Last September was a historic moment for the California chapter of the American College of Emergency Physicians (ACEP). For the first time, an outgoing woman president, Aimee Moulin, passed the baton to an incoming woman president, Chi Perlroth.
In addition to her role with CAL-ACEP, Dr. Perlroth is a Vituity emergency medicine partner, Assistant Medical Director, Emergency Department Chair, and Health System Board Member at John Muir Health in Walnut Creek and Concord, Calif. We recently sat down with her to talk about her experiences as a woman leader in emergency medicine. As you'll see, she had several thoughts on how to create a joyful, meaningful, and lasting career in this challenging specialty.
I understand you have quite a passion for advocacy. Where does that come from?
Dr. Perlroth: To me, advocacy is a natural extension of my career in emergency medicine. As emergency physicians, we care for everyone and anyone who walks through our doors. The job of an advocate is very similar. We not only make sure that physicians' voices are heard, we also make sure that patients get the care they need, regardless of their ability to pay, their race, their religion or creed, and so on.
One of the things I love about advocacy is gaining a deep understanding of the processes and players involved. Framing issues as insurance versus physician or executives versus medical staff ignores the incredible complexity we operate in. At the end of the day, it's about good people with noble intentions doing their best and making informed decisions with the knowledge they have at the moment.
What initiatives have you worked on?
Dr. Perlroth: One of the biggest was the Maddy EMS Fund, which was created to subsidize the emergency care of uninsured patients in California. This fund helps hospitals that care for disproportionate numbers of uninsured patients to serve their communities while being able to keep the lights on. In 2016, Gov. Jerry Brown signed a bill sponsored by CAL-ACEP that extended the fund for 10 years.
How did Vituity support your interest in advocacy?
Dr. Perlroth: Early on, I mostly attended state advocacy gatherings in Sacramento aimed at assisting ED physicians in taking care of our patients. There wasn't much travel involved, but I would still take a day off of work to participate and meet with legislators. And to my surprise, without me asking, Vituity offered me a modest stipend for my efforts. It was nice to know that what I was doing to help patients was valued by my partners too.
Why is it important for healthcare providers to get involved in their professional organizations?
Dr. Perlroth: There's a lot of talk lately about burnout and providers feeling like they don't have any control over how they practice. And I think that being active in your professional organization is one of the best ways to take back some of that power.
Being active could mean being on advocacy phone calls, reading email synopses of policy proposals, or giving your yearly dues to fund lobbying efforts. But when it comes to advocating for what you need, being part of a group of a smart, strategic, caring individuals takes you a lot farther than you could go alone. National ACEP and CAL-ACEP have cultivated great relationships with our legislators over the years that have allowed us to advance our goals and practice the way we believe is best.
What advice do you have for providers interested in leadership?
Dr. Perlroth: I think one thing that helped me was just showing up. That means more than saying, "I'm willing and able." It's also important to follow through and be meticulous about keeping your commitments. Even if you don't get the results you pursue at first, following through shows people that you're serious.
Knowing what you're interested in is important too. It's easy to get caught up in doing the cool thing or the next big thing. But when you do things because you genuinely feel passionate about them — because they're true and right for you — you really show everyone what you represent.
And conversely but also importantly, volunteer for things you're bad at but want to know more about. It's the best way to grow. When I started taking on leadership roles at CAL-ACEP, I knew very little about the intricacies of physician reimbursement. HMOs, PPOs, Medi-Cal, Medicare, managed Medicare, managed Medi-Cal … these are big concerns of our constituents, but I had very little experience with them.
So I volunteered for the Reimbursement Committee, and then I volunteered to cochair the Reimbursement Committee. And after immersing myself in it for a couple of years, it's amazing what I've learned. There are certainly many people who know way more than I about ED coding and reimbursement. But I understand the mechanics and where to get information, which makes me a more effective advocate.
In your experience, how does Vituity support leadership development?
Dr. Perlroth: When you are a new leader in Vituity, the directors and executives are incredibly accessible and helpful. For instance, when I was a Medical Director, I really wanted to improve our patient satisfaction scores. The Vituity Director of Patient Experience would set up several phone calls with me, and we'd spend hours discussing our options and talking about what other departments had done that had helped them succeed.
Vituity also offers some excellent leadership training. When I was thinking about putting my hat in the ring for a Medical Director position, I attended the Medical Director Academy. And wouldn't you know it, a lot of the scenarios that we practiced in that training did in fact come true when I became a Medical Director! The lessons I learned in the academy and the people I met there helped me to handle some tough issues that came up in my department.
What needs to happen to bring more women into healthcare leadership?
Dr. Perlroth: I think there's tremendous value in creating forums for women to talk about their concerns and learn from each other. When you don't see other women in leadership roles that interest you, it's hard to imagine yourself there. People assume that leadership requires a certain level of sacrifice in other areas of your life, which may or may not be true. But if there's no one to ask and share your concerns with, how will you ever find out? That's why programs like VWIM [Vituity Women in Medicine] are so valuable. They allow women to make informed decisions about leadership and receive support in these roles.
Finally, as someone who's had amazing mentors over the years, I believe it's my responsibility to pay it forward. I want women to feel empowered to follow their own path and find ways to lead that ignite their passion and excitement. Others did it for me, so now it's the least I can do.
To learn more about practicing the joy of medicine at Vituity, please visit our Career Opportunities page.
Originally published Feb. 15, 2019.