeah, I think that takes a lot of courage, you know. It takes a lot of courage and a lot of discipline and a lot of network and support. So, I have my husband at home. I think, I don't do a good enough job of it, but it's something that I've realized recently I need to do better of shutting it down and remembering that it's not everything, that there's a whole other piece that's incredibly important that you can miss.

Julie A. Freischlag: Oh, absolutely, we don't. And my son once told me to turn off my BlackBerry when we were on holidays. So, when we go on holidays, he remembers holidays. He remembers when I was with him. He remembers when I was a timer for his basketball game. You know, it doesn't have to be huge things. On Fridays at Hopkins, I would take him to the bus stop and I would come to work later. And it was every Friday. And in LA, when I was there, it was Tuesday and Thursday, I took him to school because we were closer to where I work. So, having those things and letting people know you do that, but that actually gives them permission to do that too, that this is what I do to make it happen, and I have no regrets. You know, I didn't miss much. I missed some stuff to do it, but I made sure that that was on my calendar too, it's the hardest part. Or even today, they're coming up on Father's Day or coming down, and somehow they put a clinic on that Friday, and they're going to be here, so I made them move it today. I said, "Maybe we didn't tell you, but I need that day off. Let's move it to Monday." So, the patients will be seen Monday, not Friday, so we were able to do that.

Host: So, can you talk a little bit about what motivates you?

Julie A. Freischlag: The most is to take care of patients. Today, I saw three patients we had operated on. They're doing great and taking care of patients, making a difference. The second is empowering those behind. I love that. Somebody told me yesterday, they think I had 80 kids with all the people I taught and trained, and really teaching people, probably from my mom, teaching people how to do surgery, teaching people how to be a physician. I love that, watching them do the procedure and having them get the prowess as good as myself to do it.

And then, making a difference in other lives, where you actually can be a best friend, you can be a colleague, you can be supportive to make that happen. And all that gives you energy. I love people. So when I hang with people, I get more energy because I was with people than without people. I'm not someone that needs a lot of solo reboot time. I do read a lot of books. I read tons of books and COVID was hard because you didn't travel much, because I tend to read on planes. But now, I'm back reading. But mainly, I really like people, so to me that's what reboots me and then watching others just do a great job watching them be leaders and chairs. And this young woman I talked to, who I knew at 16, who now is an emergency room physician, oh boy, that was just great to see that happen, because I knew her back when she was in high school and she did it.

Host: That's amazing. So, I love this question and I'm really excited to ask you this. What advice would you have for yourself as you were starting out? What would you tell yourself in the early days, knowing what you know now?

Julie A. Freischlag: Yeah. I should have been more easy on myself, be a little bit more patient. I was in a hurry to be accomplished, to get it done, to be chosen, to be there, really intense. Back then, in order to get into these societies, to be leaders and things, you had to be physically present. So many times, I would fly to be at a meeting for an hour and then fly back. I mean, it was just crazy having that intensity that you thought you had to be there. And COVID has actually allowed me that if a plane get canceled, I can't get there. I'll just do a virtual talk. It actually was really hard on women at the beginning with COVID, but I think it actually has helped all of us have some flexibility that you can't control it all. I think just being a little easier. I think I judged myself tough. I think it got me to be more of a perfectionist and accomplished sooner, but I think I would have gotten there the same way without the angst that sometimes I had, saying, "I've got to do what I've got to do." And maybe also, there were nobody around me like me, so everybody's watching. So I think that also was part of it where you knew everybody was watching. One time in Hopkins, I had a flat tire in my car and like 35 people came to tell my secretary it was flat. So obviously, they'll watch your car, they'll watch what you do, they'll watch what you wear. So, part of it is to learn not to be as preoccupied.

Host: So my last question, you've accomplished so much already. You're a dynamic leader. There's so much happening here. What's next and what are you excited about?

Julie A. Freischlag: Well, I'm so excited about the growth here in our market with our new buildings and our new programs. I'm so excited about our new leadership. I have a new dean, Dr. Boulware. I have a new president, Dr. Zaas, a new cancer center director, Dr. Mesa. And they all have come in the last year and they have crazy, wonderful ideas. And sometimes I go, "Okay, I'm not sure. Well, no, you have to let them do it. That was you 20 years ago. Sustain the new generation of leaders." We have a new Chair of Pediatrics, Dr. Thompson, and Chair of Orthopedics, one of six women in the country, Dr. Cynthia Emory, to do that. My chair of Psychiatr, is a woman. ,Sowe have a lot of exciting new people doing research to make it happen.

And then, could we set up a system that no matter where you sit as a patient, no matter what your payment source is to be a patient, that if I have a clinical trial or something new to offer you, we can get that? And that's what we're trying to do, is that you walk into a clinic in Green Bay, Wisconsin. And if they don't know what you have, they'll get on telemedicine and have someone look at that. And then, if you have something unusual, I treat thoracic outlet, which not everybody does, that you'll get to the right person at the right time. Maybe we'll equate it so everyone sort of gets paid okay. So if you refer the patient you don't lose income, you keep your income, you make it equal to do that, that everybody has that choice. Because I did a lot of clinical trials in the VA, and it wasn't just giving them the new intervention, whether it was a new graft or a new style that we tested, should you do a carotid endarterectomy on certain symptoms in that. They will call you for everything. They will call you about their wife and their kids and everything. So, you were their entry to the system.

My son calls it mom-directed care because whenever he needs something, he calls his mom and mom can get him anywhere. And not everyone has a mom that can do that. We have moms that do all sorts of stuff, but I can call somebody in any town and get a specialist, get this, have someone talk to them or whatever. And everybody deserves mom-directed care where you can call up, and especially if a physician doesn't know what's wrong. And they can actually reboot and try to figure it out. It's just really great so that you end up in the right place at the right time, not delayed and not mistaken.

So, I think that's what excites me especially. And I do have a list of things that I say. What has COVID-19 done for us lately? And it's not a lot. You know, there was a lot of people that suffered. But telehealth virtual interactions, ability to interview kids from medical school virtually, because they used to spend thousands of dollars interviewing. My nephew's a Surgery resident in Iowa. I think he spent $10,000 really learning how to do things in many different ways for access and for connections for people. I think I've enjoyed my telehealth with postop patients. They need to make it so it doesn't matter what state you're in right now, we can all do it. Today, I saw someone from Tennessee, I saw someone from Florida. I saw someone from South Carolina. But I think those are the kind of options that, and using artificial intelligence to help us solve problems, put data together, get information on intervention quicker and faster, so we can say, "No, that doesn't work," "Yes, that does work," similar to the vaccine. I think that's what excites me to do that, sort of making group think better.

Host: Well, Dr. Freischlag, thank you so much for the time. Thank you so much for your words and your insights. I really appreciate it, and I appreciate you.