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Lessons in Leadership: Detroit Medical Center CEO Dr. Audrey Gregory

Dr. Audrey Gregory, chief executive officer of Detroit Medical Center (DMC), joined the Chamber for the fifth installment of its virtual Lessons In Leadership series to explore challenges she has faced as a health care leader navigating a global pandemic while also managing DMC needs in her first year as chief executive officer. Gregory outlined key lessons she has learned as a leader and also discussed the importance of addressing equity in health care.

DMC is the largest non-governmental employer in the city of Detroit and is part of Tenet, one of the largest health care systems in the United States. Gregory joined DMC in October of 2019 with 15 years of experience at various hospitals owned by Tenet. She had been the chief executive officer of Tenet’s market in Memphis, Tennessee, and the city’s St. Francis Hospital. Her background is in nursing and ER.

Remembering the beginning of COVID-19 and the uncertainty

Gregory was named chief executive officer of DMC in January of 2020, just two months before COVID-19 was declared a global pandemic by the World Health Organization (WHO).

“I remember as an organization we were enjoying the start of 2020. The year had started out really well. Winter in Michigan was not scary, and I had adjusted,” recalled Gregory. “Then in no time at all we were faced with about 30% of Michigan’s coronavirus cases, [which] were residents within southeast Michigan.”

The onset of the COVID-19 pandemic in March was a challenging time that brought about “enormous challenges,” especially because COVID-19 was a novel virus, recalled Gregory.

“This was interesting, as seasoned as we were as health care operators, this was new. It was strange,” she said. “There was confusion among our employees. And most importantly there was fear.”

Initial confusion about the new deadly virus was spurred by uncertainty in every direction according to Gregory, especially given that initial guidance from regulatory agencies, such as WHO, changed daily. “It was wear a mask, then don’t wear a mask. There was just so many contradicting facts coming at us,” recalled Gregory.

Obtaining the necessary medical supplies to treat the new virus was also a major issue early on, including a worldwide shortage of the N-95 masks that medical practitioners were advised to wear around patients inflicted with COVID-19. Gregory and her DMC staff worried how were they going to manage through a sudden pandemic and the many challenges it brought on.

Lesson #1: Value transparency and ‘over-communication’

With the arrival of COVID-19 raising questions for everyone, including doctors, scientists, patients, and the public, Gregory first decided that DMC should be as transparent as possible and ‘over-communicate.’ She instructed DMC’s communications team to send correspondence even if the message was to highlight uncertainty.

“As a person of color and as leader of the DMC, this was quite the moment for us,” said Gregory. “We were transparent with all of our key stakeholders. We were constantly apprizing employees and the public of data that was important, critical updates, information, and guidance that we knew regarding COVID.”

The DMC chief executive officer noted her first lesson was to “communicate, frequently, often, and clearly.”

Lesson #2: Rely on community partners and recognize in a crisis that you cannot go it alone

Obtaining COVID-19 testing was another major issue for health care systems such as the DMC during the start of the pandemic – a direct contrast to the current abundance of testing a year and half into the pandemic. Tests can now be obtained more easily. But that was not initially the case for Gregory and her staff.

“In the beginning, there was no testing available,” said Gregory. “As an organization, recognizing who we serve, and if anyone remembers at that time, Detroit was inundated with new cases. This was all in communities of color.”

Gregory and her team needed to be able to quickly confirm the presence of COVID-19 in patients if they were going to gain control of treating the virus. Eventually, DMC looked to its community partners such as Wayne State University for help with COVID-19 testing.

“We put our heads together,” said Gregory. “We have great scientists in that university and great providers and staff. We figured out together how to manage testing for our population.”

Lesson #3: Acknowledge employees and their emotions during a crisis

Another innovative approach DMC took in response to the COVID-19 crisis was providing housing for staff who wished to avoid exposing their families to the novel virus.

Gregory said the move came about amid her efforts to listen to staff and their concerns about dealing with the virus so closely. “People were scared. I remember residents saying to me, ‘Dr. Gregory, now that we’ve figured out what we’re dealing with, I don’t want to go home to my family. Where do I stay? How do I live?’”

Gregory advised leaders to never brush off concerns being expressed by employees. She said true leaders seek to manage their staff’s uncertainty by helping them achieve solutions.

Lesson #4: Leader visibility is ‘paramount’ during a crisis

Additionally, Gregory said it’s important for leaders to be visible especially during a crisis. At the onset of the pandemic, she and other DMC leadership actively checked in with staff who were on the frontlines of diagnosing and treating COVID-19 patients.

“Our entire leadership team did a phenomenon job of being present and listening to staff feedback,” said Gregory. “And at times acknowledging that we did not always have a solution.”

The DMC leader said that being a visible leader is being the opposite of a spectator.

“I think leader visibility is paramount during a crisis,” said Gregory. “Often times, as leaders, we seem to be spectators and not participants. It’s important to be solutions-oriented.”

Lesson #5: Trust your training

Gregory also noted the importance of being authentic as a leader while always remaining assured of your own knowledge base and outcomes.

“As a leader, you know what you know,” explained Gregory. She continued to say, “While I’ve never experienced a pandemic, I knew as a leader that I was clear on what the outcomes were that I wanted, and so I trusted my training.”

Addressing equity in health care

“We specifically care for the under-insured, the underrepresented, and the underserved,” noted Gregory of her organization. She said the DMC has only become “more assured in its mission and who we serve” as it has managed through the pandemic and all of its impacts.

Gregory said addressing inequities in health care is a top priority at DMC, and also noted that she is proud of Michigan’s approaches to addressing COVID-19’s disproportionate impact on communities of color through its Coronavirus Task Force, which has earned awards for its work and leadership.

“As a health care organization, there’s so much we have to do,” said Gregory. “But really as a state, the work that we’re doing around equity and equitable care is really telling of where we sit as a state and what we believe is important to us.”