Maggie Gardner was studying sociology at the University of Vermont when a nurse-midwife came to speak during a class on reproduction. After graduating from the University of Vermont in 2001, Gardner went to work for that midwife’s home birth practice, Welcoming Home Family Nurse-Midwifery in Hinesburg. She went on help start a midwifery practice in her hometown of Vergennes, Tapestry Midwifery, and returned to the University of Vermont, undertaking the master’s entry program in nursing and earning her registered nurse certificate. Board certified by the American Midwifery Certification Board and a member of the American College of Nurse Midwives, Gardner is seeing patients at Gifford’s clinics in Randolph and Berlin. Gifford’s practice, she notes, takes the best of the home and hospital birth experience, and combines them into a natural, hospital-based midwifery birth. Gardner will do the same in her practice at Gifford as well as focusing on open communication, equal partnerships with patients and families, and individualized care. Gardner cares for all types of patients, from women needing routine gynecologic care to women expecting a baby, but has special interests in breast feeding support, Pap test follow-up, testing for and educating women on risk factors for sexually transmitted infections, and sexual health. March of Dimes Vermont State Chapter Director Roger Clapp, right, presents Gifford Medical Center caregivers with a Leadership Legacy award for their support of healthy babies and the March of Dimes. RANDOLPH – The Vermont Chapter of the March of Dimes today honored Gifford Medical Center with a Leadership Legacy award.
The award, presented by March of Dimes Vermont Chapter Director Roger Clapp, recognizes the Randolph hospital for both its commitment to prenatal, birth, and newborn care, and its support of the March of Dimes. The March of Dimes strives to prevent birth defects, premature births, and infant mortality through research, quality initiatives, community services, education, and advocacy.
This is the second recent award for the Randolph hospital for its work around positive birth outcomes. Gifford’s midwives were recognized as a “best practice” in the nation by the American College of Nurse-Midwives. The resolution recognized Gifford for its more than 100 years of service to the Randolph area and for its recent achievements and accolades.
In December, Gifford was named a Top 100 Critical Access Hospital in the nation by The National Rural Health Association. Gifford’s midwives were further recognized in 2011 as a “best practice” in the country by the American College of Nurse-Midwives for its positive results with vaginal births after cesareans and a “runner-up best practice” for having the fewest numbers of low birth weight infants and for its low use of vacuum or forceps. The hospital’s day care, The Robin’s Nest Child Enrichment Center, earned the maximum five “STARS” from the state’s STep Ahead Recognition System, a voluntary quality program that is part of the Vermont Department for Children and Families’ Child Development Division. Menig has also won many state awards for quality and national awards for resident satisfaction. Townsend initiated the Resolution and was among one of 12 legislators who brought forth the resolution, which was passed by the full House on March 13. Gifford Administrator Joseph Woodin and Director of Development and Public Relations Ashley Lincoln were present to receive the resolution.
The resolution also recognized the hospital’s 12 consecutive years of meeting its state-approved budget and operating margin, and the recognition of all of Gifford’s primary care practices as Patient-Centered Medical Home by the National Committee for Quality Assurance.
When checked, Shutterstock's safe search screens restricted content and excludes it from your search results. The New England Journal of Medicine carried an excellent article by David Casarette, MD, on the topic of healthcare illusions and medical appropriateness. Casarette observes that humans have a tendency to see success in what they do, even if there is none.
In medical care, the phenomenon has been referred to as “therapeutic illusion,“ and it affects both doctors and patients. In one clinical study, faux surgery worked as well or better than an actual surgery for the treatment of specific conditions. Toomey had an interesting conversation with the chief medical officer (CMO) of a major health system. Healthcare involves people – patients, physicians, and other providers — and the human element makes it even more complex. We are biased – we believe the employers are the catalyst to drive change for increased consistency by working collaboratively with suppliers (think Six Sigma).
In Part 1 and Part 2 of this series, David Toomey and I described a wildly successful collaboration with Virginia Mason Medical Center (VM) and a few Seattle employers. During the the time of the VM collaboration, we invited major physician groups to meet with the employers.
As you would suspect, the employers were better prepared for this meeting than they had been for the meetings with VM. Afterward, the employers expressed concerns about whether this premier provider could improve care and reduce costs. The employers were aware of the dynamics with network configuration and the trouble that businesses have when a provider is dropped from the network and even a few employees complain.
After a couple of follow-up meetings, the employers recognized that this group was not committed to the process of care that they expected. The CEO of the provider group felt respected, because of the time the employers spent with him, even though he did not like the outcome. The big question is: Why are more self-insured employers not engaging directly with providers? A major reason why healthcare costs grow faster than general inflation is because most self-insured employers are simply not dealing with healthcare providers in the way we have described in this series of posts. Cover Letters For Medical Resumes are examples we provide as reference to make correct and good quality Resume. In the past decade there has been a focus on the importance of encouraging consultants to embrace leadership to enhance the quality of patient care.
A common misconception among doctors is that you either specialise in leadership within your role as your career develops or you avoid it. One of the foundations of effective medical leadership is the development of a deeper awareness of your own self through reflective practice. The ability to reflect and to acknowledge how your own values, principles, and assumptions can differ from those around you is a key step towards developing self awareness. The ability to manage efficiently and effectively the myriad of clinical, personal development, and extracurricular activities that many consultants are involved in is pivotal to supporting your development as an effective leader. Appreciating how poor time management can contribute to stress and reduce your ability to lead effectively is vital.
Is your personal development plan, created as part of your own appraisal process, up to date? Accessing a mentor or coaching scheme is a good way to develop your leadership skills and well worth exploring.
How many times have you heard the leadership mantra, “Do as I say, not as I do?” How disengaged did you feel? When was the last time you led an initiative to promote collaborative interdisciplinary working? Working to change the culture of an organisation to promote interdisciplinary working can be a huge challenge that requires determined leadership. How do you actively encourage those around you to contribute to service innovation and improvement? Engendering an inclusive culture that reflects a primary focus on service innovation and improvement will encourage those around you to pull in the same direction when contributing to a particular project.
Getting the best out of your team can be the difference between acceptable performance and exceptional performance.
Developing a greater awareness of your personal qualities and the current approaches you take to leading your team will enable you to identify areas you can develop to enhance your leadership skills.
Competing interests: MG and LG are employed by BPP University College School of Health, which provides leadership and management courses for NHS organisations across the United Kingdom. Pacific’s alliance partners bring over 100 years of experience including senior level positions with several multinational companies. As an example, one 30-year veteran headed the largest privately held managed-care company in the United States.
Pacific's alliance partners bring to our clients the best and boldest business thinking from across the integrated cost control and payment integrity industry.
Ayo Kalejaiye has over 20 years experience in the healthcare industry as an owner, C-Level executive, entrepreneur and founder of several breakthrough technologies. Ronald Kuerbitz was appointed Chief Executive Officer of Fresenius Medical Care North America (FMCNA) in January 2013 after holding executive positions in operations and administration within the organization for more than 15 years. From 2010-2013 Ron served as Chairman of Kidney Care Partners, a coalition of industry advocates, where he introduced and garnered support for a bundled payment methodology from Medicare for dialysis services, which has yielded significant improvements in the quality and efficiency of care.
Bill Valle is Executive Vice President of Fresenius Medical Care North America (FMCNA) and President of Fresenius Kidney Care (FKC), the largest division of FMCNA. Prior to joining FMCNA, Bill had 22 years of experience in the dialysis industry, serving in executive roles in sales, marketing and business development, as well as ownership in several private dialysis centers.
Mark Costanzo was named as President of Fresenius Medical Care North America’s Renal Therapies Group in January, 2010. He began his career in the renal industry more than 30 years ago with Baxter International. He joined FMCNA in May of 2014 following Fresenius Medical Care’s acquisition of MedSpring Urgent Care, where he served as Senior Vice President of Infrastructure.
Frank joined the organization in 2009 after Fresenius Medical Care acquired a company he founded, Health IT Services Group, a leading-edge Electronic Health Record (EHR) software company. Frank has more than 30 years of health care experience, including the practice of nephrology at the Danville (Virginia) Urologic Clinic, where he served as its president from 1995 to 2005.


Frank is a Clinical Associate Professor of Medicine at the University of North Carolina School of Medicine and has served on numerous boards and regional committees involved in technology initiatives, banking and health care. Angelo Moesslang was named Chief Financial Officer of Fresenius Medical Care North America in August of 2010.
He began his career with Fresenius Medical Care in Germany in 1995, and held a variety of positions, including: Head of Investor Relations, Vice President of Business Development and Regional Director of NephroCare in Asia Pacific based in Hong Kong, and most recently, Chief Financial Officer of EAMELA (Europe, Africa, Middle East, Latin America). Prior to joining Fresenius Medical Care, Angelo served as a scientific assistant to the University of Stuttgart Hohenheim’s Business Administration faculty. Brian Silva is Fresenius Medical Care North America’s (FMCNA) Chief Human Resources Officer and Senior Vice President, Administration.
Prior to FMCNA, Brian was Senior Vice President of Human Resources at Gentiva Health Services, the country’s leader in home health care.
Doug Kott oversees the Fresenius Medical Care North America Law Department, which provides legal advice and support to the company's businesses in several practice areas, including health care law, corporate law, litigation, securities law, general finance, real estate, labor and employment, intellectual property, and FDA regulatory. Doug joined the company in 1997, following his role as a corporate law partner in the Boston law firm of Nutter, McClennen and Fish, LLP, where he advised a broad range of public and private businesses. Ravi Kalathil has more than 30 years of experience in the development and management of Information Technology and more than 20 years of experience as the company’s top level executive responsible for health care technology, strategy and leadership. Prior to his focus on health care, he worked at Hughes Aircraft, multiple companies on Wall Street and the SWIFT Worldwide Interbank Consortium. Since October 2003, he has been Chief Information Officer at Fresenius Medical Care North America. David Kembel is Fresenius Medical Care North America’s Senior Vice President and Chief Compliance Officer.
David joined the organization in 1990 as Assistant General Counsel and was promoted to Associate General Counsel in 2001. In Brian Gauger’s role as Chief Development Officer and Senior Vice President for Fresenius Medical Care North America, he oversees the organization’s joint ventures, mergers and acquisitions, and physician contracting for North America. Kim Sonnen leads Fresenius Medical Care North America’s (FMCNA) negotiations with commercial insurers and develops new models for engaging with and developing coordination among government payors, exchange-based plans, risk-bearing provider systems and other new payors. She plays a leading role in the development of FMCNA’s strategic business operations and has significantly contributed to the growth of the company’s dialysis services business. Kim joined FMCNA in 2003 as Vice President of Managed Care and Marketing, after serving as Chief Operations Officer of Renaissance Health Care, a renal disease management company. Lisa Dombro serves as Chief of Staff for Fresenius Medical Care North America’s (FMCNA) CEO, as well as Senior Vice President, Physician Practice Services. In addition, as SVP of Physician Practice Services, she oversees a team responsible for recruiting physicians, developing recruitment and financial support models, and cultivating opportunities to develop and acquire practices that are strategically important to FMCNA. Prior to Lisa’s engagement with FMCNA, she provided strategic consulting services to hospitals, physician practices and other health care service organizations, including Surgical Care Affiliates, a leader in the ambulatory surgery center space, as it pursued national growth and physician collaboration opportunities. Gardner was the office manager and assistant, both clerically and clinically, including assisting at births. Next was nurse midwifery school at the Frontier Nursing University in Kentucky – a master’s degree program. In addition to her midwifery experience, Gardner has worked in pediatrics, emergency medicine, and infectious disease at Fletcher Allen Health Care in primarily office assistant type roles, and most recently was a manager at Planned Parenthood of Northern New England, where she was responsible for the implementation of a new centralized lab management system for 21 Planned Parenthood health centers in Maine, New Hampshire and Vermont.
Gifford has been a leader in low intervention births and midwifery and obstetrics for more than 30 years. The practice looked at 2010 benchmarking data and named Gifford as having the highest success rate with vaginal births after caesareans as compared to similar small-size practices.
The Vermont Chapter of the March of Dimes was the only in the nation to receive an “A” rating recently from the national March of Dimes organization.
The hospital’s nursing home, the Menig Extended Care Facility, just last month was named one of the nation’s top 39 nursing homes by U.S. The program looks at compliance with state regulations, staff qualifications and training, daily activities with the children, improvement plans, and more. Peter Shumlin; Vermont Department of Disabilities, Aging and Independent Living Commissioner Dr.
The CMO relayed that his wife was having pain in her hand, so they scheduled an appointment with one of their system’s highly recommended specialists. A group of 20 national employers have come together to share data, so they can assess the healthcare supply chain. A big driver was the variation in the volume of procedures, and cognitive biases among doctors can help drive those volumes. So how do those involved in healthcare address the variation in medical care that is driving up costs?
One of the most memorable meetings was with the CEO and chief medical officer (CMO) from a very well-regarded physician group in Seattle that has high fees but low performance.
When the CEO and CMO talked about their strong emphasis on quality, the employers asked about quality monitoring and the process of care. We posed a couple of questions: Are you saying you don’t want this provider in the network? The employers responded that they wanted to have additional meetings with this group, because of its reputation. For some reason, the healthcare procurement process involves the carriers and other vendors but often skips the actual suppliers of healthcare (except in a fairly small, but rapidly growing, number of major corporations). These subdomains outline the competencies that doctors at undergraduate, postgraduate, and senior level should strive to develop to become more effective in the planning, delivery, and transformation of health services. The Medical Leadership Competency Framework promotes the idea that leadership is the responsibility of all doctors at every stage of their career through a shared leadership approach. Many consultants have not experienced the self reflection process that current junior doctors go through in the development of their portfolio, so for consultants this domain can be an excellent reference base against which to appraise personal qualities and determine areas that can be developed.
Gaining a clearer understanding of how your own values, principles, and assumptions influence your day to day behaviour and decision making, and the manner in which you interact with others, will give you a solid foundation on which to develop your leadership skills. When was the last time you took a step back and reviewed in detail how you plan, prioritise, and undertake your own day to day activities and those of your team or department?
In a given situation, do you find yourself taking things personally, or do you eliminate emotional bias and respond constructively? The importance of leading by example and demonstrating professional values, principles, and ethics in your day to day practice as a consultant should not be underestimated.
Consultants’ ability to engage, inspire, and get the best out of those around them is pivotal to delivering high quality care, but being the most senior person in a team can be a lonely and sometimes daunting challenge.
The ability to break down barriers diplomatically within your organisation and to facilitate collaboration and sharing of resources between teams and across departments is one of the key challenges that consultants face today, thanks to the traditional divisions between professional groups in the NHS. Seeking the views, and ideally the involvement, of the wider healthcare team, together with patients’ representatives, to improve and develop services together is an important step towards achieving this. When a member of staff comes to you to discuss a confidential matter, are you dismissive or do you listen and show empathy when responding to any concerns raised? Treating colleagues with respect and humility will enable you to build and maintain productive relationships, engage those around you, and ultimately improve patient care. As a consultant leading your team, one of your key responsibilities is to encourage contributions from those around you to improve services.[6] Are you receptive, and do you consider all suggestions made to you with equal measure, or are you prone to dismissing suggestions out of hand because you are too busy to listen?
You should consider taking steps to encourage feedback and suggestions from staff and other service users to support you in your goal of improving the quality of care.
When leading a team it is important to ensure that team members are clear on their role, responsibility, and purpose within the team. Embracing effective leadership will increase job satisfaction for yourself and those in your team and contribute considerably to the improvement of care in your organisation.
Bumgardner's commitment to research education is based on the recognition of the value and perspective that her own scientific training provides her with regard to the care of patients, the fulfillment of pursuing novel research relevant to patients and the reward of interacting with and mentoring some of the next generation of biomedical scientists. Pacific expects our people to maintain high ethical standards in everything they do, both in their work for the firm and in their personal lives. Our experience shows that if Pacific's leaders serve our clients well, our own success will follow. Duncan was recently nominated to become a Hoag Center Fellow at the Chapman University School of Business and Economics, Irvine, CA. Duncan is a Charter Member of the Industrial Asset Management Council and a member of its 2008 Board of Directors.
Duncan graduated from the University of Notre Dame with a Bachelor of Business Administration Degree in Accounting and played on the 1977 National Championship Football Team. Neal has over 15 years of experience in building and developing early stage companies in both the non-profit and for-profit sectors.
Neal graduated from Arizona State University with a Degree in Communications from the Hugh Downs School of Human Communications. Brewer has over 25 years experience in international sales management, product branding development, distribution channel management, public relations and speaking, marketing communications, market research, customer service and information technology.
Brewer graduated from the University of California at Berkeley with a Bachelor of Arts in Political Science. Bregante graduated from the University of California at Santa Barbara with a Bachelor of Arts Degree.
Guerrero's years of experience in workers' compensation cost containment, Definiti services employers, third party administrators, public entities and insurance companies.
Guerrero led the Managed Care Division for TRISTAR Risk Management including bill review, utilization management, PPO development and specialty bill review. Kalejaiye currently serves as President of Medisoftrx, a Pacific Medical International Partner Company that specializes in population health management and predictive analytics.


Moss brings an unprecedented level of expertise to Pacific and ensures a level of competence unmatched in the industry.
Under his leadership, FMCNA has evolved to become the country’s leading provider of integrated health care services for renal patients, and its capabilities have expanded into hospitalist medicine, cardiovascular care and programs designed to flourish in a consumer and value driven health care system. A graduate of Yale Law School, Ron is also a member of the Management Board of Fresenius Medical Care AG & Co.
He is responsible for the successful management of more than 2,200 outpatient facilities, 1,400 inpatient programs, and 800 home dialysis programs across the U.S. In that capacity, he led several of the organization’s vital business functions, integrating them into a high performance renal network that can improve the outcomes and reduce the costs of managing renal disease.
He oversees renal products and pharmaceutical operations including sales, marketing, research and development, medical & regulatory affairs, as well as Mexico and Canada operations. Later that year, after being named President of Fresenius Health Partners, he launched FMCNA’s health plan. He holds both a Bachelor of Science degree in Computer Engineering and a Bachelor of Science degree in Mathematics from Southern Methodist University, Dallas, Texas. He additionally founded Specialty Care, a leading provider of perfusion and surgical support services. He holds a Doctorate in Business Administration from University Stuttgart Hohenheim, and a Graduate Degree in Economics from Ludwigs-Maximilians University in Munich.
His role is focused on delivering solutions to human capital issues and managing the company’s corporate real estate activities.
Before Gentiva Health Services, he served as Senior Vice President Human Resources, Administration and Corporate Secretary for Linens N Things, and held senior HR roles at The Guardian Insurance Company and Allstate Insurance. Before joining Fresenius Medical Care, he was with Gambro Healthcare for 9 years, leading both its CIO and CTO functions. In this capacity he oversees the company’s Ethics and Compliance Program, which is responsible for managing and implementing a program designed so Fresenius Medical Care North America complies with applicable laws, regulations, and established company standards in operating the business. He was named Vice President and Associate General Counsel in 2009, prior to assuming the leadership of our compliance function. Prior to joining FMCNA in 2003, he served as Senior Vice President of Business Development for Gambro Healthcare. Her previous health care roles included leadership positions with Gambro Healthcare and a consulting organization which she founded. As Chief of Staff, Lisa provides strategic and administrative support for the CEO by managing a wide range of high priority projects, internal and external relationships, and communications across the organization, as well as collecting and synthesizing data and fact base to support critical decision making. All of these services are designed to support the organization’s initiative to build best-in-class renal integrated delivery systems.
The midwives were additionally named a “runner-up best practice” for both lowest rates of low birth weight infants and operative vaginal births. News and World Report, which recognized nursing homes achieving a solid year of five-star ratings on all Medicare benchmarks. Peter Shumlin, Joseph Woodin, Laura Pelosi, Menig Extended Care Facility, National Committee for Quality Assurance, National Rural Health Association, patient-centered medical home, Rep.
The specialist looked at the wife’s hand and, after a few minutes, stated that she needed surgery.
But, as noted in our last blog post, analyzing the data is complex, especially because claims data are just a collection of medical bills. Rather than acknowledging opportunities for further analysis and professing an openness to collaboration, the providers responded with confidence about their model of care.
Are you really ready to tell your leadership that this physician group, which many executives use, is not in the top tier? Importantly, the employers were now equipped to discuss their rationale with their leadership teams. It is time to reward employees and channel them to primary care physicians and specialists who are truly committed to medically appropriate care.
Do you need a strategic resume to get your next leadership role or even a more challenging position? There are so many kinds of Free Resume Templates.
Research has shown that, within healthcare, shared leadership delivers the best results through a shared sense of responsibility for the success of the organisation and the quality of the services provided. Efficient planning of your time will invariably reduce your stress levels and enable you to perform optimally as a leader. With the imminent introduction of revalidation for all doctors, and given the central role of appraisal in this process, now is a good time to consider how developing your leadership skills will form part of your continuing professional development activities. As a good role model who inspires those around you, you must be prepared to lead with integrity, to support those around you, and, where you identify incompetent behaviour or poor quality care, take the appropriate corrective course of action. How often do you make sure that your team is clear about what the ultimate goal is in a given situation or project?
In the next feature we will explore the remaining three domains of the Medical Leadership Competency Framework. We are dedicated to complying fully with the letter and spirit of the laws, rules and ethical principles that govern us. As an owner, investor, C-Level executive, entrepreneur and founder of several national companies, Mr. Approximately 165,000 dialysis patients receive life-sustaining dialysis therapy in these facilities. Mark joined Fresenius Medical Care in 1990 and has held several positions of increasing responsibility including Vice President, Peritoneal Dialysis Products, and Vice President, Sales & Marketing. Maddux is the Chief Medical Officer and Executive Vice President for Clinical and Scientific Affairs of Fresenius Medical Care North America. Brian is also Chairman of the Board of Directors at the Society for Human Resource Management (SHRM). From 2001 to 2003, Ravi was Senior Vice President and General Manager at a health care startup venture providing business to business integration, disease management and clinical trials solutions to the payer, provider, pharmaceutical and biotech industries. We have the same goal to start babies on the right foot, and we’re here to support them, I say, until they go to college,” said Gifford Birthing Center registered nurse Karin Olson. Vermont’s rate of premature births is 8.4 percent compared to a national average of 12 percent.
The specialist did not know he was taking to a physician, and the CMO questioned how the specialist could arrive at a diagnosis from just looking at a hand.
The framework is built on this concept, whereby at whatever level, be it within a ward based team or the directorate: it is not just those in designated leadership roles who contribute leadership behaviours.
He holds the coveted BCIR certification by IAMC (only 5 awarded worldwide), the BCCR test-based certification, (only 48 awarded worldwide), the Senior Leader designation, SLCR, by CoreNet Global and is a Certified Commercial Investment Member, CCIM, (past Chapter President). SHRM has a global membership of more than 260,000 professionals in 140 countries and is committed to advancing the Human Resources profession. He holds multiple engineering patents and has served on the Technical and Industrial Advisory Boards and CIO councils for various technology companies and universities. The March of Dimes has set a 9.6 percent premature birth rate as a 2020 goal – a figure Vermont is already well below.
The response was, “years of experience.” The CMO and his wife got a second opinion and opted for the recommended therapy rather than surgery, and the therapy solved her issue.
Pacific’s alliance partners bring strong organizational leadership, client-service-focus and an industry-wide vision to Pacific. While recognizing that the old way may still be the best way, Pacific constantly strives to find a better solution to a client's problems. Duncan was the founder and head of the Structured Equity Division of CBRE Melody, an international division of CB Richard Ellis (NYSE: CBG), a Fortune 500 company. Duncan is a past Co-Chairman of the Membership Committee and past Western Region Co-Chairman. Brewer is currently President of Digital EYE, a leading national brand management and information technology firm that dominates the internet marketing industry using search engine optimization, e-commerce solutions and social media end-to-end marketing. They fully support our efforts to expand Pacific aggressively yet under solid control and accountability.
Moss was responsible for directing all the activities of the technical and medical bill review departments. Brian holds his Senior Certified Professional (SHRM-SCP) certification from the Society for Human Resource Management. He is a member of the company's Executive Administrative Committee, which oversees the design and operation of the company's employee benefit programs.
We pride ourselves on having pioneered many of the technologies, practices and methodologies that have become standard in the industry. Guerrero implemented sales production and quality standards and designed system tools to effectively monitor quality assurance. Kalejaiye's team developed a clinical solution that benchmarked physician's clinical practices against established guidelines and won the Wellpoint Outstanding Clinical Service Award in 2006. Brewer was the Senior Vice President of Global Sales for Rand Technology, one of the most respected and successful international electronic component distributors in the world. Neal is one of the most powerful and connected executives in Santa Barbara, California: one of the nation's premier C-Level communities. Bregante has extensive experience, specialized disciplines and long-standing, unbroken relationships with top-ranking healthcare leaders.



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