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

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

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

Remembering the beginning of COVID-19 and the uncertainty

Dr. Gregory was named CEO 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 Dr. 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 brought about “enormous challenges,” especially because COVID-19 was a novel virus, recalled Dr. Gregory.

“As seasoned as we were as health care operators, this virus was new to us, and it was strange,” said the DMC CEO. “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 Dr. 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 Dr. 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. Dr. Gregory and her staff worried about how they were going to manage through a sudden pandemic and the many challenges it brought on. But, Dr. Gregory said navigating both the pandemic and a novel virus as the chief leader of a medical center led her to several key lessons she won’t soon forget.

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

With the arrival of COVID-19 raising questions among everyone, including doctors, scientists, patients, and the general public, Dr. 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 Dr. Gregory. “We were transparent with all of our key stakeholders. We were constantly appraising employees and the public of data that was important, critical updates, information and guidance that we knew regarding COVID.”

The DMC CEO noted that her first lesson was to “communicate, frequently, often and clearly.”

Lesson #2: Rely on community partners 

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 a half into the pandemic. Tests can now be obtained more easily. But that was not initially the case for Dr. Gregory and her staff.

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

Dr. 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 Dr. 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 

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.

Dr. Gregory said the decision was made after listening to staff and their concerns about dealing with COVID-19 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?’”

Leaders should never brush off concerns being expressed by employees, noted Dr. Gregory. Effective leaders “seek to manage their staff’s uncertainty by helping them achieve solutions,” she concluded.

Lesson #4: Leader visibility is ‘paramount’ 

Dr. Gregory also emphasized the importance of leaders remaining visible and reachable, especially during a crisis. During 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,” shared Dr. Gregory. “And at times acknowledging that we did not always have a solution.”

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

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

Lesson #5: Trust your training

Dr. Gregory also noted the importance of being an authentic leader and remaining self-assured of your own knowledge base and desired outcomes.

“As a leader, you know what you know,” said Dr. Gregory. She explained: “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 underinsured, underrepresented and underserved,” said Dr. 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.

Dr. Gregory noted that addressing inequities in health care is a top priority at DMC. She is also proud of the state of Michigan’s own approach to addressing COVID-19’s disproportionate impact on communities of color with the establishment of the Coronavirus Task Force on Racial Disparities, which has earned awards for its work and leadership.

“As a health care organization, there’s so much we have to do,” said Dr. 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.”