Dr. Vivian Lee (MBA '06) Shares Her Insights on Fixing the U.S. Healthcare System

Dr. Vivian Lee (EMBA '06)
NYU Stern Program: Executive MBA
Company: Verily Life Science (an Alphabet company)
Industry: Health Care
Dr. Vivian Lee, president of health platforms at Verily Life Science and author of The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone, shares her perspective on why the U.S. health care system needs to be fixed and insights from her book on ways to do it.

Tell us a bit about your professional history, including what led you to pursue an Executive MBA at Stern and where your career path has taken you since.

I sought the EMBA at Stern when I was the Vice-Chair for Research in the Department of Radiology and found myself responsible for managing a team of about 60 scientists, research coordinators, and staff at NYU Langone. Not long thereafter, I became the Chief Scientific Officer and Vice-Dean for Science there and was then recruited to be the CEO and Dean (and SVP) at the University of Utah Health, a $3.6 billion integrated health system. After six years in that role, I had a year’s sabbatical and wrote a book about health care (The Long Fix) and then joined Verily two years ago as President of Health Platforms. Verily is Alphabet’s life sciences and health care company, dedicated to improving health. So many of the lessons I learned at Stern have been put to excellent use along the course of my career!

Perhaps never before has the U.S. healthcare system been under such close scrutiny and faced such acute, intense demand. From your perspective, what weaknesses in the system has the current crisis highlighted? Conversely, have you seen any innovative solutions implemented that inspire hope for future change?

The Covid-19 pandemic is like a giant stress test for our health care system, and in large part, we’re not performing all that well. The fee-for-service model of health care is reactive and not proactive. We haven’t focused on prevention or public health. Most of our hospitals and clinics—paid on a fee-for-service basis—are running out of cash as their clinics have been mostly empty (except for Covid-19 patients).
There are a few silver linings. First, we can truly admire the dedication, courage, and commitment of our health care workforce on the frontlines. They are our heroes. Additionally, doctors and patients are discovering how to use more telehealth (videoconferencing, for example) and payers are reimbursing for this modality of care. It’s also becoming increasingly clear that technologies to enable patients with chronic diseases (like diabetes, hypertension, depression) are powerful ways for people to manage their conditions outside of clinics and hospitals. These need to be prioritized (and covered by health plans). Finally, there’s an increasing recognition that investments in public health will be critical to prevent history from repeating itself.

At a high level, what changes would need to happen in the US healthcare system to make the country better able to manage public health crises like the one we’re currently facing?

The single biggest problem in U.S. health care is the underlying business model—fee-for-service, or paying for action rather than paying for health. Today, we incentivize hospitals and doctors to do more things to us, operations, procedures, imaging studies, regardless of whether they make us better. Flying into the headwinds of capitalism, market forces are incentivizing waste and overtreatment rather than better health outcomes. With new pay-for-outcomes or pay-for health models (and the military health system is a great example in the US), we can get to better health—and lower costs—and those savings are vital if we are going to be able to support health care for all.

What inspired you to write your recently published book? Are there any particular stories or insights from the book that you would like to highlight? 

The Long Fix is the book I wish I could have read before I got into medicine and health care. It tells the stories of people and places where health care is really working well, and then weaves those narratives together to arrive at an action plan for addressing many of our health system’s woes. For people who are caring for aging parents, new models of Medicare Advantage clinics, like ChenMed or Iora Health, are devoting 30 minutes to an hour for each patient visit, offering shuttle service to clinics, delivering refills to homes, and even offering yoga and Tai Chi classes. The book shares stories about employers who have banded together to demand “performance specs” from the doctors who care for their employees. It describes how technologies like telehealth are helping patients with depression and people with type 2 diabetes manage better at home. Health care is everyone’s problem to fix, and there are ways forward for a brighter future!

What have you learned from your own career about making large-scale organizational or system-level changes, both in terms of healthcare specifically, and in organizations in general? Please feel free to use an example to illustrate the point.

One of the initiatives that I feel the most satisfied about was the work we did at the University of Utah to improve patient satisfaction and quality of care and to reduce the costs of care. The algorithm was taken straight out of a business school change management textbook, and the most important lessons were that we effectively engaged our physicians in the process, so that they felt like they had some autonomy to decide how we were going to change, and see the benefits for their patients and for themselves. In the end we succeeded on all metrics (top ten in quality among all University hospitals and #1 in 2016) plus doubled our operating margin.

What lessons have you learned about leadership from your career as a healthcare executive? 

I’ve learned how to appreciate the diversity of skills, styles, and backgrounds that it takes to manage a complex organization. I understand just how important it is to communicate well and to listen even better. I try to live in the moment—whatever challenges or responsibilities, to own it/them fully and to see every challenge as an opportunity.

What advice do you have for fellow Stern alumni as they face the professional challenges brought on by a global pandemic, such as managing teams remotely and making quick pivots as circumstances change?

Take the time to talk to people about how they’re doing, share a fun story, and try to get outside to take at least a few of your calls every day if you can!

What are your favorite Stern memories?

One of my favorite memories was bringing our newborn baby in one of those carriers during a nap and prepping for a capstone project with my team at Stern. I loved so many classes—will never forget how we debated whether new products like Tivo and Zipcar had any real future. Really loved hearing my classmates pitch their products in the entrepreneurship class, and still want to launch the company “Atalanta” that our team worked on!

How do you stay connected to the Stern community now?

I love how Janet Vitebsky keeps us all connected, and now that we’re back in NYC, I hope we’ll be able to catch up in person with former classmates!

Have you taken up any new hobbies during quarantine? Any podcast or book recommendations to share (perhaps related reading/listening for those interested in learning more about the healthcare system)?

With the new book, I’m getting introduced to many new podcast hosts, which is fantastic. Like many, we’ve been trying all kinds of new recipes (how did we live without the internet and YouTube?). A few wonderful surprises like polish doughnuts (Pacski) and homemade pizza, and some not to be recommended (spinach and ricotta ravioli made with cottage cheese and wonton skins).