Alexis Clark:

Hello, everyone. Welcome back to From the Front Row, brought to you by the University of Iowa College of Public Health. My name is Alexis Clark, and if this is your first time with us, welcome. We’re a student run podcast that talks about major issues in public health and how they are relevant to anyone, both in and out of the field of public health.

Alexis Clark:

Today, I am joined by Erin Willits, outgoing administrative fellow for the University of Iowa Hospitals and Clinics, and Ryon Rasmussen, outgoing administrative fellow for the University of Iowa Physicians Group. Welcome to the show Erin and Ryon. Thank you so much for being here.

Erin Willits:

Thanks for having us.

Ryon Rasmussen:

[inaudible 00:00:41] Yeah, appreciate it.

Alexis Clark:

Before we begin. I thought it would be a good idea to share what an administrative fellowship is for those listeners that may not know. So an administrative fellowship is a period of training following formal graduate education that typically lasts 12 to 24 months. The objective is to provide students with an opportunity to learn about the field through direct exposure and hands-on experience as defined by the Association of University Programs and Health Administration.

Alexis Clark:

Now let’s dive into our discussion with Erin and Ryon on their experience as administrative fellows. So, Erin, what did your career path look like prior to being an administrative fellow?

Erin Willits:

Yeah, so I got my undergraduate education from the University of Iowa in child life. So I was a child life specialist who worked clinically for six years prior to applying for an administrative fellowship position. Most people probably don’t know what child life specialists are. So they are specifically trained individuals who help support the unique needs of pediatric patients in the medical setting. So helping with procedures, helping with diagnosis, education, end-of-life scenarios. Really anything that causes stress to kids in the hospital was my area of work. And so I was thankful enough to do that at Texas Children’s in Houston, at Peyton Manning Children’s in Indianapolis, and then most recently here at the [inaudible 00:02:06] Children’s Hospital. So, yeah, I was able to do that, got a master’s degree in healthcare administration, and then became a fellow. So that’s a little bit about my background.

Alexis Clark:

Very cool. Ryon-

Ryon Rasmussen:

I’m on similar lines of a non-traditional fellow, kind of like Erin. I didn’t go straight from my master’s, or I didn’t go straight from my undergrad to my master’s to my fellowship. I did my undergraduate at Central College in Pella, Iowa, and got a sociology degree thinking I was going to do school counseling. Ended up moving to Iowa City several years later. Didn’t really know what I was going to do, got into the revenue cycle in the emergency departments, worked as a rep down there for two years, and then transitioned into a coordinator for another year. So I was down there for about three and a half years and then moved on and got my MBA and got the fellowship shortly after that.

Alexis Clark:

So since you both took, sometimes someone would say non-traditional routes to get to your positions, what would you say was beneficial for having that work experience prior to going into a master’s program and prior to the fellowship?

Ryon Rasmussen:

Yeah, I mean, for myself, I was able to get some real life experience in the ER and working with the revenue cycle, which is something that I thought benefited me a lot going into my fellowship. And then I had some background with supervising people, which I would really… Something that I think everybody should do eventually. It’s quite the experience doing that. So that brought a lot of… Was able to get me to where I wanted to go in my fellowship there.

Erin Willits:

Yeah, I would agree. And I think the big thing for me was understanding what health care is like at the point of care delivery. And I think that that’s [inaudible 00:03:51] something that a lot of administrators lack. [Inaudible 00:03:54] early careers who would take a traditional fellowship route maybe wouldn’t have that insight and that experience. And I would like to think that that made me, helped me be successful in my fellowship and will help me be successful as a future leader in healthcare is that understanding what it’s like when things come down the chain and being that person at the point of care, but also understanding that you really have to value those people because that’s what… The people boots on the ground are what makes this place run and help us fulfill our mission every day. And so I just have a lot of respect for our clinicians being someone that did that work.

Alexis Clark:

Yeah. I think it’s interesting that you mentioned having boots on the ground. In my internship right now, my preceptor had mentioned having her clinical background as her safeguard, and she asked me, why I don’t have a clinical background, so what’s my plan with that? And I think me being a traditional MHA right after undergrad, I think it’s important that you’re willing to learn, even if you don’t have that experience. So it’s good to see, you both have different experiences that you’ve been able to relate to what you guys are doing now, ultimately. So Ryon, can you talk about what a typical day as a fellow for UIP, what did that look like?

Ryon Rasmussen:

It’s a really good question. I don’t think there is a typical day in my job and what I was doing. I wrote down a couple of the things that I’ve done. So working with the budget, our occupational health team and the providers, and doing a little provider relations and employer relations with them, I worked with our health ventures team and HR initiatives. I assisted in some of our acquisitions, TA-ing, which was a blast and then COVID testing and then the COVID vaccine clinics. So those are just a couple of things that I worked on, but I would say every day was different. I never worked on the same project for probably more than a couple hours sometimes. It always seemed to transition on and on.

Alexis Clark:

Yeah. Erin, what about you?

Erin Willits:

I would echo the comment of, no day is really typical, which I think is what’s so great about fellowships, and honestly, healthcare in general is you don’t really have a prescriptive day every single day. So I really love that. I think, I know we’ll talk about this later, but just a really unique year, given the pandemic and as our organization was in times of crisis, I think that my day looks different. So, working with a lot of our department administrators across the organization to track data and metrics of importance to the CEO and of the executive team, really getting to participate in some high level meetings and things of that nature to get exposure. So it’s been a wild ride, but no day was really the same, which I think is what makes healthcare so great.

Alexis Clark:

Yeah. That is interesting. And we will talk about COVID later. So since, we talked about this earlier, but you both come from different backgrounds, Erin, what was the most surprising aspect of healthcare administration specifically to you?

Erin Willits:

Yeah, I think there’s some things about UIHC specifically that were surprising to me. But when I think about it and when you get to the administrative level, you really have to look at the big picture. In my clinical experience you’re focused on your job, your day, that moment and the work you do to impact the patient. But when you work in health administration, you have to think about the whole picture. And so at an institution as large as ours, it was eye opening to me the ripple effects of the decisions that are made.

Erin Willits:

So we have a three-part mission in clinical care, research, and education. And so, when really big decisions are made, those cascade down through a variety of areas in our enterprise. And so I think that it was really eye-opening to me that a decision is not a decision. I mean, it is, but there are so many other components that go into it that one decision can change or impact 10, 15 plus different areas of care. And so I think that our administrators have really big jobs. And I think that I always knew that, but it was surprising to me to really be immersed in that culture.

Alexis Clark:

Yeah. Ryon, do you have thoughts?

Ryon Rasmussen:

I mean, I agree with everything Erin said there. It’s interesting bringing everybody to the table when we’re trying to make a decision, the providers, the nurses, the LPNs, everybody comes to the table on those. But I would say for me, the biggest surprise is the pace of healthcare administration. I thought it was going to be fairly boring, crunching numbers. Bringing in. I don’t, I didn’t know what I wanted to expect going into my fellowship, but working in the emergency department prior to that, there was, I mean, everything was fast. Everything’s fast. Very similar in my fellowship. Something that really surprised me. You can move really fast at a healthcare administration. For example, I was eating breakfast at eight and we decided we needed to pop up a COVID clinic at Holiday Road outside by the Walmart and Coralville that day. And so we were calling trailers to see if we could get a trailer out there and what kind of staff were available. So pace was very surprising to me.

Alexis Clark:

Yeah. I think even just being immersed in the new aspects of healthcare can be intimidating and fast paced, and it’s good to see that you both are still here with us, so made it through.

Erin Willits:

So just squeaked by.

Alexis Clark:

Yeah. So oftentimes we hear people say, what’s your why in healthcare, or finding your why, and that may be the most important thing we could implore our listeners to do is to find your why about anything, life in general. Ryon, can you discuss your, why? Why healthcare?

Ryon Rasmussen:

Yeah, like I mentioned earlier, I fell into health care, so I didn’t have a why going into it necessarily, but I really got passion for the patients and the best outcome that we can do for our patients. I think overall the money and the budget, that’s one side of healthcare, but the main side and what our priorities should be as our patients. And so I’ve really, especially when I was working in the ED side-by-side with a lot of these patients, it makes a lot of difference and you can really get that [inaudible 00:09:51] strings to our patients. And so I would say our patients, for sure.

Alexis Clark:

Erin, what’s, what’s your why?

Erin Willits:

Yeah. I think my why for why I started and why I stay are two different things. So I initially got into healthcare… You have family experiences or what have you, friends with childhood cancer, and I was like, wow, I want to be the human that is in healthcare, helping these patients. And that got me into paeds and why I loved paeds. Similar to Ryon’s point, it’s amazing the gratitude that you feel and it’s very humbling that these families allow us to provide the medical care. I would say my why for healthcare administration is a little different. And I think seeing, knowing those experiences, that it’s patients and families deserve really high quality, equitable medical care. And I think that something that I’m really passionate about now and will be in the future is it starts with our leadership team and ensuring that that happens.

Erin Willits:

And so working for really high caliber organizations that embody their mission of doing the right thing for patients. And I think that it’s really easy to get lost in a variety of contributing, competing, excuse me, [inaudible 00:10:53] when it comes to running a business, because healthcare is a business. But I think my mission and my why is to center it back to the patient, similar to what Ryon had said. They deserve really high quality care and I think it’s our job to ensure that they get it.

Alexis Clark:

Yeah, absolutely. Transitioning to overcoming barriers. COVID-19 has been at the forefront of any institution, whether that’s healthcare or non, what has been the most difficult aspect of trying to learn and train during COVID-19?

Erin Willits:

Yeah, I think it was a lot better than I thought it was going to be, to be honest. I was working clinically when the pandemic first started and then I was like, what in the world is this going to be like. But our leadership team was very much present and in-person, and grinding out and really trying to keep this place running and keep our patients and our employees safe. And so for me, I think the hardest part was, it was like drinking from a fire hose. It was like, everything was, to Ryon’s point, very fast paced at baseline, but wow, everything was happening, everything was an emergency, everything was highest [inaudible 00:11:58]. And so when you’re trying to learn and be a sponge, but then everything is just happening so quickly. I just think that there’s a lot to learn and very little time to do it. And so I think that it was just an overload of information.

Erin Willits:

I don’t feel like my experience was hindered at all by the pandemic. I think that I was still able to get a fantastic experience and if not a better experience than prior fellows, because hopefully I don’t ever have to lead in a pandemic ever again, but I’m sure things like this will happen and it’s been great experience.

Alexis Clark:

Yeah. Ryon, what about you?

Ryon Rasmussen:

I think again, I agree with a lot of Erin’s points. I mean, drinking from the fire hose is quite the analogy, but I do agree. I would say for me, UIP works on a lot of the outpatient side of things, so it was a lot more virtual and that was very challenging at first. I met a lot of our team towards the end of my fellowship the last six months, in-person. I talked to him a lot over Zoom and Skype and everything in between, but I would say that was very challenging. Just getting to know people via Zoom and Skype is not the easiest thing. I think a lot of what we do is getting to know people and how they act and how their leadership styles are. So that was very challenging at first, but came a long way, and I agree with Erin. I don’t think I would have had it any other way, honestly. And I couldn’t imagine it any other way. I feel like the experience was one of a kind and I appreciated every second of it, so.

Alexis Clark:

That’s great. So you both mentioned how fast paced decisions were being made and traditionally academic medical centers are known for taking a long time to make a decision or make a change. So since we are slowly getting back to what some may call normal, have you noticed a big shift in the length of decision time it’s taking to make decisions or is it… Do you think we’re heading towards a new, maybe quicker paced healthcare administration system versus not as fast as COVID, but maybe not as slow as pre-COVID?

Ryon Rasmussen:

That’s a great question. I don’t know if I could answer that fully right now, just knowing that we’re still at the end of the quote, unquote pandemic and we’re getting towards the vaccine rollouts and all of that. So I would say we still move very fast, especially on UIPs timeline, we’re moving really fast, but I think it’s to be determined. I’d love to say that we’re going to continue doing that because I think it’s great for our patients to change. Our patients are changing. The culture in Iowa, Iowa City, the surrounding areas is changing. So just changing with the times I think is going to be really important. And I hope we can keep up as we move on here.

Erin Willits:

Yeah. I agree. And making decisions in a time of crisis, for lack of a better word, our staff were in crisis. Our community was in crisis. So you had no choice but to move fast and our leadership team did an incredible job expediting processes and being very swift in decision-making. I just think that we have a really fast paced leadership team. And I think that they’re highly motivated and they’re excited and determined and driven to get the work done and to get it done right and in a reasonable timeframe. So I agree. I think it’s too early to tell, but I don’t know. This leadership team is a quick team, so I can see it just continuing,

Ryon Rasmussen:

I don’t know any other way either. I was talking about-

Erin Willits:

So true.

Ryon Rasmussen:

We came in fast and I’ve ended fast, so I don’t really know another way. So I if this is how it’s going to keep going then I think that’s good.

Erin Willits:

Yeah. I totally agree. Don’t know any different, so.

Alexis Clark:

Yeah, I agree. And so would you both say the 12 months of your fellowship went super quick?

Ryon Rasmussen:

Yeah. Some days felt longer than others. Some weeks felt longer than others, but I would say looking back now, it seems crazy. We were just joking in here about my photo, about just how much it seems like a year ago, getting a new badge and everything just seems crazy to me.

Alexis Clark:

Any more gray hair or…

Ryon Rasmussen:

Probably.

Erin Willits:

I don’t see any.

Ryon Rasmussen:

[inaudible 00:16:18].

Erin Willits:

I felt like it went pretty fast. I mean, fast and slow at the same time. There were weeks that were really, really hard weeks and definitely drug on, especially during the surge and these winter months were really challenging, but I think anytime you look retrospectively, it feels like it went fast.

Ryon Rasmussen:

[inaudible 00:16:33].

Alexis Clark:

So Ryon, if you had to pick one thing, what would you pick as the most rewarding experience of your fellowship?

Ryon Rasmussen:

I’d for sure say the vaccine clinic. Being able to have somewhat of a leadership role out there and talking with patients and talking with staff. Our staff, I mean, Erin mentioned it was just go, go, go nonstop. And time seemed to go a lot slower out there, which was really nice because you were able to experience everything. How the patients were feeling. We had patients in tears, they were so happy and staff in tears, they were so happy. It was life changing, honestly, just being a part of something like that. So that was easily my most rewarding experience.

Erin Willits:

Yeah. My most rewarding yet, probably most challenging… So Ryon got to be really integrated in the patient vaccine clinic, whereas I was very involved in our employee vaccination clinics. So my colleague, John and I were responsible for scheduling our 11,000 plus employees to be vaccinated and doing all the data analytics and things surrounding that. So met with employees who were very excited to receive their vaccine. Those who were frustrated that they weren’t getting it sooner, collaborating with our University of Iowa partners across the river to get their respective employees who fell into those high-risk categories vaccinated. So to Ryon’s point, definitely a life-changing really rewarding experience also the most challenging thing I’ve ever done. And so I think that just learned a lot about myself, learned a lot about how people operate under stress. I honestly think that was probably my biggest takeaway is, how to lead people and how to get people to come around to ideas and concepts when they’re just in places of stress and fear. And people really were in places of stress and fear. And so invaluable experiences that I wouldn’t trade, but challenging and rewarding all at the same time.

Alexis Clark:

Do you, since you were the employee vaccine queen, for lack of better terms, what’s the percentage of UI healthcare employees vaccinated? Is it a large percentage?

Erin Willits:

Yeah, I think it’s upwards of 90 plus percent.

Alexis Clark:

Wow. That’s phenomenal.

Erin Willits:

Yeah. Very impressive.

Ryon Rasmussen:

Yeah.

Alexis Clark:

So we are creeping up on administrative fellowship recruiting season. Erin, do you have a piece of advice for those people that are interested in fellowships or maybe not interested in fellowships?

Erin Willits:

So yeah, I have some advice. I think for those interested in fellowships and specifically the application process, I think it’s really, really important to be genuine and to be yourself. And I think that so much of a fellowship and finding a fellowship is something… It needs to be a good fit for you. And it’s really hard to find things that are a good fit if you’re not being genuine throughout the process. And so I would just really encourage students to be genuine, to really share what they’re passionate about, why they’re interested in healthcare. And you’re really interviewing these organizations as much as they’re interviewing you. So I think finding a good fit, finding someone whose values align with yours, finding someone who’s willing to invest in you and help you achieve your goals is really important. And like I said, it’s hard to do that when you’re not genuine.

Erin Willits:

On the flip side of that would encourage those who aren’t successful in the fellowship process or those who don’t want to seek a fellowship that that’s perfectly okay. And I think that Ryon and I would have… I think, I won’t speak for Ryon, but my fellowship experience definitely helps advance my career in more ways than one.

Erin Willits:

I would like to think that I would still have been a successful leader in healthcare if I took a different path. And I just don’t want folks to feel like the fellowship option is the only option because we have so many great MHA programs across this country and especially at the University of Iowa and you folks are educated and prepared and I don’t want people to get stuck in the mindset of that, that fellowship route was the only route.

Alexis Clark:

Yeah. I like that. I like that you’re imploring people to explore all options. Ryon?

Ryon Rasmussen:

Yeah. I mean, great points Erin. But I would say, yeah, definitely don’t give up. I had six nos and one yes. So I didn’t have my pick at where exactly I wanted to go. I mean, I picked my fellowships of what I applied for, but got the opportunity with UIP and very grateful for that, but got a lot of no’s. So don’t give up on that. And then similar to Erin’s, your story doesn’t end with your fellowship or getting a fellowship. So don’t feel like if you didn’t get a fellowship that you had to get one. It’s a great opportunity to learn and I would, like I mentioned before, wouldn’t have traded it for the world, but there are a lot of opportunities out there and you’re going to find your fit, so don’t give up and don’t feel like it has to end with a fellowship.

Alexis Clark:

Yeah. That’s great advice as well. So the last question we’d like to ask on From the Front Row is a good question. Ryon, it is, what is one thing you thought you knew, but were later wrong about? And this can be any aspect of your life. It doesn’t have to be healthcare related but it’s okay if it is.

Ryon Rasmussen:

I’d say everything. I would say everything about my… If I think about my fellowship it’s with everything. I don’t know. I think I have more advice on this. I never really went into my fellowship knowing anything. I was the go-to. I went in learning a lot. I’m speaking specifically about the fellowship, but it’s a great opportunity to make mistakes in a safe environment with a leader that’s going to point you in the right direction. So I’d say be prepared to learn. In my own life, similar, if you’re not married, you’ll figure it out fast that you’ll learn fast. So I’m wrong about everything there too.

Alexis Clark:

I’m sure. You know, they say happy wife, happy life. [inaudible 00:22:22].

Ryon Rasmussen:

Exactly. Exactly.

Alexis Clark:

Erin, what is one thing you thought you knew, but were later wrong about?

Erin Willits:

Kind of twofold. I think that it’s always really entertaining to me when people ask you like early in your fellowship, or even as an early career, what do you want to do? And I think anyone who feels like they know what they want to do, they probably will change their mind. And so I always thought you think, you know what you want, but then you get immersed in so many things and you’re like, I had no idea about this whole other world of things that were out there. And so would encourage people to be open-minded. But I laugh, working with our team here, when I was asked those questions, I was like, I don’t know anything about finance. I don’t need to know that I don’t like it. I’m not good at it. I don’t… Okay, I’m so wrong. You have… Finance touches everything. You have to be very savvy in finance to succeed at anything else in healthcare.

Erin Willits:

And so that’s my thing. And I’ve grown to love it, honestly. This year I was like, there’s no way. And at the end I’m like, I don’t know. I could see a career in finance. I mean, I’d have a ton of learning to do, but nonetheless, I think people get really narrow-minded and like I’m never going to do that. I have zero interest. But healthcare it’s a system and everything is very interdependent, so I think there’s a lot of value in being balanced. But finance is the joke with my group of colleagues for me.

Alexis Clark:

Yes. I’m not going to comment on my finance opinion. Ryon was my TA for a whole year so I’m just going to leave that for off the record. But nonetheless, I want to thank you both for being willing to meet with me on From the Front Row and sharing your insight and experiences with the listeners.

Erin Willits:

Yeah. Thanks for having us.

Ryon Rasmussen:

Thanks [crosstalk 00:23:58], yup.

Alexis Clark:

That’s it for our episode this week. Big thanks to Erin and Ryon for coming on with us today. This episode was hosted, written, edited, and produced by Alexis Clark. You can learn more about the University of Iowa College of Public Health on Facebook. Our podcast is available on Spotify, Apple podcasts, and SoundCloud. If you enjoyed this episode and would like to help support the podcast, please share it with your colleagues. Our team can be reached at cph-gradambassador@uiowa.edu. This episode was brought to you by the University of Iowa College of Public Health. Stay happy, stay healthy and keep learning.