From Policymaker to Advocate: A Conversation with Truman Medical Centers CEO Charlie Shields
Each quarter, we feature a Federal Action Network (FAN) member leading the charge on Capitol Hill to protect essential hospitals. This quarter, we spoke with Charlie Shields, CEO of Truman Medical Centers/University Health, in Kansas City, Mo. His eight years serving in the Missouri Senate, including two years as Senate president, and 12 years in the House of Representatives have given him valuable insights into communicating essential hospital needs to policymakers.
Tell us about your transition from state politics to essential hospital leadership.
Missouri is a citizen legislature. Like the vast majority of state legislators, most of us have jobs outside of the General Assembly. I was a Chief Marketing Officer for another health system in Missouri and then was offered the position [at] Truman. I came to Truman for many different reasons, but mostly because of the mission and the fact that we were an academic medical center. I loved the idea of being around learners in that kind of environment. That was 10 years ago. As someone who had spent most of my life in public service, coming to an [essential] hospital like Truman seemed like a perfect extension of that work.
How is essential hospital leadership an extension of public service?
It’s similar in that our constituency is our patient base. In our case, that includes a significant percentage of uninsured. I take meeting their needs just as seriously as I did meeting the needs of the people of my district and the state when I was in public office. Rounding on patients is like going door-to-door when running for office. You get to hear from your constituency in person what their issues, wants and needs are, and go back to work with others to determine a solution.
What do you wish more hospital executives knew about the political process and elected officials?
They need to understand that policymakers deal with multiple issues every single day. Sometimes, when people in the hospital world lobby and talk to policymakers, they think the only thing that legislator or that member of Congress has to deal with is health care. And that’s just not the case. They’re expecting people who, by the nature of their work, have to be somewhat generalist, to be an expert in the matter they’re bringing to them rather than taking time to help that legislator be more informed about their issue.
What is the biggest misconception folks have about elected officials?
I think the vast majority of elected folks are absolutely in it because they have a passion for public service. People sometimes get their view of the world based on the cable news network of their choice, and the reality of it is that’s just a small part of what members of Congress and members of state legislatures are doing. These people are passionate about service to their constituency, and, more times than not, these are really smart people who have a great curiosity about learning. Building alliances with legislators and teaching them about the issues you deal with in very real terms, that’s how you get them to care about your issues.
How do you (or should you) separate and balance your own personal political ideals with political policies that advance TMC/UH or are good for the hospital industry?
There are people on both sides of the political spectrum that can help advance the mission of essential hospitals. People need to understand that, and they need to set their partisanship aside. It is no secret the party I ran under for 20 years as a state legislator, but that certainly does not preclude my relationships with members of the other party. If you’re in [political] office, you learn that very quickly that you need people from both political parties to be successful, and that certainly carries over to my role as a CEO as I deal with policymakers.
The November election is just around the corner. Is it the role of hospital executives and health care providers to get involved in the political process? At what level … local, state, federal, or all of the above?
Yes, yes, and yes. The best time to get involved in the political process is in the campaign before the election. If you help in an election, whether it’s financially or, more importantly, if you actually go out and volunteer your time, that has an impact on those legislators.
I had a physician friend who I met early on in my political career. Gary Dyer was a dermatologist who enjoyed politics, and he would walk in parades with me, go door to door with me, do fundraisers for me. When I was in the legislature, if there was any issue that affected his specialty or physicians in general, that was the guy I called for advice because he was there right from the beginning.
After you’re elected, everybody wants to be your friend, but in the campaign, those people who were there for you early on are very meaningful, and that’s who you seek out for advice when you’re in office.
For those who have never been involved in politics, what are some first steps they should take beyond simply educating themselves?
The education part of it is key, which is part of what the FAN is all about. Particularly in election years, there [are] all kinds of people seeking help campaign-wise. Contributing financially to candidates and contributing to America’s Essential Hospitals’ Political Action Committee, which is significant, helps. Build those relationships over time with policymakers. Go to their forums, take their phone calls where they ask people about issues. You just have to take that first step and get involved. There’s no better time to do it than right now; this is as big of a campaign season as there is.
How can FAN members best advocate for their systems at the state and federal levels?
I think one thing is to pay attention, to read what comes out from America’s Essential Hospitals to understand what the issues are, and then work with legislative affairs staff to understand who’s in a position to make a difference. I think that’s one of the things people often do wrong. If you make an uninformed ask and you do it too often, that just falls on deaf ears. So, you have to be really informed about what’s going on and who has the ability to make the decisions you’re trying to impact.
Building those relationships before you need something is really important, so you don’t just call when the world is coming apart — you can call and advocate when you need help later. When members of Congress are back home in their district, that is the time to build relationships and communicate with them. It’s not on your trade association’s annual trip to the U.S. Capitol to spend the day meeting in their office. You build better relationships and get more information across when they’re back in their own district. They’re away from the Capitol, where their time pressures are so great.
Is there anything you’d like to add?
I’m president of our state hospital association, and we’re working to get more people from health care backgrounds to actually run for the state legislature. I was blessed in my career. I had a CEO who knew the importance of allowing me to serve in the state legislature and made accommodations at the hospital to allow me to do that. We’re pushing that with hospitals that have physicians or nurses or hospital folks that right now serve on school boards or as city aldermen. They would make great state legislators if they knew how to do it and they had a workplace that would give them the accommodations. I think it will take some time to get there, but I think we’ll be successful.
It’s not just that you’re electing people who are going to vote for health care. You’re electing people who understand health care and can make informed decisions when those items come before them in the state legislature. One step further, the state legislatures are the training ground for members of Congress. If you can elect a state rep or a state senator with a health care background, they potentially could become a member of Congress and help us even more at the federal level.
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