Master Your Healthcare Career
Master Your Healthcare Career
"Leaders Never Arrive," a conversation with Bill Santulli on Lifelong Learning
This podcast features a conversation between Anthony Stanowski and Bill Santulli, operating partner at Water Street Healthcare Partners and former president of Advocate Health-Midwest Region.
Bill discusses his career journey and provides insights for early careerists to achieve success. With a theme of “Leaders Never Arrive”, Bill begins with his decision to pursue a Master's in Health Administration at the University of Minnesota, and his early experiences as an administrative resident and as a fellow.
Bill highlights the importance of the American College of Healthcare Executives, where he is Chair for 2024-2025.
Anthony and Bill delve into the importance of lifelong learning, inquisitiveness, seeking feedback, bringing positive energy to work, and staying true to core values.
Well, Melissa, thank you very much for that introduction and a warm welcome today to an old friend, Bill Santulli. Bill, thanks for joining our show today.
Bill Santulli:Pleasure to be here.
Anthony Stanowski:You're in a time of kind of moving from the president of Advocate Health West to Water Street Healthcare Partners, but what I really want to do is kind of explore the early part of your career. So you know, let's kind of first talk, bill, what made you go into healthcare? Why did you go to University of Minnesota to get your MHA? What was the fact that kind of turned that switch on Anthony when?
Bill Santulli:I as an undergrad. I was a sociology major and I was planning to go into academia. In fact, I went right from undergrad to the University of Florida to continue my studies in sociology. The summer between undergrad and starting grad school I randomly landed at a hospital in Norristown, pennsylvania, close to where my parents were living at the time, and that's what sparked an interest in health care. That's when the light bulb first went on, because I was very fortunate it was a small mental health facility. I worked in the billing department. I also worked part-time as a nursing assistant, got to know the hospital leadership and the wheels started to turn. So when I went down to Florida I focused on medical sociology and health services research and really used my first year in Gainesville to be very intentional about exploring the pros and cons for me in some type of healthcare leadership role versus academia. And I obviously chose the healthcare leadership route but stayed in Gainesville for the two years, completed my master's there and went directly to the MHA program in Minnesota. So that was quite.
Anthony Stanowski:you know, I went from one of the warmest climates in the country to one of the coldest when I made that switch. Well, the good part about Minnesota, though, at least in Minneapolis, is everything. You can actually stay indoors when you walk down the sidewalks there. Well, bill, it's interesting. I mean I want to catch back up with you with where you worked in suburban Philadelphia, around Norristown, because that's where I'm from, in that general area, and I think we might have some friends in common as we kind of go back on there. But we'll talk about that afterwards, I guess, as we kind of go back on there, but we'll we'll talk about that afterwards, I guess so. So you went to Minnesota and and great program Minnesota was one of the founding programs of CAMI, one of the first CAMI accredited programs back when CAMI began, back in 1968. But you did two things at that point. One of them you, you did an administrative residency. One of them you did an administrative residency. Then you also did another year as an administrative fellow. So people confuse those two items, could you?
Bill Santulli:talk a little bit about what you get out of the residency and why you did the fellowship? I'd be happy to, anthony. So the residency was the summer between my first and second years at Minnesota and I was very fortunate that I stayed on at the hospital I did my residency at At the time it was called Metropolitan Medical Center in downtown Minneapolis. I stayed on and worked part-time during my second year of school. The fellowship was a post-graduate experience. I had completed, you know, the degree at Minnesota and then, in my case, I headed out to the West Coast and did a fellowship with Health West, which was a at the time a fairly large, you know, multi-hospital system based out of Los Angeles. But I was very fortunate with both experiences. So, you know, as a resident in and you're testing my memory a little bit, anthony- I know as a resident, because that would take me back to the summer of 1983.
Bill Santulli:And the chief operating officer at the time, frank Larkin, was my preceptor and mentor, and he was extraordinary. He gave me exposure to everything from the board to I was a part of the executive team. I, you know, was able to work on projects in a variety of aspects of the operation. I was able to build relationships with every exec on that team at the time, and so I was very, very fortunate. It was an incredible launch and a couple of things were happening at that time. One, it was the advent of DRGs and second, in the case of where I was at, we merged with a hospital across town in St Paul to form you know what today is part of the nucleus of Alina, and you know here I was a student gaining exposure to, you know, a pretty significant merger at the time and just as kind of a footnote, Anthony.
Bill Santulli:It was an incredible experience and, you know there was a lot of positives, but there was some things that I still on your day job.
Bill Santulli:You got to keep focused on what you're accountable to deliver while at the same time you're participating in, you know, building this new thing, and toggling the two is critically important. Shifting gears to the fellowship for a moment. So I, like I said, I went out to Los Angeles and at the time it was a significant, you know, health, growing health system based out of Southern California, and I was very, very fortunate. The CEO, a gentleman by the name of Paul Teslow, was, you know, in the 80s and 90s, arguably one of the most visionary CEOs in the country, and he assigned me to a gentleman by the name of Leighton Crouch and our singular focus during my fellowship was to plan and launch a health plan inside this multi-hospital system and we actually accomplished that and it grew into a significant health plan on the West Coast and we were actually the first health plan in the country that entered into capitated or fully at-risk arrangements with hospitals. So I was very fortunate to gain deep exposure into that whole risk health plan space as a fellow.
Anthony Stanowski:Bill, it's phenomenal because it's almost like what you're doing with your career. In those periods was very similar to where I was, because I was doing an administrative Fellowship at Graduate Hospital in Philadelphia and it was the same thing. It was the RGs are kicking in, what are they doing? And then graduate also started to do a merger. And then Graduate also started to do a merger.
Anthony Stanowski:And exactly what you said is you know, I remember my boss saying to me the merger was occurring and automatically, when the mergers happened, going, how does it affect me? And there I am, an administrative resident or fellow. You know, all of 23 years old, in the bigger scheme of things, how it affected. Anthony Stansky at that point was minuscule of what was going on. But you, all of a sudden, you kind of take it what's doing for me? What's it doing? And she said the same thing it's it's think about, keep doing your job, keep your nose down, do what you're supposed to be doing, do your work. And ultimately it did pay off for me because, as the mergers occurred, eventually moved up to the system office as well too.
Anthony Stanowski:But I think that's great advice, so true. Well, you know you hit on some of the interesting responsibilities, with a residency and a fellowship, which is you get to go to the board meetings and you get to see those decisions that are being made, and it's an important part of your job that you don't actually see for a few years, quite a few years later, after that kind of occurs with there. That kind of occurs with there. What would you say to a student who's kind of looking you know what I hear some is I have students come and say, well, geez, I don't know whether I should do a fellowship because I don't get as paid as much and I should go to a job and I would make more money doing that instead of doing a fellowship. What would you say to a student who came to you with those thoughts?
Bill Santulli:Most well. As you know, Anthony, many of the MHA programs across the country require some type of internship or residency between the first and second year, so that's almost a given. Now the fellowship is another matter, because today's students, or today's graduating students, have a variety of options in addition to fellowships. However, I would strongly urge students that are seriously thinking about healthcare delivery, whether that's in the acute environment, the home environment, the ambulatory environment, et cetera to strongly consider a fellowship, because it gives you a macro view, a strategic view of the organization that, as you just said, anthony, you may not get that same view exposure to governance and senior leadership until five, ten or more years after you're out of school. So it really serves as like an accelerant to gain a deeper understanding of how the organization functions.
Anthony Stanowski:I agree. You know, bill, maybe it took you five or 10 years to get back there, but probably took me close to 20. So a little bit more longer time to get back into the boardroom. But it was, it was, it was. It was certainly an important part and a formative part of my career too. So if you're a student now I mean you talked about, you know you were involved in the development of the first health, one of the first health plans, if not the first health plan within a hospital. It took fully capitated arrangements and you know some of your knowledge and skills from your MHA and your experience kind of went in there. If you were looking at students right now, where do you see as some potential growth areas for them?
Bill Santulli:I would point to several areas, anthony, so one you've got to tune into and understand what's the new health care delivery front door, which is digital medicine.
Bill Santulli:It's you know it grew very, very rapidly during, you know, the COVID-19 pandemic and it continues, and then we had a slowdown, but it continues to grow and it will continue to be a significant part of how health care, particularly primary care, mental health and some of the specialties, are delivered.
Bill Santulli:I would also recommend to emerging, to early careerists to gain perspective on the entire healthcare ecosystem, whether that's health systems, whether that's medical groups, to build relationships with other folks across the ecosystem and learn from them.
Bill Santulli:I would also you know we're probably not even at first base with applying, you know, machine learning and artificial intelligence into the healthcare delivery sector, when you exclude sort of the back office and administrative functions. So I think it's critically important for early careerists to gain an understanding of how AI can and will play a role and, as early careerists, really kind of push yourself, push your team, push your organization, because it's such an exciting time to come in that we don't even know what some of the possibilities are that you know this technology will enable us. So all of that, whether it be technology, home-based care, the growing ambulatory space, you want to tune into all of that. But at the same time, I'm big on the fundamentals, are enduring and, and the fundamentals, whether it be, you know, communication skills, relationship management, problem solving, financial acumen. You've got to continue to work hard at getting better and better at the fundamentals, and I don't know if any of us ever master those fundamentals, but you've got to be intentional about it.
Anthony Stanowski:Yeah, you know it's funny, they call those the soft skills, but they're actually some of the hardest skills to learn. Yeah.
Bill Santulli:I agree.
Anthony Stanowski:Yeah, bill, the whole thing around machine learning and AI, though. It really does remind me of, you know, when the Internet kicked in and we didn't quite know what it would do where it would go.
Anthony Stanowski:Kept in and we didn't quite know what it would do where it would go, and you know who could have pictured back when it started and and look, I was playing around with FTP and going on the FTP and going on the sites and trying to figure out you know what's out there and kind of see where we are today and how it is kind of moving around on the internet. You know freely, quickly and in a lot of ways more efficiently what AI will do in 10 or 20 years.
Bill Santulli:You know, anthony, before we leave this topic, the other thing I want to underscore is, if I was an early careerist and I was interested in healthcare delivery, health system, medical group etc. I would gain an understanding of how do we open up patient access while at the same time reducing the total cost of care. Healthcare delivery systems, health plans in particular, have a significant role to play in doing that. You know. As an example, if you know, I'll take Chicago, my hometown, where the life expectancy gap between Streeterville in the city of Chicago versus the South Side it's almost a 30-year gap. It's one of the worst gaps in the country. And I raise that simply because access to health care can and should play a role in helping to reduce the variation in that kind of significant gap. But at the same time, as health care leaders, we all have a significant role to play in helping to reduce the total cost of care and lots of opportunity on that front.
Anthony Stanowski:Yeah, and a lot of different organizations kind of approaching it in ways folks like CVS, health and, you know, amazon and I know I think was it Walmart's getting out of the business right now They've kind of figured that it's a little too hard for us to understand and moving a little bit away from it. Some organizations are still kind of doubling down.
Bill Santulli:Yep, well said, anthony, that, uh, that's Walmart exiting sends a huge signal into the marketplace. Uh, that gosh. This, this business, this arena is a is pretty darn complex, Uh, and in some cases it's, it's tough to make a healthy margin. So they kind of retreated a bit.
Anthony Stanowski:Yeah, absolutely, Bill. One of the things we talked about different things for students to know and understand the different options that are available, but I think one of them that's near and dear to your heart and to my heart as well as ACHE, and you're the incoming chair of the American College of Healthcare Executives, which is, I would arguably say, is the largest professional organizations of healthcare executives in the world and just an Just an amazing association to be part of. Bill, what kind of led you to ACHE? And you know why, why did you get involved in ACHE?
Bill Santulli:That's a great question, anthony. So, first off, to be honest at the time it goes back to 1982, 83, as a student at University of Minnesota, we were required to join. So all of my classmates and I joined ACHE as students back in the day and I've been active, you know, in the college since, for 40 years. And you know to your question well why. And I would point to three things.
Bill Santulli:One, ache does provide, you know, world-class education, whether it's, you know, the annual Congress or you know, the clusters or the you know myriad of virtual offerings that ACHE provides. The second thing is it's a great opportunity to network, to network with colleagues from other markets and other parts of the country in a safe environment where you can really let your hair down. And then, third, folks that get involved, particularly at the chapter level. We have 78 chapters across the country. It offers some nice leadership opportunities for folks outside of their organization and it's for those reasons that you know I stuck with ACHE and decided to play a leadership role and I'm blessed to serve on the board and honored to serve as the 24-25 chair.
Anthony Stanowski:Yeah, and Bill, really truly what a great organization. And you've named all three of the things that I think were really important to me with ACHE as well. And let me talk about the third one, because that's one that a lot of young careers don't quite get, I think, which is, you know, when you're in a job in an organization, you always kind of see, well, the president has the most power and whatever the president says, as you know, bill, whatever you say would get done right. So it doesn't quite always work like that. It's different types of power that's involved in moving an organization through referent power, expert power and the like. But what you really learn at a chapter level is you really are trying to make things different, trying to move things through without any formal power, and understanding how to use that in a way to get things accomplished is, to me, one of the major benefits of participating at a chapter level.
Bill Santulli:Completely agree and at that level, I think that's a great way you can quickly well, first off, all of our chapter leadership are volunteers, but you can quickly get involved in supporting the chapter in roles where you play a leadership role, and it gives you an opportunity to present, it gives you an opportunity to innovate, it gives you an opportunity to frankly, build your network and help, to you know, coach and mentor and support others. So, yeah, I would strongly encourage early and mid-careerists. To you know, get involved at that level. And ACHE is only as strong as the strength of our 78 chapters. Ache is only as strong as the strength of our 78 chapters. The chapters are really what I would call almost like the interstitial glue that holds ACHE together.
Anthony Stanowski:Yeah, yeah, that was so true. And what you've kind of described in there about networking, the importance of networking is really what I think is essential with getting involved in the chapter level, because you're not just networking, you're not just handing your cards out to people and go hey, you know, if you know of a job, give me a call, but it's really working with individuals and helping other people succeed. And by doing that, by giving of yourself and helping the success of others, you actually find it comes back to you and helps you as well. Well said, the world-class education part is amazing though. I mean with ACHE again, ache Congress. For anyone who's ever been there, you know how valuable that is and the depth of experience and the speakers are there. But the clusters are incredibly valuable as well. I've got a couple of books on my bookshelf about clusters. I've attended at ACHE Bill. What are they for our listeners out there? Tell me about the clusters.
Bill Santulli:So we offer clusters several times a year Boston, san Diego, some of the cities in Texas, orlando. But more importantly than the location, a cluster will focus on several topics over a multi-day period. So in a lot of ways you're getting kind of a deep immersion into you know whether it's negotiating skills or advanced problem solving skills, except the, you know, advanced communication skills all kind of packaged into a you know two or three day session. So there's not a lot of downtime but it's a very you know you'll get out of it what you put into it. But it's a very powerful couple three days from a learning and education perspective.
Anthony Stanowski:Yeah, intense and knowledgeable, the one that you were just referring to. I, you know, I probably one of the the most important clusters that I've ever had the process and techniques and negotiation, and I'm sure, if you talk to a lot of ACHE people, that's one that almost everyone is going through. Yeah, yeah.
Bill Santulli:Many years, many years ago. But I yeah, I literally still carry around that car that was handed out.
Anthony Stanowski:Me as well, bill, it's so funny. So you know, we've gone through a nice kind of like a journey here, kind of touching on a variety of different things. You know, if you were to talk to a student right now, you kind of talked about some of the areas to kind of think about, but what would be the main piece of advice you would give a student?
Bill Santulli:Yeah, anthony, I would share several pieces of advice, and where I start is commit to lifelong learning, and I've read some of General Stanley McChrystal's work. He served as a four-star general in the US Army, he's a West Point grad and he did some research on. You know what is it that differentiates highly effective leaders? And his conclusion is that leaders never arrive, that it is a perpetual ongoing journey and that we all have the opportunity to continue to learn, to improve and to get better. So that's where I start with commit to lifelong learning, to lifelong learning, and, frankly, that's one of the things that I find so intriguing about healthcare, because it's so darn complex and there's so many parts and pieces and sectors to this large industry. With that, there's so much opportunity to learn, both from a business, technical, medical knowledge perspective as well as leadership.
Bill Santulli:The second thing I would point to is be inquisitive. Every day is an opportunity to learn from your colleagues. Clearly, you know health care is a team sport. None of us succeed on our own. So lean into your teammates and your colleagues and, you know, be aggressive in learning from each other and from them.
Bill Santulli:Over the years of Stephen Covey and I love one of his mantras, which is simply seek to understand than to be understood. I also think it's important for all of us, not just for early careerists. You got to ask for feedback because and you got to seek folks out that will share a candid commentary and feedback, because most folks will kind of sugarcoat and gaining. You know, getting rich feedback is foundational to gaining a deeper understanding of who each of us are and where we have opportunities to get better and to improve. Another thing I would recommend, anthony, is that you got to bring your whole self to work every single day and bring positive energy to your organization and your team. When you bring positive energy, others will be drawn to you and, frankly, want to collaborate and partner with you. Two more things. One is never compromise your core values. It's so foundational. And then, finally, be humble but play confidently.
Anthony Stanowski:Great advice on all of them, bill, and you know, before we kind of end off, I want to go back to the first one you said, which is leaders never arrive, and you yourself. You were the president of Advocate Health Midwest Region and you're now going to be arriving at a new organization. Talk a little bit about that journey, what you hope to accomplish at Water Street Healthcare Partners.
Bill Santulli:So you know, Water Street is a healthcare private equity firm based in Chicago. In Chicago, and Water Street invests in three areas One healthcare services, services to hospitals, health systems, medical groups.
Bill Santulli:Two services to life science and pharma and research organizations and then three medical device. In all three of those areas, the vision of the company is to simply invest in people and ideas and in organizations that can help to drive innovation within this healthcare ecosystem, and most of my new colleagues come from a deep investment banking background. Firms like Water Street periodically bring on operating partners or advisors who, like you and I, who have a deep operational background, who can provide support to the companies that the PE firm invests in. So I'll know more about what I'm getting into after a few months, but I'm very excited about this next chapter a few months, but I'm very excited about this next chapter.
Anthony Stanowski:Well, leaders never arrive and I want to say you know, I've known you for quite a few years and you truly are one of the great leaders out there and I'm looking forward to seeing what you do at Water Street. Maybe we'll invite you back on a future episode where you can kind of describe how that process is going. Thank you very much for your time today. I think this was a great conversation and so much enjoyed you sharing your time with us.
Bill Santulli:Thank you very much, anthony, it's been a great pleasure.