Home to some of the country’s most prestigious hospitals and academic medical centers, the city of Boston is at the cutting edge of U.S. health care. Earlier this month, Doximity spoke to one of the local leaders using data-driven tools to increase treatment access for patients, Boston native Susan M. Szulewski, MD. Dr. Szulewski is a board-certified psychiatrist affiliated with the Mass General Brigham (MGB) health system. She is primarily based at McLean Hospital as the associate chief medical officer (CMO), and she also has a system-level role within the MGB network as the medical director of inpatient psychiatry. 

Dox: How have you utilized your background as a physician in your roles as associate CMO at McLean and medical director of inpatient psychiatry at MGB? 

SS: My training as a physician has been essential for many of my daily responsibilities, including general medical staff management, clinical care oversight, identifying meaningful goals for patient care, staying up to date with patient care quality initiatives, ensuring compliance with regulatory and health policy guidelines, recruiting and retaining staff, as well as department/program development.

Having a medical background well positions me to recognize the need for bridges between clinical and nonclinical operations, especially being cognizant of drivers to maintain and strengthen trust between practicing physicians and nonclinical leaders with an effort to harmonize the two groups. In the end, we all share the intended outcome of doing what is best for our patients. 

Dox: Why did you initially decide to transition from clinical care to taking on your current roles? Could you describe your experience of the process? 

SS: The transition happened rather organically for me. Immediately out of training, I stepped into a departmental leadership role with oversight of a large, high volume psychiatric ED in Rhode Island. ... After remaining in that role for seven years, I [landed] at McLean Hospital. 

... As I was exposed to more possibilities, I found myself drawn to learning more about health care policy, leadership, hospital operations, and finance. It was at that point I decided to pursue a health care-focused MBA, to further expand my skill set and foundational knowledge. I chose a program that was designed for practicing physicians, which unbeknownst to me at the time, came with the bonus of having a well-curated network of peers to tap for advice after graduation. Shortly after earning my MBA, I became the associate CMO at McLean Hospital. 

In the last two years, I have had the opportunity to take on even greater responsibilities at a system level with oversight of several cross-entity inpatient psychiatric initiatives, including implementation of coordinated centralized inpatient access across 12 hospitals within the MGB network.

Dox: How has COVID-19 affected your approach to leadership and to what a community needs from a leader?

SS: The pandemic forced me to learn how to manage new expectations for myself, staff, and patients with the frequent changing policies, new infection control measures, and unprecedented demand for service — all while being mindful to acknowledge the personal challenges we were facing. We had to work differently; [we were] working at a fast pace, developing rapport through virtual communication and/or while masked, and maintain[ing] social distancing with the inability to eat or drink in public while at work.

… The pandemic also placed a significant strain on the available medical resources that required affiliated and nonaffiliated facilities to work together to consolidate efforts. Inadvertently, this led to building relationships, aligning services and stakeholders, and engaging teams to have a shared vision to provide high quality psychiatric care amid a crisis. 

Lastly, COVID-19 brought to light the importance of being a present leader with effective communication skills. Early in the pandemic things seemed to change daily, or even by the hour — so it was especially important for teams to be kept aware, in real time, to effectively care for their patients and maintain safety. 

Dox: What are the main challenges to becoming an associate CMO/medical director or a similar role? And what do you view as the benefits of being an associate CMO/medical director or a similar role?

SS: As with every job, there are challenges. My job frequently requires a high attention to detail and meticulous time management skills. It often feels like there are not enough hours in a day to complete all the necessary tasks or connect with everyone you may have hoped to, especially when each day often tends to present a new challenge. I learned quickly to be nimble, pivoting to deal with urgent issues then jumping right back into daily operations. 

One of the largest benefits of having administrative oversight is that it allows me to continue to draw from my leadership skills as a physician while providing input at an organizational level. I continue to strive to make meaningful impacts that will improve patient and [clinician] satisfaction. … I am compelled to advocate for equitable care, overcome barriers to access, and navigate system issues while creatively working with colleagues to find solutions in real time.

Dox: What lessons have you learned through the process of becoming an associate CMO/medical director and what advice and strategies can you offer aspiring physicians? In other words, how can other physicians get there?

SS: One piece of advice I can offer to aspiring physicians entering administrative roles is to always consider multiple perspectives in your decision-making — health care is a collaborative field! It can be very difficult to please everyone all the time, but having a strong clinical foundation and awareness of hospital day-to-day functioning allows you to draw on those experiences and know who the key stakeholders are. 

For more pointed advice on next steps: Take advantage of as many growth opportunities as possible, such as mentorship, work projects, continuous process improvement trainings, further education, or training if appropriate. 

Dox: What drew you to Boston in the first place and what keeps you there? 

SS: I grew up in Boston and my family lives here — this certainly had a large influence over my decision to reside here.

With that said, Boston is home to over 20 hospitals and is an established center of academic medicine, making it a desirable choice for physicians. Most of the Boston hospitals are ranked top in the nation on quality, innovation, and education. 

Dox: What projects are you currently working on, whether in a clinical or research setting, in the greater Boston community, or on an executive/admin level?

SS: In response to the behavioral health ED boarding crisis that followed the COVID-19 pandemic, I have been working within the MGB network to develop a single point of centralized, coordinated behavioral health access for our patients. The goal is to get patients to the treatment they need sooner, moving them out of EDs and medical floors to inpatient psychiatric units using data driven, real-time digital tools. The right patient into the right bed at the right time. 

This has been a multi-institutional, multi-disciplinary effort — and early metrics have been able to demonstrate decreased length of stay of psychiatric patients in EDs and higher utilization of psychiatric inpatient beds within our network. 

Dox: On a lighter note, what's the best kept secret in your neighborhood?

SS: My neighborhood has an extensive outdoor trail system, including biking, walking, and hiking paths that are accessible throughout the four seasons. It is the perfect way to clear your head and decompress after a long day!

Interview conducted by Joy Westerman

Image by Susan M. Szulewski