As a Leominster resident sat down at the Spanish American center recently on Spruce Street to get immunized against COVID-19 as a part of a UMass Memorial Health clinic, Eric Dickson introduced himself as a doctor, going through a set of questions before poking a syringe into the man’s left arm.
Not every health care system CEO may be out on the front lines administering vaccines. But for Dickson, giving people hope in the form of a shot is a bright spot more than a year into the pandemic.
“It’s the simplest medical procedure I could possibly do,” Dickson said. Though simple, Dickson sees the work as impactful. Helping at a vaccine clinic is something he does about once a week, part of his strategy to lead by example and bring health care directly into neighborhoods as a response to the pandemic.
In the last 12 months, UMass Memorial has had to put a laser focus on equity issues, working to bring health care out into underrepresented communities as the Black and Latino residents of Central Massachusetts have seen a disproportionate rate of COVID infections. The topic of equity is a consistent one for Dickson, popping up throughout a busy day last week from morning meetings, to time at the vaccine clinic, and during afternoon visits at a Community Health Link location in Leominster.
“We knew there were inequities and we had worked on them, but we never saw inequities like this,” Dickson told a MassLive reporter, who shadowed him for the day on April 21. “We had to respond in a different way and that different way had to be testing … and we had to get into the underserved neighborhoods for testing, and vaccination, the same thing.”
People in vulnerable populations don’t always have the access to health care that they need. And locally, residents of color were three times more likely to be diagnosed with the coronavirus, Dickson said.
“If you’re non-English speaking, to go to a foreign place and leave a center like this, a Spanish American Center, that’s really scary. We have to find a way to bring the care to the people instead of the people having to come to the care,” said Dickson, who got his start with UMass Memorial about 30 years ago as a respiratory therapist.
Irene Hernandez, the director of Active Life Health Care, an adult daycare center in Fitchburg, said having vaccines available in Leominster was instrumental for residents who have no way to drive to the large-scale vaccine sites at Gillette Stadium or in Boston. Access in a walkable neighborhood at a trusted center helps buttress vaccine propaganda made to stoke fear, she said.
“Historically, we’re not at the table,” Hernandez said. “I just thank UMass, Dr. Dickson, Rosa Fernandez, for making sure this happens here, at this location, at the Spanish American center, because it really takes care of the marginalized populations that aren’t able to access equity in health care.”
At the clinic, translators helped doctors prepare to administer shots, asking residents if they felt sick, if they had ever been on any medications for the coronavirus before and if they had ever had an adverse reaction to a vaccine before. The process went smoothly, with a quick shot in the arm and then a 15- or 30-minute wait in an adjacent room.
Before the Leominster vaccine clinic, Dickson had changed from a blue shirt and tie worn for the morning’s formal meetings into a more casual black pullover labeling the 54-year-old CEO as part of UMass Memorial’s vaccination team. The same garment was worn by other system employees working at the vaccine clinic, including Dickson’s wife, Cathy Jones, an emergency physician.
Lately, Dickson can often be heard speaking about the difference between being non-racist and being anti-racist. One of the health care systems equity goals this year was to eliminate the gap seen in pediatrician visits between white children and Black or Latino children. The topic got attention at one of Dickson’s morning meetings.
Officials said the system is seeing more Black and Latino children coming in for annual well-child visits. For Black children, the rate of patients who had their annual visit is now 64.9%, up from a baseline of 59% in October 2020. Among Hispanic children, the rate has increased from 64% to 69.2%. Since the system made changes earlier this year, including proactively calling families that had no-showed for a well-child visit before, the system had seen fewer cancellations.
UMass Memorial Chief Quality Officer Eric Alper said it was too soon to claim victory on the system’s goal, but noted the improvement.
“It’s that extra work that is moving this,” Dickson said, taking a brief moment to celebrate the progress. “We’ve got to eliminate the gap. That’s the ultimate goal.”
Among changes made during the last year was a rebrand for the health care system, which is the largest employer in Central Massachusetts and the third-largest health care system in the state.
UMass Memorial Health dropped the word “care” from the end of its name and unveiled a new slogan: “The Relentless Pursuit of Healing.”
“While the health care we provide is incredible, we actually provide so much more,” the organization said in a video announcing the new name. “By changing our brand name to UMass Memorial Health, we’re signaling to those we serve that we work just as hard to prevent illness, keep them healthy and improve all aspects of life.”
During COVID, UMass Memorial turned to its ‘army of problem solvers’
During a late morning virtual meeting with leaders from various UMass Memorial departments, Dickson heard that staffing levels remain an area of concern.
“I get an earful during these meetings but it’s a useful earful, as it allows me to understand the challenges you face every day and if I don’t understand those challenges it’s hard for me to help,” Dickson told colleagues.
Allison Wendt, who said she’s worked as a nurse manager in the emergency department and in other roles at UMass Memorial since 2005, told Dickson that beyond staffing, one of her challenges is the increase in pediatric psychiatric patients.
Dickson listened to similar stories from roughly a dozen employees. He thanked the group for working hard during the pandemic and encouraged them to get some rest so they could come back to the table with fresh ideas.
“Having an army of problem solvers saved us during COVID,” Dickson said, his voice easily booming through a face mask. “That’s why we got the field hospital twice and the governor went to us and he didn’t go to the other health care systems, because we could pull it off.”
As the pandemic slows down, the system is not shifting away from taking health care efforts outside the system’s hospitals. New projects for the health care system include “hospital at home,” which is slated to start in August. Dickson said that program will allow for two physician or nursing visits a day to patients at home, as well as other services like physical or occupational therapy, or respiratory therapy.
There’s a lot needed to get the program off the ground, including IT training as those involved will rely on a mobile app, Dickson said.
In general, Dickson said he wants the system doing more digital medicine, things like moving emergency room, rehab and skilled nursing services into the home setting.
Dickson said he feels his sweet spot as a leader is in long-term strategic planning and understanding how to navigate through the external environment while staying close to the front lines. While he focuses on external relationships and a patient focus with the system’s caregivers, the rest can fall to the presidents, the vice presidents and the people who run operations. Dickson said he’s tough on his executives because they make a lot of money and are expected to bring in results.
For Dickson, last Wednesday brought a packed schedule with little time to check emails or take a lunch break. For sustenance in between meetings, Dickson said his favorite healthy snack is almonds. At an afternoon stop at the Community Healthlink/Lipton Early Intervention program on Erdman Way in Leominster, Dickson and his staff left a bag of dark chocolate. He’s gotten into the practice of leaving employees with healthy snacks.
At Community Healthlink, Dickson sat with employees for a “huddle,” hearing stories about working through the pandemic and helping to problem solve. He learned that getting parent signatures has been a struggle and offered to help the office obtain DocuSign, a seemingly simple fix that drew smiles and sighs of relief from workers.
Leading through a pandemic and racial tensions
In the last year, the hardest part of leading the system through a pandemic was in seeing his own employees get sick, said Dickson.
“I have worked in medicine for a long time and people get sick, we do everything to prevent it. We do everything we can to take care of them. But when you’re having your own people go in and take a risk, that was the hardest thing,” Dickson said.
Now, fewer hospital employees are contracting COVID, though not everyone is fully vaccinated. Among the UMass Memorial ranks, about 80% of 14,000 employees have been inoculated as of last week. Every week, a few more get the shot, Dickson said.
“Everybody wants a shot or a medication that has no side effects or risks,” Dickson said. “There isn’t any.”
The flu shot has been a requirement for UMass Memorial employees. As of now, the COVID shot is not because it remains under emergency use authorization.
“As soon as it is fully FDA approved we’re going to mandate it,” Dickson said. “Because if people choose not to be protected themselves, that’s one thing, but if you’re working in a health care environment where you could carry an infection that could infect our patients or your coworker, that’s when we have to say you know what if you don’t want to be vaccinated — we do this with influenza — you just can’t work here.”
Preparing to take a stand on mandatory vaccinations, Dickson also felt the need to take a stand last week when jurors came to a verdict in the trial of former Minnesota police officer Derek Chauvin, who has been convicted of murdering George Floyd by pressing his knee into the man’s neck for more than 9 minutes last May. After the guilty verdict came out, Dickson issued a statement. Typically a hospital system would not comment on the outcome of a trial. But the last year, replete with conversations about racism and the treatment of Black people in America, changed that.
“We were prepared for a not guilty verdict and a guilty verdict. I had both statements written. And some people said, ‘jeez why do you feel like you have to comment on this’ and some people said ‘well, it wasn’t passionate enough in terms of anti-racism,” Dickson said.
Dickson said CEOs have a big megaphone, one that they have to use carefully. That’s among the reasons why he chose to participate in a COVID vaccine trial last year.
“People said ‘what are you, crazy getting that?’ It’s the same thing as being here, you go first,” Dickson said from the Leominster vaccine clinic. “If you’re in a leadership role and you want people to do something, you go first.”
For Dickson, running the hospital system ultimately comes down to one thing: the people.
“Develop your people. It’s all about the people,” he said. “I don’t know what’s going to happen next, but I know if I have great problem solvers, we’ll get through with flying colors.”